scholarly journals The Role of Physical Activity and Physical Function on the Risk of Falls in Older Mexican Americans

2016 ◽  
Vol 24 (3) ◽  
pp. 342-349 ◽  
Author(s):  
Zakkoyya H. Lewis ◽  
Kyriakos S. Markides ◽  
Kenneth J. Ottenbacher ◽  
Soham Al Snih
Keyword(s):  
Physical Activity ◽  
Physical Function ◽  
Mexican Americans ◽  
Mexican American ◽  
Epidemiologic Study ◽  
The Elderly ◽  
High Physical Activity ◽  
Risk Of Falls ◽  
Over Time

We investigated the relationship between physical activity and physical function on the risk of falls over time in a cohort of Mexican-American adults aged 75 and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE). Participants were divided into four groups according to their level of physical activity and physical function: low physical activity and low physical function (n = 453); low physical activity and high physical function (n = 54); high physical activity and low physical function (n = 307); and high physical activity and high physical function (n = 197). Using generalized linear equation estimation, we showed that participants with high physical activity and low physical function had a greater fall risk over time, followed by the high physical activity and high physical function group. Participants seldom took part in activities that improve physical function. To prevent falls, modifications to physical activity should be made for older Mexican Americans.

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 Documentation of Dementia as a Cause of Death Among Mexican-American Decedents Diagnosed with Dementia

2021 ◽  
pp. 1-10
Author(s):  
Brian Downer ◽  
Lin-Na Chou ◽  
Soham Al Snih ◽  
Cheyanne Barba ◽  
Yong-Fang Kuo ◽  
...  
Keyword(s):  
Older Adults ◽  
Cause Of Death ◽  
Mexican Americans ◽  
Mexican American ◽  
Hospice Care ◽  
Epidemiologic Study ◽  
The Elderly ◽  
High Risk Population ◽  
Physician Visits ◽  
Lower Odds

Background: Hispanic older adults are a high-risk population for Alzheimer’s disease and related dementias (ADRD) but are less likely than non-Hispanic White older adults to have ADRD documented as a cause of death on a death certificate. Objective: To investigate characteristics associated with ADRD as a cause of death among Mexican-American decedents diagnosed with ADRD. Methods: Data came from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, Medicare claims, and National Death Index. Results: The final sample included 853 decedents diagnosed with ADRD of which 242 had ADRD documented as a cause of death. More health comorbidities (OR = 0.40, 95% CI = 0.28–0.58), older age at death (OR = 1.18, 95% CI = 1.03–1.36), and longer ADRD duration (OR = 1.08, 95% CI = 1.03–1.14) were associated with ADRD as a cause of death. In the last year of life, any ER admission without a hospitalization (OR = 0.45, 95% CI = 0.22–0.92), more physician visits (OR = 0.96, 95% CI = 0.93–0.98), and seeing a medical specialist (OR = 0.46, 95% CI = 0.29–0.75) were associated with lower odds for ADRD as a cause of death. In the last 30 days of life, any hospitalization with an ICU stay (OR = 0.55, 95% CI = 0.36–0.82) and ER admission with a hospitalization (OR = 0.67, 95% CI = 0.48–0.94) were associated with lower odds for ADRD as a cause of death. Receiving hospice care in the last 30 days of life was associated with 1.98 (95% CI = 1.37–2.87) higher odds for ADRD as a cause of death. Conclusion: Under-documentation of ADRD as a cause of death may reflect an underestimation of resource needs for Mexican-Americans with ADRD.

scholarly journals Understanding Transitions in IADL and Their Consequences for Cognitive Impairment Among Older Mexican Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 333-334
Author(s):  
Jiwon Kim ◽  
Jacqueline Angel ◽  
Sunshine Rote
Keyword(s):  
Cognitive Impairment ◽  
Mexican Americans ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Cognitive Frailty ◽  
Transition Analysis ◽  
Socioeconomic Resources ◽  
Iadl Disability ◽  
Over Time

