scholarly journals A 20-YEAR COHORT STUDY OF LIVING ARRANGEMENTS AND COGNITIVE DECLINE IN THE MEXICAN AMERICAN POPULATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S712-S712
Author(s):  
Phillip A Cantu
Keyword(s):  
Social Support ◽  
Cognitive Decline ◽  
Living Arrangements ◽  
Mexican Americans ◽  
Independent Living ◽  
Mexican American ◽  
Living Arrangement ◽  
Growth Mixture Modeling ◽  
The Elderly ◽  
Community Based Interventions

Abstract Backgrounds/Objectives: The prevalence of dementia in the elderly Latino population is expected to significantly increase from around 200,000 cases in 2000 to as many as 1.3 million cases in 2050. This demographic trend has important consequences for options in care and living arrangements. Very little is known about how of cognitive impairment trajectories co-vary with support available to Mexican Americans. We examine the relationship between living arrangements and the social support of individuals with dementia. Methods: Using data from nine waves from the 23 years of the Hispanic EPESE (n=3,952), we examine trajectories of cognitive functioning and family and social support. We first describe the change in Mini Mental Status Examination (MMSE) scores for survivors from Wave 1 (1993/1994) to Wave 9 (2015/2016), n=255. Growth Mixture Modeling (GMM) is then used to assess how changes in MMSE scores are distributed among living arrangements for individuals living independently compared to household extension (living with others) using the full sample. Results: Analyses reveal different trajectories in MMSE score. 12% (n=27) of the sample had no decrease, while the remaining (88%) were split between moderate decline (60% n=136, 1-10 point decline in MMSE) and severe decline (28% n=62 >10 point decline In MMSE). Changes in living arrangement over the same period show that 89% of individuals who move from independent living into extended household experienced cognitive decline. Conclusions: This study provides new information on how cognitive trajectories are associated with living arrangements. We discuss implications for improving community-based interventions for Latino family caregivers.

Living Arrangement Preferences of Elderly People in Taiwan as Affected by Family Resources and Social Participation

2012 ◽  
Vol 37 (4) ◽  
pp. 381-394 ◽  
Author(s):  
Yen-Jong Chen ◽  
Ching-Yi Chen
Keyword(s):  
Elderly People ◽  
Social Participation ◽  
Living Arrangements ◽  
Independent Living ◽  
Choice Theory ◽  
Living Arrangement ◽  
Large Family ◽  
The Elderly ◽  
Elderly Persons ◽  
Family Resources

This article investigates living arrangement preferences of elderly people in Taiwan, including coresidence with family (their children or spouse), coresidence with spouse only, living alone, and living in an institution. The authors consider the effects of three factors: the elderly persons’ health situation, their family resources, and their social participation, such as community workshops or political activities. Accordingly, the authors propose empirical logit models based on the well-developed discrete choice theory. Empirical results reveal that (1) elderly people with higher socioeconomic status, prefer either independent living arrangements or coresidence with their children, (2) elderly people with more family resources, such as large family size, prefer to coreside with their children, and (3) elderly people with adequate social support and/or contact networks prefer independent living arrangements.

scholarly journals Demography of Living Arrangements Among Oldest-Old Mexican Americans: Evidence From the Hispanic Epidemiologic Study of the Elderly

2017 ◽  
Vol 29 (6) ◽  
pp. 1015-1038 ◽  
Author(s):  
Phillip A. Cantu ◽  
Jacqueline L. Angel
Keyword(s):  
Living Arrangements ◽  
Mexican Americans ◽  
Filial Piety ◽  
Living Arrangement ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Future Research ◽  
Elderly Parents ◽  
Household Headship

Objective: In this article, we examine the demographics of living arrangements and household headship status among Mexican-origin individuals aged 85+ years. Method: Data come from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) caregiver and respondent surveys. Results: Finances of the elderly individual and their caregiver inform living arrangement decisions. Physical and cognitive disability differentiate among living arrangements: The most mentally and physically impaired are most likely to live with others and less likely to be the head of the household. Discussion: Motivations for living with others are clearly more complex than simple filial piety considerations might hold. Extended living arrangements provide concrete financial and instrumental benefits for both elderly parents and their adult child caregiver. Future research should address the question of the capacity of the Mexican American family to provide care for elderly parents in the face of major demographic and social changes.

