Lower Risk of 10-Year Incident Cognitive Impairment for Mexican Americans Aged 75 and Older in 2004-05 Compared to 1993-94

There is growing evidence for a decline in the prevalence and incidence of Alzheimer’s disease and related dementias. These findings have been attributed to greater educational attainment, reduced incidenced of stroke, and better management of chronic health conditions. However, limited research has examined if the declining trend in dementia risk are also occurring in minority populations, especially Mexican Americans. Methods: Data: This analysis used data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) to examine differences in the 10-year risk of cognitive impairment for Mexican Americans aged 75 and older in 2004-05 compared to Mexican Americans aged 75 and older in 1993-9

Cohort Differences in Cognitive Impairment and Cognitive Decline Among Mexican-Americans Aged 75 Years or Older

Research suggests that the prevalence and incidence of cognitive impairment among older adults is decreasing. This analysis used data from 9 waves (1993–2016) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess cognitive status and cognitive decline for 2 cohorts of Mexican-Americans aged ≥75 years in 1993–1994 versus 2004–2005. Logistic regression, joint longitudinal survival models, and illness-death models for interval-censored data were used to examine cohort differences in the odds of prevalent cognitive impairment, trajectories of cognitive decline, and the risk of 10-year incident cognitive impairment, respectively. Results indicated that compared with the 1993–1994 cohort, the 2004–2005 cohort had higher odds for prevalent cognitive impairment (odds ratio = 2.51, 95% confidence interval (CI): 1.92, 3.29), particularly among participants with \u3c4 years of education (odds ratio = 2.99, 95% CI: 2.14, 4.18). Conversely, the 2004–2005 cohort exhibited significantly slower rates of cognitive decline (βˆ = 0.50, 95% CI: 0.39, 0.62) and had a significantly lower risk of incident cognitive impairment (hazard ratio = 0.75, 95% CI: 0.62, 0.91) compared with the 1993–1994 cohort. This analysis provides mixed results for cohort trends in the cognitive health of older Mexican-Americans. Continued research is needed to identify risk factors that contribute to these population-level trends

Acculturation and Disparities in Telemedicine Readiness: A National Study.

Telemedicine provided older adults the ability to safely seek care during the coronavirus disease (COVID-19) pandemic. This study aimed to evaluate the potential impact of acculturation factors in telemedicine uptake between ethnic groups. As part of the National Health and Aging Trends Study 2018 survey, 303 participants (≥65 years) were interviewed. We assessed the impact of acculturation on telemedicine readiness by race and ethnicity. Compared to the white non-Hispanic immigrant population, Hispanic and Asian/Pacific Islander (API) populations had significantly lower telemedicine readiness and uptake. Limited English proficiency or older age at the time of migration was associated with telemedicine unreadiness and uptake in the Hispanic and API populations. Our findings suggested that acculturation factors play a substantial role in telemedicine uptake among older adult immigrants in the United States. Therefore, acculturation factors should be considered when promoting and adopting telemedicine technologies in older adults

Cohort Differences in Cognitive Impairment and Cognitive Decline Among Mexican-Americans Aged 75 Years or Older

Research suggests that the prevalence and incidence of cognitive impairment among older adults is decreasing. This analysis used data from 9 waves (1993–2016) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess cognitive status and cognitive decline for 2 cohorts of Mexican-Americans aged ≥75 years in 1993–1994 versus 2004–2005. Logistic regression, joint longitudinal survival models, and illness-death models for interval-censored data were used to examine cohort differences in the odds of prevalent cognitive impairment, trajectories of cognitive decline, and the risk of 10-year incident cognitive impairment, respectively. Results indicated that compared with the 1993–1994 cohort, the 2004–2005 cohort had higher odds for prevalent cognitive impairment (odds ratio = 2.51, 95% confidence interval (CI): 1.92, 3.29), particularly among participants with \u3c4 years of education (odds ratio = 2.99, 95% CI: 2.14, 4.18). Conversely, the 2004–2005 cohort exhibited significantly slower rates of cognitive decline (βˆ = 0.50, 95% CI: 0.39, 0.62) and had a significantly lower risk of incident cognitive impairment (hazard ratio = 0.75, 95% CI: 0.62, 0.91) compared with the 1993–1994 cohort. This analysis provides mixed results for cohort trends in the cognitive health of older Mexican-Americans. Continued research is needed to identify risk factors that contribute to these population-level trends

Erratum: A Comprehensive Analysis of Morbidity Life Expectancies Among Older Hispanic Subgroups in the United States: Variation by Nativity and Country of Origin (Table 3 & Figure 2)

Background and Objectives: Although a clear advantage in mortality has been documented among older Hispanic subgroups, particularly the foreign-born, research examining health selectivity in morbidity life expectancies among older Hispanics are scarce. Differences in sociocultural characteristics among Hispanic subgroups may influence racial/ethnic and nativity disparities in morbidity. Research examining the heterogeneity among older Hispanic subgroups may further our understanding of why some Hispanics are able to preserve good health in old age, while others experience a health disadvantage. Thus, the primary goal of this analysis is to examine racial/ethnic, nativity, and country of origin differences in morbidity life expectancies among older adults in the United States. Research Design and Methods: We used individual-level data (1999–2015) from the National Health Interview Survey to estimate Sullivan-based life tables of life expectancies with morbidity and without morbidity by gender for U.S.-born Mexicans, foreign-born Mexicans, U.S.-born Puerto Ricans, island-born Puerto Ricans, foreign-born Cubans, and whites in mid-life (age 50), and late-life (age 65). Results: Hispanics are heterogeneous in morbidity life expectancies. Among females, U.S.-born Mexicans, foreign-born Mexicans, and island-born Puerto Ricans spent more late-life years with morbidity than whites. For men, U.S.-born Puerto Ricans were the only Hispanic subgroup disadvantaged in the number of years lived with morbidity. Conversely, foreignborn Cubans exhibited the healthiest outcomes of all groups, regardless of gender. Discussion and Implications: Reducing the risk for late-life morbidity must be informed by a comprehensive understanding of a wide range of factors that shape health among older adults. Research should avoid pan-ethnic groupings that overlook important differences in chronic disease risk profiles among Hispanic subgroups. Recognizing the various sociocultural and environmental processes that underlie Hispanic subpopulations is important for development and implementation of social and public health policies aimed at ameliorating negative health outcomes of late-life morbidity among minority and immigrant groups