Abstract Mexican Americans tend to live longer lives than other ethnic groups, but it remains unclear how this trend influences the trajectory of disability and its consequences for cognitive frailty. Building on previous research, we assess transitions in IADL among the oldest old. We use data from three waves of the Hispanic Established Population of the Epidemiologic Study of the Elderly (H-EPESE) to investigate trajectories of IADL disability as individuals’ age into their 80s and 90s, a period of the life course with much higher rates of morbidity and decreasing socioeconomic resources. The H-EPESE is a benchmark longitudinal cohort study based on an original sample of 3,050 Mexican-Americans aged 65 and older in the Southwestern United States. Our modeling approach estimates transitions in patterns of IADL employing the Latent Transition Analysis (LTA). Results revealed three heterogeneous latent classes: high IADLs, difficulty in transportation and mobility, and low IADLs. Those with high IADLs tended to remain in the same class over time. Individuals having difficulty in transportation and mobility tended to stay in the same class or transfer to high IADLs, whereas those with overall low IADLs transferred to either the same class or to difficulty in transportation and mobility. Additional analysis revealed that cognitive impairment was a significant predictor of instrumental disability over time. Furthermore, females were more likely than males to belong to difficulty in transportation or mobility class than to the low IADL class. Our results highlight the long term consequences of cognitive decline on IADL limitations.

scholarly journals The Role of Education in the Relationship Between Age of Migration to the United States and Risk of Cognitive Impairment Among Older Mexican Americans

2017 ◽  
Vol 40 (5) ◽  
pp. 411-431 ◽  
Author(s):  
Brian Downer ◽  
Marc A. Garcia ◽  
Joseph Saenz ◽  
Kyriakos S. Markides ◽  
Rebeca Wong
Keyword(s):  
Cognitive Impairment ◽  
Mexican Americans ◽  
Epidemiologic Study ◽  
Decomposition Analysis ◽  
The Elderly ◽  
The United States ◽  
Foreign Born ◽  
And Gender ◽  
The Relationship

Prior research indicates age of migration is associated with cognitive health outcomes among older Mexican Americans; however, factors that explain this relationship are unclear. This study used eight waves from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine the role of education in the risk for cognitive impairment (CI) by nativity, age of migration, and gender. Foreign-born women had a higher risk for CI than U.S.-born women, regardless of age of migration. After adjusting for education, this risk remained significant only for late-life migrant women (risk ratio [RR] = 1.28). Foreign-born men who migrated at >50 had significantly higher risk for CI compared to U.S.-born men (RR = 1.33) but not significant after adjusting for education. Findings from a decomposition analysis showed education significantly mediated the association between age of migration and CI. This study highlights the importance of education in explaining the association between age of migration and CI.

scholarly journals The Impact of 10-Year Physical Activity Changes on 7-Year Mortality in Older Mexican Americans

2018 ◽  
Vol 15 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Zakkoyya H. Lewis ◽  
Kyriakos S. Markides ◽  
Kenneth J. Ottenbacher ◽  
Soham Al Snih
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Mexican Americans ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Lower Mortality ◽  
All Cause Mortality ◽  
The Impact ◽  
Lower Mortality Risk

Background: We investigated the association between 10 years of change in physical activity (PA) levels and 7-year all-cause mortality. Methods: Mexican American adults aged 67 and older (N = 803) participating in the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/1996–2012/2013) were included. All-cause mortality was our outcome. Participants were divided into 4 groups based on their difference in overall PA between 1995/1996 and 2005/2006 measured by the Physical Activity Scale for the Elderly. Participants were classified as having unchanged low PA (n = 339), decreased activity (n = 233), unchanged high activity (n = 166), and increased activity (n = 65). Change in the frequency of PA domains was also investigated. PA domains included leisure, household, sedentary, and walking activities. Results:After controlling for all covariates, results from the Cox proportional hazards regression found a 43% lower mortality risk in the increased PA group (hazards ratio = 0.57; 95% confidence interval, 0.34–0.97) compared with the unchanged low PA group. In the entire sample, a significantly lower mortality risk was also present among walking (hazards ratio = 0.88) and household (hazards ratio = 0.88) activities. Conclusion:Our results suggest that, independent of other factors, increasing PA is most protective of mortality among older Mexican Americans.

scholarly journals LIFE-SPACE MOBILITY AS A PREDICTOR OF MEDICARE UTILIZATION AMONG COMMUNITY-DWELLING OLDER MEXICAN AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S793-S793
Author(s):  
Jason P Johnson ◽  
Lin-Na Chou ◽  
Yong-Fang Kuo ◽  
Kenneth Ottenbacher ◽  
Soham Al Snih
Keyword(s):  
Mexican Americans ◽  
Mexican American ◽  
Negative Binomial ◽  
Epidemiologic Study ◽  
Negative Binomial Regression ◽  
The Elderly ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Life Space ◽  
Physician Visits