scholarly journals Transitions in Living Arrangements Among Older Mexican Americans

2016 ◽  
Vol 39 (3) ◽  
pp. 396-417 ◽  
Author(s):  
Kate C. Prickett ◽  
Jacqueline L. Angel
Keyword(s):  
Life Course ◽  
Cognitive Abilities ◽  
Living Arrangements ◽  
Mexican Americans ◽  
Independent Living ◽  
Service Providers ◽  
Living Arrangement ◽  
Epidemiologic Study ◽  
Late Life ◽  
The United States

This study examines the transition from independent living to a coresidential living arrangement across the late life course among older unmarried (i.e., widowed, divorced/separated, and single) Mexican Americans. Using 18 years’ worth of panel data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, event history analyses revealed that age at migration, physical disability, and cognitive impairment were strong predictors of the transition to a coresidential living arrangement. Importantly, a decline in physical and cognitive abilities heightened the risk of transition to a coresidential living arrangement, net of time-variant measures of disability and impairment. These findings provide evidence for incorporating a dynamic approach to examining living arrangements across the late life course for Mexican-origin Hispanics living in the United States, with implications for policy and service providers.

Village senior centres and the living arrangements of older people in rural China: considerations of health, land, migration and intergenerational support

2016 ◽  
Vol 37 (10) ◽  
pp. 2044-2073 ◽  
Author(s):  
HUIJUN LIU ◽  
KAREN N. EGGLESTON ◽  
YAN MIN
Keyword(s):  
Older People ◽  
Rural Areas ◽  
Living Arrangements ◽  
Urban Areas ◽  
Independent Living ◽  
Rural China ◽  
Living Arrangement ◽  
Population Ageing ◽  
Intergenerational Support ◽  
North East

ABSTRACTChina is experiencing rapid urbanisation and population ageing, alongside sometimes contentious rural land consolidation. These on-going social, economic, political and demographic changes are especially problematic for older people in rural areas. In these regions, social and institutional support arrangements are less developed than in urban areas; older people have few options for re-settlement but are resistant to or incapable of adjusting to high-rise apartment living. In 2012–13, we gathered rich qualitative and quantitative data on over 600 older residents in 12 villages under the jurisdiction of City L in north-east coastal China to analyse residents’ living arrangement choices during the village renovation process. We compared villages with and without senior centres to shed light on the correlates of co-residence and independent living. Senior centres play a role in balancing the burden on rural Chinese families resulting from population ageing, smaller families, widespread migration for work, and the rapid urbanisation that is restructuring land rights and social support arrangements.

scholarly journals Dual Trajectories of Dementia and Social Support in the Mexican-Origin Population

2020 ◽  
Author(s):  
Sunshine M Rote ◽  
Jacqueline L Angel ◽  
Jiwon Kim ◽  
Kyriakos S Markides
Keyword(s):  
Social Support ◽  
Mexican American ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Living Alone ◽  
Instrumental Support ◽  
Latent Classes ◽  
Mexican American Families ◽  
High Support

Abstract Background and Objectives In the next few decades, the number of Mexican American older adults with Alzheimer’s disease and related disorders will increase dramatically. Given that this population underutilizes formal care services, the degree of care responsibilities in Mexican American families is likely to increase at the same time. However, little is known about the changing need for assistance with instrumental day-to-day activities and emotional support by long-term patterns of cognitive impairment. Research Design and Methods We use 7 waves of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (1992/1993–2010/2011) and trajectory modeling to describe long-term patterns of perceived emotional and instrumental support, and dementia. Results Results revealed 2 latent classes of both emotional and instrumental support trajectories: low and high support. Specifically, those living alone were more likely to belong to the group with low support than to that with high support. Three latent classes for likely dementia were also revealed: likely dementia, increasing impairment, and no impairment. Those living alone were more likely to belong to the increasing impairment and likely dementia groups. The dual trajectory of emotional and instrumental support with likely dementia revealed that the probability of belonging to the low-support group was highest for those with increasing impairment. Discussion and Implications These findings highlight the risk and vulnerability of those who live alone concerning perceived social support and dementia. Implications of the findings for the potential dependency burden on Latino caregivers are discussed.