Life Expectancies With Depression by Age of Migration and Gender Among Older Mexican Americans

Background and Objectives: Prior studies examining depression among older Mexican Americans suggest both women and immigrants are at higher risk of depressive symptomatology than males and U.S.-born Mexican Americans. We use data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine whether life expectancy with depression and without depression varies by nativity, age of migration, and gender. Research Design and Methods: Sullivan-based life tables were used to estimate depression life expectancies among Mexican Americans aged 65 years and older residing in the Southwestern United States. Depression is based on the 20-item Center for Epidemiological Studies Depression scale (CES-D). The CES-D is a continuous scale (0–60) with higher values indicating worse mental health. We dichotomize depression as a score of 16 or greater. Results: Immigrant women, particularly those who migrated in late-life (after age 50) are at a significant disadvantage in the number of years after age 65 lived with depression and the ratio of years spent without depression relative to U.S.-born women. Among men, only late-life immigrants were disadvantaged in the number of years spent with depression. Early- and mid-life immigrant males did not differ from U.S.-born males. Discussion and Implications: Our results highlight the heterogeneity among older Mexican Americans in life expectancies with depression. These findings illustrate the importance of considering age of migration as a high-risk factor for depression among Mexican-origin immigrants. Including this risk factor as a part of depression screening is a key step for timely interventions in preventing disability and comorbidities associated with untreated depression

A Comprehensive Analysis of Morbidity Life Expectancies Among Older Hispanic Subgroups in the United States: Variation by Nativity and Country of Origin

Background and Objectives: Although a clear advantage in mortality has been documented among older Hispanic subgroups, particularly the foreign-born, research examining health selectivity in morbidity life expectancies among older Hispanics are scarce. Differences in sociocultural characteristics among Hispanic subgroups may influence racial/ethnic and nativity disparities in morbidity. Research examining the heterogeneity among older Hispanic subgroups may further our understanding of why some Hispanics are able to preserve good health in old age, while others experience a health disadvantage. Thus, the primary goal of this analysis is to examine racial/ethnic, nativity, and country of origin differences in morbidity life expectancies among older adults in the United States. Research Design and Methods: We used individual-level data (1999–2015) from the National Health Interview Survey to estimate Sullivan-based life tables of life expectancies with morbidity and without morbidity by gender for U.S.-born Mexicans, foreign-born Mexicans, U.S.-born Puerto Ricans, island-born Puerto Ricans, foreign-born Cubans, and whites in mid-life (age 50), and late-life (age 65). Results: Hispanics are heterogeneous in morbidity life expectancies. Among females, U.S.-born Mexicans, foreign-born Mexicans, and island-born Puerto Ricans spent more late-life years with morbidity than whites. For men, U.S.-born Puerto Ricans were the only Hispanic subgroup disadvantaged in the number of years lived with morbidity. Conversely, foreignborn Cubans exhibited the healthiest outcomes of all groups, regardless of gender. Discussion and Implications: Reducing the risk for late-life morbidity must be informed by a comprehensive understanding of a wide range of factors that shape health among older adults. Research should avoid pan-ethnic groupings that overlook important differences in chronic disease risk profiles among Hispanic subgroups. Recognizing the various sociocultural and environmental processes that underlie Hispanic subpopulations is important for development and implementation of social and public health policies aimed at ameliorating negative health outcomes of late-life morbidity among minority and immigrant groups

Life Expectancies With Depression by Age of Migration and Gender Among Older Mexican Americans

Background and Objectives: Prior studies examining depression among older Mexican Americans suggest both women and immigrants are at higher risk of depressive symptomatology than males and U.S.-born Mexican Americans. We use data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine whether life expectancy with depression and without depression varies by nativity, age of migration, and gender. Research Design and Methods: Sullivan-based life tables were used to estimate depression life expectancies among Mexican Americans aged 65 years and older residing in the Southwestern United States. Depression is based on the 20-item Center for Epidemiological Studies Depression scale (CES-D). The CES-D is a continuous scale (0–60) with higher values indicating worse mental health. We dichotomize depression as a score of 16 or greater. Results: Immigrant women, particularly those who migrated in late-life (after age 50) are at a significant disadvantage in the number of years after age 65 lived with depression and the ratio of years spent without depression relative to U.S.-born women. Among men, only late-life immigrants were disadvantaged in the number of years spent with depression. Early- and mid-life immigrant males did not differ from U.S.-born males. Discussion and Implications: Our results highlight the heterogeneity among older Mexican Americans in life expectancies with depression. These findings illustrate the importance of considering age of migration as a high-risk factor for depression among Mexican-origin immigrants. Including this risk factor as a part of depression screening is a key step for timely interventions in preventing disability and comorbidities associated with untreated depression

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