Abstract Hispanics are a large and growing group of older adults, with higher rates of morbidity and disability than other racial/ethnic groups. Mexican Americans make up more than half of this population and are well represented in the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE) survey, a longitudinal study of community-dwelling older Mexican Americans. The University of Alabama Birmingham Life-Space Assessment (LSA) is a measure assessing patterns of functional mobility in and around the home, neighborhood, and community. This study addresses the gap in research of life-space mobility and healthcare utilization with linked insurance claims data. Four hundred eight participants with 1-year continuous Medicare enrollment from wave 7 (2010) of the HEPESE were linked with Medicare claims. Logistic regression analysis was used to estimate the odds ratio of hospitalization and ER admissions. Negative binomial regression was used to estimate the rate ratio of physician visits. LSA score ranges 0 to 120, with higher scores indicating greater life-space mobility; LSA was analyzed as a 10-point decrease or dichotomously as restricted ≤59 or not restricted ≥60. A restricted LSA score among older Mexican American Medicare beneficiaries was associated with OR of 2.73 for hospitalizations (95% CI= 1.18-6.31). In addition, a 5-point decline in LSA score was associated with OR of 1.12 for hospitalizations (95% CI= 1.04-1.22). LSA score was not significantly associated with ER admission or physician visit. Interventions aimed to increase mobility in the home and the community may reduce the risk of hospitalizations in this population.

scholarly journals Frailty and Trajectories of Blood Pressure Among Older Mexican Americans Over Time

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 269-269
Author(s):  
Soham Al Snih ◽  
Martin Rodriguez ◽  
Lin-Na Chou ◽  
Kyriakos S Markides ◽  
Kenneth Ottenbacher
Keyword(s):  
Blood Pressure ◽  
Mexican Americans ◽  
Mexican American ◽  
High Body Mass Index ◽  
Female Gender ◽  
The Elderly ◽  
P Value ◽  
Frailty Status ◽  
Time Dependent Covariates ◽  
Over Time

Abstract The objective of this study was to examine whether blood pressure (BP) trajectories differ by frailty status among older Mexican Americans. Data are from an 18-year prospective cohort study of 1,781 non-institutionalized Mexican American aged ≥ 67 years from the Hispanic Established Population for the Epidemiological Study of the Elderly (1995/96-2012/13). Frailty was defined as meeting three or more of the following: unintentional weight loss of >10 pounds, weakness, self-reported exhaustion, low physical activity, and slow walking speed. General linear mixed models were used to estimate trajectories of systolic and diastolic BP over an 18-year period as a function of frailty status. All variables were analyzed as time-dependent covariates except for gender and education. At baseline, 46.3% participants were non-frail, 44.8% were pre-frail, and 9.0% were frail; and the mean of systolic and diastolic BP was 136.9 mmHg (SD=18.6) and 77.3 mmHg (SD=12.2), respectively. Frail participants had greater systolic and diastolic BP decline over time than non-frail (estimate=-3.94, SE=0.88, p-value=<0.0001 and estimate=-1.32, SE=0.54, p-value=0.0138, respectively); and pre-frail participants had greater systolic BP decline than non-frail (estimate=-1.51, SE=0.54, p-value=0.0049), after controlling for all covariates. Those with high body mass index and hypertension with and without treatment had increased levels of systolic and diastolic BP over time. Older age, female gender, arthritis, diabetes, and stroke had decreased levels of diastolic BP over time. This study showed progressive decline in systolic and diastolic BP in frail compared to non-frail older Mexican Americans, which might have implications when treating frail older adults with hypertension.

scholarly journals Nativity, Family, Disability: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly

2021 ◽  
Vol 31 (2) ◽  
pp. 253-262
Author(s):  
Elizabeth Vasquez ◽  
Weihui Zhang ◽  
Joanna Dreby ◽  
Sunghee Lee ◽  
Anda Botoseneanu
Keyword(s):  
Activities Of Daily Living ◽  
Family Support ◽  
Mexican Americans ◽  
Daily Living ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Foreign Born ◽  
Cohort Differences ◽  
And Migration ◽  
Over Time