Patterns of living arrangements of the elderly in mainland China

2017 ◽  
Vol 6 (2) ◽  
pp. 179-191 ◽  
Author(s):  
Jiehua Lu ◽  
Yun Zhang
Keyword(s):  
Elderly People ◽  
Living Arrangements ◽  
Census Data ◽  
Living Arrangement ◽  
Mainland China ◽  
The Elderly ◽  
Living Alone ◽  
Population Census ◽  
Content Type ◽  
Healthy Longevity

Purpose The purpose of this paper is to examine the changes and consequences of the patterns of Chinese elderly population’s living arrangements. It contains information that can be considered for future policy making for the elderly and to gain a better understanding of the social transition in China. Design/methodology/approach Based on the analysis of the population census data in 2000 and 2010, the authors examined the changes and trends of the living arrangements of the elderly Chinese population. Furthermore, the authors analyzed factors influencing the Chinese elderly’s living arrangements according to the data acquired from the Chinese Longitudinal Healthy Longevity Survey. Findings First, the proportion of the elderly people living with children has been decreasing. Second, the proportions of elderly people “living alone” and “living with spouse independently” has largely increased. Third, the changes and trends showed differences between urban and rural regions. Originality/value By looking at the characteristics among elderly people with different living arrangement patterns, those that are “living alone” are typically in disadvantaged conditions, and thus special attention should be paid with regards to related research and policies for the elderly who are “living alone.”

Mortality risk by living arrangements for the elderly Belgian population

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Michel Poulain ◽  
Luc Dal ◽  
Anne Herm
Keyword(s):  
Gender Gap ◽  
Mortality Risk ◽  
Living Arrangements ◽  
Living Arrangement ◽  
The Elderly ◽  
Personnes Âgées ◽  
Living Alone ◽  
Age Difference ◽  
Belgian Population ◽  
And Gender

RésuméObjectifs : Le risque de décéder aux âges élevés est associé avec l’état matrimonial, mais également avec la situation de ménage de la personne considérée (avec qui une personne vit). Cette étude analyse comment l’association entre situation de ménage et risque de décéder varie en fonction de l’âge et du sexe. Données et méthodes : Nous utilisons des données extraites du Registre national belge concernant la situation de ménage de plus de 3 millions de personnes âgées de 60 ans et plus, ob-servées du 1er janvier 1991 au 31 décembre 2010. Tout d’abord nous calculons et comparons les probabilités annuelles de décéder pour les personnes selon les différentes situations de ménage. Ensuite nous construisons des tables de mortalité mul-ti-états en utilisant les probabilités annuelles de transition entre différentes situations de ménage et ce, afin de reconstituer les trajectoires de situation de ménage. Résultats : Nos résultats confirment l’effet protectif associé au fait de vivre en couple marié, mais ils montrent également que vivre seul aux âges plus élevés devient favo-rable à la survie. Un croisement apparaît entre les risques de décéder de ceux vivant seuls et ceux vivant avec d’autres personnes, mais pas avec leur conjoint. Toutefois de fortes différences ressortent selon le sexe. Enfin vivre en ménage collectif est largement défavorable pour la survie par comparaison à tous les types de ménages privés et ce, pour les deux sexes. Discussion : La façon dont le risque de décéder varie selon la situation de ménage est différente selon le sexe et diminue avec l’âge de fa-çon relative. Parmi d’autres explications, le rôle sélectif de l’état de santé est majeur, tout comme le soutien du conjoint qui est, dans la plupart des cas, le premier donneur de soin. Selon cette perspective, la différence d’espérance de vie en santé entre hommes et femmes et la différence d’âges entre conjoints pourraient contribuer à expliquer les différences du risque de décéder selon la situation de ménage entre les hommes et les femmes. Nos résultats sont importants dans le cadre des politiques sociales relatives aux personnes âgées et plus particulièrement pour l’évaluation des besoins futurs de nos populations vieillissantes.AbstractObjectives: Mortality risk in old age is associated with both marital status and living arrangements (with whom a person is living). This study analyses how the association between living arrangements and mortality risk varies by age and gender. Data and methods: We use a dataset extracted from the Belgian national register for the population aged 60 years and over, from 1 January 1991 to 31 December 2010, that includes more than three million persons and describes their living arrangements. First we compute and compare single-year probabilities of death for each living arrangement. Then, in order to recompose the living arrangement trajectories, we construct multistate life tables using annual probabilities of the transitions between successive living arrangements. Results: Our results confirm the protective effect of living with a spouse, and also show that at older ages living alone becomes advantageous. A crossover occurs in the mortality risks of those living alone and those living with others (not with a spouse), but large differences appear between the genders. Institutional living arrangements are largely detrimental for survival compared with private living arrangements for both genders. Discussion: The variation of mortality risk by living arrangements is gender-specific and decreases by age in relative terms. Among possible explanations, the selective role of health is paramount, as well as the presence of a spouse, who is the primary caregiver in most cases. According to this perspective, the gender gap in healthy life expectancy and the age difference between spouses contribute to explaining the gender differences. Our findings are highly relevant to social policies and the social discourse pertaining to the future needs of the elderly within the context of population ageing.

