Age of Migration Life Expectancy with Functional Limitations and Morbidity among Mexican Americans

The U.S. Mexican American population enjoys longer life expectancies relative to other racial/ethnic groups but is disproportionately affected by chronic conditions and functional limitations. Studying the impact of heterogeneity in age, time and other characteristics of migration among older Mexican Americans can inform our understanding of health disparities and health care needs in later-life. This research employed 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess the proportion of life spent with functional limitations and one or more morbidity (by age of migration and gender) in the United States Mexican American population. Our results indicate early-life and late-life migrant women spend a larger number of years with performance-oriented mobility assessment (POMA) limitations than U.S.-born women. Conversely, mid-life migrant women were not statistically different from U.S.-born women in years spent disabled. Among men, mid-life migrants had longer life expectancies and spent more years disability-free than U.S.-born men. For morbidity, late-life migrant women spent a significantly smaller proportion of their elderly years with morbidity than U.S.-born women. However, late-life migrant men spent more years with morbidity than U.S.-born men. These findings illustrate that older Mexican Americans in the United States are heterogeneous in nativity and health outcomes. More years spent disabled/unhealthy may result in greater burden on family members and higher dependency on public resources. These findings have implications for the development of social and health policies to appropriately target the medical conditions and disabilities of older Mexican Americans entering late-life

Physical Performance Trajectories and Mortality Among Older Mexican Americans

Background: We sought to identify distinct trajectory classes of physical performance in Mexican Americans aged 75 years and older and to examine whether these trajectories predict mortality. Methods: We used four waves of Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) data for adults 75 years and older from 2004–2005 to 2013. Latent growth curve analysis was used to identify distinct trajectory classes. Multinomial logistic regression analysis was used to examine the association between baseline characteristics and the newly constructed trajectories. Cox proportional hazards regression models examined the hazard of mortality as a function of Short Physical Performance Battery (SPPB) trajectories. Results: The study follow-up period was approximately 9.5 years. One thousand four hundred and eleven adults were successfully classified into three (low-declining, high-declining, and high-stable) physical performance trajectory classes. Depressive symptoms (relative risk ratio = 1.94, 95% confidence interval [CI] = 1.17–3.22), diabetes (relative risk ratio = 2.44, 95% CI = 1.63–3.65), number of other comorbid health conditions (relative risk ratio = 1.40, 95% CI = 1.16–1.68), and obesity (relative risk ratio = 2.83, 95% CI = 1.67–4.80), increased the relative risk of classification into the low, relative to high-stable trajectory class. Male gender and foreign-born status significantly reduced risk of classification in the low-declining and high-declining trajectory classes. We observed a statistically significant association between low-declining (hazard ratio = 3.01, 95% CI = 2.34–3. 87) and high-declining (hazard ratio = 1.64, 95% CI = 1.32–2.03) trajectories and increased risk of mortality. Conclusions: Differences in mortality across physical performance trajectory classes suggest that these physical performance classes represent differences in underlying disease progression, and thus differences in mortality risk among older Mexican Americans, which warrants additional research to better understand differential physical performance trajectories and their effects on morbidity and mortality in heterogeneous aging populations

Age of Migration Life Expectancy with Functional Limitations and Morbidity among Mexican Americans

The U.S. Mexican American population enjoys longer life expectancies relative to other racial/ethnic groups but is disproportionately affected by chronic conditions and functional limitations. Studying the impact of heterogeneity in age, time and other characteristics of migration among older Mexican Americans can inform our understanding of health disparities and health care needs in later-life. This research employed 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess the proportion of life spent with functional limitations and one or more morbidity (by age of migration and gender) in the United States Mexican American population. Our results indicate early-life and late-life migrant women spend a larger number of years with performance-oriented mobility assessment (POMA) limitations than U.S.-born women. Conversely, mid-life migrant women were not statistically different from U.S.-born women in years spent disabled. Among men, mid-life migrants had longer life expectancies and spent more years disability-free than U.S.-born men. For morbidity, late-life migrant women spent a significantly smaller proportion of their elderly years with morbidity than U.S.-born women. However, late-life migrant men spent more years with morbidity than U.S.-born men. These findings illustrate that older Mexican Americans in the United States are heterogeneous in nativity and health outcomes. More years spent disabled/unhealthy may result in greater burden on family members and higher dependency on public resources. These findings have implications for the development of social and health policies to appropriately target the medical conditions and disabilities of older Mexican Americans entering late-life

Physical performance trajectories and mortality among older Mexican Americans

Background: We sought to identify distinct trajectory classes of physical performance in Mexican Americans aged 75 years and older and to examine whether these trajectories predict mortality. Methods: We used four waves of Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) data for adults 75 years and older from 2004–2005 to 2013. Latent growth curve analysis was used to identify distinct trajectory classes. Multinomial logistic regression analysis was used to examine the association between baseline characteristics and the newly constructed trajectories. Cox proportional hazards regression models examined the hazard of mortality as a function of Short Physical Performance Battery (SPPB) trajectories. Results: The study follow-up period was approximately 9.5 years. One thousand four hundred and eleven adults were successfully classified into three (low-declining, high-declining, and high-stable) physical performance trajectory classes. Depressive symptoms (relative risk ratio = 1.94, 95% confidence interval [CI] = 1.17–3.22), diabetes (relative risk ratio = 2.44, 95% CI = 1.63–3.65), number of other comorbid health conditions (relative risk ratio = 1.40, 95% CI = 1.16–1.68), and obesity (relative risk ratio = 2.83, 95% CI = 1.67–4.80), increased the relative risk of classification into the low, relative to high-stable trajectory class. Male gender and foreign-born status significantly reduced risk of classification in the low-declining and high-declining trajectory classes. We observed a statistically significant association between low-declining (hazard ratio = 3.01, 95% CI = 2.34–3. 87) and high-declining (hazard ratio = 1.64, 95% CI = 1.32–2.03) trajectories and increased risk of mortality. Conclusions: Differences in mortality across physical performance trajectory classes suggest that these physical performance classes represent differences in underlying disease progression, and thus differences in mortality risk among older Mexican Americans, which warrants additional research to better understand differential physical performance trajectories and their effects on morbidity and mortality in heterogeneous aging populations