Objectives: Nativity and family support may influence attitudes and behaviors that delay or accelerate the disability process in older adults. The objectives of this study were twofold: 1) to evaluate nativity and migration cohort differences in trajecto­ries of disability (assessed by activities of daily living [ADL]) among older Mexican Americans; and 2) to determine the role of objectively measured family support in the association between nativity, migration cohort, and disability changes over time.Methods: This is a longitudinal study with up to 18 years follow-up (1993-2011) using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (N=2,785, mean age =72.4 years). Disability was assessed using self-reported limitations in activities of daily living (ADL). Nativity and migration cohort were self-reported. Family support was as­sessed by marital status and the number of their children participants saw each month. Linear growth curve models evaluated the trajectory of ADL disability over 18 years and assessed variations by nativity status, migration cohort and family support.Results: Foreign-born respondents who migrated before age 20 had more starting ADL limitations (β= .36, P<.001) and ac­cumulated disability faster (β=.04, P<.01) compared with their US-born counterparts. In contrast, foreign-born respondents who migrated at later ages showed disability trajectories similar to US-born respondents. Married respondents had a lower level of disability (β= -.14, P<.01) and a lower rate of accumulation over time (β= -.02, P=.001) compared with participants who were not married.Discussion: Mexican Americans who migrate at younger ages may experience greater disability over time; however, family support may help mitigate the accumula­tion of disability among older Mexican Americans.Ethn Dis. 2021;31(2):253-262; doi:10.18865/ed.31.2.253

Differences in physical function and metabolic syndrome risk factors according to the level of physical activity in elderly Korean men: a pilot study

2020 ◽  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Metabolic Syndrome ◽  
Physical Function ◽  
Vigorous Physical Activity ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Berg Balance Scale ◽  
Lower Percentage ◽  
Mineral Density

Background and objective: Managing the decrease in physical function in the elderly is a major task in aging societies globally. Here, we aimed to compare the physical function and metabolic syndrome (MetS) risk factors according to levels of physical activity (PA). Material and methods: We measured PA in 77 elderly Korean men (74.21 ± 6.26 years old) with an accelerometer and recorded body composition, physical function, and MetS-related risk factors. Participants were divided into three groups based on daily moderate-vigorous physical activity (MVPA): low (under 60 min), middle (60-120 min), and high (over 120 min). The groups were compared using a one-way analysis of variance and the Scheffe post hoc test. Odds ratios (OR) were calculated by logistic regression analysis. Results: Significant differences were found between the groups for sedentary behavior time (P < 0.001), light PA (P < 0.05), moderate PA (P < 0.001), vigorous PA (P < 0.05), and total energy expenditure (P < 0.001). The high PA group showed a significantly lower percentage of body fat and fat mass and higher muscle mass than did the low and middle PA groups (P < 0.05). The 6-min walk test was significantly better in the high PA group than in the low and middle PA groups (P < 0.05). Grip strength and the Berg balance scale were also significantly better in the high PA group (P < 0.05). Bone mineral density (BMD) and high-density lipoprotein cholesterol (HDL-C) were significantly higher in the high PA group than in the low PA group (P < 0.05). Systolic blood pressure (SBP) was significantly higher in the middle PA group than in the low PA group (P < 0.05). Participants with more than three MetS criteria showed an OR of 0.09 (95% confidence interval 0.01-0.82) in the high PA group as compared with the low PA group (P < 0.05). Conclusions: Moderate-vigorous physical activity of more than 120 min daily showed better physical function and lower OR of MetS than did lower MVPA levels in elderly Korean men.

An ORBIT Phase 1: Design study of a citywide employer-based walking challenges in a predominantly Mexican American metropolitan area

2020 ◽  
pp. 135910532097765
Author(s):  
Jennifer J. Salinas ◽  
Roy Valenzuela ◽  
Jon Sheen ◽  
Malcolm Carlyle ◽  
Jennifer Gay ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mexican Americans ◽  
Mexican American ◽  
Phase 1 ◽  
El Paso ◽  
Intervention Development ◽  
Obesity Intervention ◽  
Physical Activity Recommendations ◽  
Orbit Model ◽  
Activity Recommendations

Most Mexican-Americans do not meet current physical activity recommendations. This paper uses the ORBIT model of obesity intervention development as a framework to outline the process of establishing three employer-based walking challenges in El Paso, Texas, a predominantly Mexican American community. The walking challenges were planned and implemented through the Border Coalition for Fitness and participating partnering organizations. Over 2000 participants and several employers took part in the walking challenges. Results from this ORBIT Phase 1 design intervention suggest that walking challenges are a feasible approach to increase physical activity in Mexican-Americans.

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