scholarly journals Stability and Change in Health Insurance Among Older Mexican Americans: Longitudinal Evidence From the Hispanic Established Populations for Epidemiologic Study of the Elderly

2002 ◽  
Vol 92 (8) ◽  
pp. 1264-1271 ◽  
Author(s):  
Ronald J. Angel ◽  
Jacqueline L. Angel ◽  
Kyriakos S. Markides
Keyword(s):  
Health Insurance ◽  
Mexican Americans ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Stability And Change

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.

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 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 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 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.

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