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 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 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 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 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 Diet quality and its relationship with central obesity among Mexican Americans: findings from National Health and Nutrition Examination Survey (NHANES) 1999–2012

2016 ◽  
Vol 20 (7) ◽  
pp. 1193-1202 ◽  
Author(s):  
Yilin Yoshida ◽  
Richard Scribner ◽  
Liwei Chen ◽  
Stephanie Broyles ◽  
Stephen Phillippi ◽  
...  
Keyword(s):  
National Health ◽  
Diet Quality ◽  
Mexican Americans ◽  
Mexican American ◽  
Central Obesity ◽  
Healthy Eating Index ◽  
Nutrition Examination Survey ◽  
Total Proteins ◽  
Lower Odds ◽  
Health And Nutrition

AbstractObjectiveUsing the Healthy Eating Index-2010 (HEI-2010), the present study aimed to examine diet quality and the impact of overall diet quality and its components on central obesity among Mexican-American men and women.DesignCross-sectional data from NHANES 1999–2012 were used. The HEI-2010 data, including twelve components for a total score of 100, were collected with a 24 h recall interview. Central obesity was defined as a waist circumference of ≥88 cm for women and ≥102 cm for men. Weighted logistic regressions were performed to assess associations between HEI-2010 scores and central obesity.SettingNational Health and Nutrition Examination Survey (NHANES) 1999–2012.SubjectsA total of 6847 Mexican Americans aged ≥20 years with reliable dietary recall status and non-pregnancy status.ResultsHigher HEI-2010 total score was associated with lower odds of central obesity in Mexican-American men (OR; 95 % CI=0·98; 0·98, 1·00). Among all Mexican Americans, one-unit higher score of total fruit and sodium (i.e. lower level of intake) was associated with 4 % (0·96; 0·93, 0·99) and 2 % (0·98; 0·96, 0·99) lower odds of central obesity, respectively. However, a higher total proteins score was associated with higher odds of central obesity (1·08; 1·00, 1·16). In gender-specific analyses, a higher whole fruit or sodium score was inversely associated with central obesity in men but not in women.ConclusionsHEI-2010 scores of total fruit and sodium were inversely associated with central obesity among all Mexican Americans. However, total proteins score and central obesity was positively associated. In Mexican-American men, HEI-2010 total and whole fruit scores were inversely associated with central obesity.

scholarly journals Mobility but Not Balance Limitations Are Associated With Cognitive Decline among Older Hispanics

2020 ◽  
Vol 6 ◽  
pp. 233372142094795
Author(s):  
Paul A. Wadsworth ◽  
Nai-Wei Chen ◽  
Mukaila Raji ◽  
Kyriakos S. Markides ◽  
Brian Downer
Keyword(s):  
Cognitive Decline ◽  
Gait Speed ◽  
Mexican Americans ◽  
Successful Aging ◽  
Epidemiologic Study ◽  
Summary Score ◽  
High Risk Population ◽  
Lower Body ◽  
Cognitive Changes ◽  
Body Function

Aging is associated with changes in lower-body functioning. The extent to which lower-body function is associated with cognitive changes over time is unclear, especially among older Hispanics, a high-risk population for declines in physical and cognitive functioning. We sought to determine if the association between lower-body functioning and cognitive decline over 9-years differentially varied with respect to balance, gait speed, lower-body strength (chair stands), or a summary score of the three measures. This retrospective cohort study used clinical performance data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE). Cognitive function was measured using the Mini-Mental Status Exam. Linear mixed modeling was used to investigate the association between lower-body function and cognitive decline, controlling for patients’ demographic and health characteristics. We found that gait speed and timed chair stands but not balance were associated with accelerated cognitive decline in Mexican-Americans age 75 years and older. These parameters of lower-body function can be feasibly measured in any clinic. As limitations in lower-body functioning may be an early marker of cognitive decline, this suggests an opportunity for the development of interventions to slow cognitive and physical disablement and promote successful aging among persons older than 75 years.

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.

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