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.
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.
|Garcia, Marc A; Saenz, Joseph L; Downer, Brian et al. (2018) Age of Migration Differentials in Life Expectancy With Cognitive Impairment: 20-Year Findings From the Hispanic-EPESE. Gerontologist 58:894-903|
|Downer, Brian; Garcia, Marc A; Saenz, Joseph et al. (2018) The Role of Education in the Relationship Between Age of Migration to the United States and Risk of Cognitive Impairment Among Older Mexican Americans. Res Aging 40:411-431|
|Downer, Brian; Al Snih, Soham; Howrey, Bret T et al. (2018) Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans. Aging Ment Health :1-8|
|Jarvis, Jessica M; Downer, Brian; Baillargeon, Jacques et al. (2018) The modifying effect of positive emotion on the relationship between cognitive impairment and disability among older Mexican Americans: a cohort study. Disabil Rehabil :1-8|
|Salinas, Jennifer J; Gonzalez, Jennifer M Reingle; Al Snih, Soham (2018) Type 2 diabetes, depressive symptoms and disability over a 15-year follow-up period in older Mexican Americans living in the southwestern United States. J Diabetes Complications 32:75-82|
|Collins, Diane M; Downer, Brian; Kumar, Amit et al. (2018) Impact of Multiple Chronic Conditions on Activity Limitations Among Older Mexican-American Care Recipients. Prev Chronic Dis 15:E51|
|García, Catherine; Garcia, Marc A; Chiu, Chi-Tsun et al. (2018) Life Expectancies With Depression by Age of Migration and Gender Among Older Mexican Americans. Gerontologist :|
|Howrey, Bret T; Al Snih, Soham; Markides, Kyriakos S et al. (2018) Frailty and diabetes among Mexican American older adults. Ann Epidemiol 28:421-426.e1|
|Mutambudzi, Miriam; Chen, Nai-Wei; Howrey, Bret et al. (2018) Physical Performance Trajectories and Mortality among Older Mexican Americans. J Gerontol A Biol Sci Med Sci :|
|Garcia, Marc A; Reyes, Adriana M (2018) Physical Functioning and Disability Trajectories by Age of Migration Among Mexican Elders in the United States. J Gerontol B Psychol Sci Soc Sci 73:1292-1302|
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