scholarly journals Documentation of Dementia as a Cause of Death Among Mexican-American Decedents With Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 59-60
Author(s):  
Brian Downer ◽  
Lin-Na Chou ◽  
Soham Al Snih ◽  
Cheyanne Barba ◽  
Yong-Fang Kuo ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Mexican Americans ◽  
Mexican American ◽  
Hospice Care ◽  
Healthcare Resource ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Medical Specialist ◽  
Physician Visits ◽  
Lower Odds

Abstract There is lack of data on the frequency and correlates of dementia being documented as a cause of death in Hispanic populations. We investigated characteristics associated with dementia as a cause of death among Mexican-American decedents diagnosed with dementia. Data came from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, Medicare claims files, and the National Death Index. Of the 744 decedents diagnosed with dementia before death, 26.9% had dementia documented as a cause of death. More health comorbidities (OR=0.38, 95% CI=0.25-0.57), older age at death (OR=1.05, 95% CI=1.01-1.08), and longer dementia duration (OR=1.09, 95% CI=1.03-1.16) were associated with dementia as a cause of death. In the last year of life, any ER admission with (OR=0.56, 95% CI=0.32-0.98) or without (OR=0.31, 95% CI=0.14-0.70) a hospitalization, more physician visits (OR=0.95, 95% CI=0.92-0.98) and seeing a medical specialist (OR=0.41, 95% CI=0.24-0.70) were associated with lower odds for dementia as a cause of death. In the last 30-days of life, any hospitalization with an ICU stay (OR=0.57, 95% CI=0.37-0.88) and ER admission with (OR=0.58, 95% CI=0.40-0.84) or without (OR=0.48, 95% CI=0.25-0.94) a hospitalization were associated with lower odds for dementia as a cause of death. Receiving hospice care in the last 30-days of life was associated with 2.09 (95% CI=1.38-3.16) higher odds for dementia as a cause of death. The possible under-documentation of dementia as a cause of death on death certificates may result in underestimation of healthcare resource need of dementia care for Mexican-Americans.

scholarly journals ROLE OF SOCIAL DETERMINANTS IN ENROLLMENT AND DISENROLLMENT IN MEDICARE INSURANCE PLANS IN OLDER MEXICAN AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S563-S563
Author(s):  
Amit Kumar ◽  
Maricruz Rivera-Hernandez ◽  
Lin-Na Chou ◽  
Amol Karmarkar ◽  
Yong-Fang Kuo ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Mexican Americans ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Fee For Service ◽  
Clinical Factor ◽  
Medical Risk ◽  
Medicare Data ◽  
Dual Eligible

Abstract Objective: The objective of this study is to examine the association between social-medical risk factor with disenrollment from Medicare Fee-for-Service (FFS) and enrollment in a Medicare Advantage (MA) plan in Older Mexican Americans. Methods: The sample included older adults participating in the Hispanic Established Populations for the Epidemiologic Study of the Elderly linked with Medicare data. We used logistic regression to estimate odds ratios (OR) for the association of each sociodemographic and clinical factor with insurance plan switching. Results: FFS enrollees were more likely to speak Spanish, less educated, lower income, disability, and be dual eligible compared to MA enrollees. At 2-year follow up, older adults with social support had higher odds of switching from FFS to MA after controlling for all covariates (OR; 1.73, 95% CI: 1.11-2.69). Conclusion: Having social support from family and the community was strongly associated with disenrollment from FFS and transition to an MA plan.

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