This application seeks funds to conduct two in-person follow-ups of the Hispanic EPESE (Established Population for the Epidemiological Study of Elderly) during 2009-2010 and 2011-2012. The study's baseline was conducted during 1993-1994 when a representative sample of 3,050 Mexican Americans age 65 and over residing in the five Southwestern states - Texas, New Mexico, Colorado, Arizona, and California - were interviewed and followed up four times. By 2004-2005 (Wave 5) 1,167 of the original subjects now aged 75 and over were re-interviewed. An additional representative sample of 902 Mexican Americans also aged 75 and over was added at Wave 5 giving us a combined sample of 2069 subjects aged 75 and over. Of these, 1542 were re-interviewed in 2007 (data still being processed), approximately 2 1/2 years later. The study thus far has generated over 170 publications and has provided valuable information related to the health and health care needs of older Mexican Americans. Wave 7 is proposed to take place in 2009-2010 and we estimate interviewing slightly over 1,000 surviving subjects aged 80 and over. We also propose to interview a """"""""focal relative"""""""", most likely a child, who will supply information on the subjects'health, family, and financial situation. Both will be followed up two years later in 2011-2012. We expect that we will re-interview 700 subjects aged 82 and over and 800 of the focal relatives. Family members of deceased subjects will provide information on circumstances surrounding the subjects'death, which we have done over the years by using a proxy death questionnaire. Our first and new aim will be accomplished primarily by interviewing the focal relatives who will provide assessments of the older subjects'financial, family, and health situation. We will assess the nature and extent of any caregiving arrangements in very old Mexican Americans and the physical, psychological, and financial burdens of advanced age on the extended family. Given the advanced age of the sample, we expect to have sufficient numbers of subjects entering nursing homes and assisted living facilities to learn about factors leading to institutionalization. Although the rate of institutionalization among Mexican Americans is lower than that in the general population, our data thus far have suggested that it may be rising. We will have the opportunity to assess the influence of psychosocial and medical factors leading to institutionalization. We continue to assess trajectories of change in physical function, depressive symptomology, and cognitive function. We also propose to do a more extensive assessment of cognitive function including assessments made by the focal relatives. As we have done in the past, we plan to rapidly archive the data and to encourage others to use them. The Mexican American population is experiencing rapid rates of aging, and very little is known about the health, health care needs, and financial situation of the very old. Our findings thus far suggest that this is a population characterized by rising life expectancy which is accompanied by increased disease burden and increasing disability rates.

Public Health Relevance

Data on the health and health care needs of older Mexican Americans (aged 80+) will be obtained from interviews with them as well as one of their close relatives. Such information will have significant implications for health and social policy aimed at improving the health and quality of life of very old Mexican Americans.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG010939-19
Application #
8233387
Study Section
Neurological, Aging and Musculoskeletal Epidemiology (NAME)
Program Officer
Patmios, Georgeanne E
Project Start
1992-09-30
Project End
2014-03-31
Budget Start
2012-04-01
Budget End
2013-03-31
Support Year
19
Fiscal Year
2012
Total Cost
$753,076
Indirect Cost
$116,343
Name
University of Texas Medical Br Galveston
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
800771149
City
Galveston
State
TX
Country
United States
Zip Code
77555
Mutambudzi, Miriam; Chen, Nai-Wei; Markides, Kyriakos S et al. (2016) Effects of Functional Disability and Depressive Symptoms on Mortality in Older Mexican-American Adults with Diabetes Mellitus. J Am Geriatr Soc 64:e154-e159
Lewis, Zakkoyya H; Markides, Kyriakos S; Ottenbacher, Kenneth J et al. (2016) The Role of Physical Activity and Physical Function on the Risk of Falls in Older Mexican Americans. J Aging Phys Act 24:342-9
Downer, Brian; Vickers, Benjamin N; Al Snih, Soham et al. (2016) Effects of Comorbid Depression and Diabetes Mellitus on Cognitive Decline in Older Mexican Americans. J Am Geriatr Soc 64:109-17
Downer, Brian; Chen, Nai-Wei; Wong, Rebeca et al. (2016) Self-Reported Health and Functional Characteristics of Mexican and Mexican American Adults Aged 80 and Over. J Aging Health 28:1239-55
Hill, Terrence D; Uchino, Bert N; Eckhardt, Jessica L et al. (2016) Perceived Social Support Trajectories and the All-Cause Mortality Risk of Older Mexican American Women and Men. Res Aging 38:374-98
Nam, Sanggon; Al Snih, Soham; Markides, Kyriakos (2016) Lower body function as a predictor of mortality over 13 years of follow up: Findings from Hispanic Established Population for the Epidemiological Study of the Elderly. Geriatr Gerontol Int 16:1324-1331
Downer, Brian; Raji, Mukaila A; Markides, Kyriakos S (2016) Relationship between metabolic and vascular conditions and cognitive decline among older Mexican Americans. Int J Geriatr Psychiatry 31:213-21
Downer, Brian; Kumar, Amit; Veeranki, Sreenivas P et al. (2016) Mexican-American Dementia Nomogram: Development of a Dementia Risk Index for Mexican-American Older Adults. J Am Geriatr Soc 64:e265-e269
Peterson, Mark D; Zhang, Peng; Duchowny, Kate A et al. (2016) Declines in Strength and Mortality Risk Among Older Mexican Americans: Joint Modeling of Survival and Longitudinal Data. J Gerontol A Biol Sci Med Sci 71:1646-1652
Nam, Sanggon; Al Snih, Soham; Markides, Kyriakos S (2016) A concordance of self-reported and performance-based assessments of mobility as a mortality predictor for older Mexican Americans. Geriatr Gerontol Int :

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