Funds are requested to conduct two in-person follow-ups of the Hispanic EPESE (Established Populations for Epidemiologic Studies of the Elderly) giving us a total of four contacts (1993-4, 1995-6, 1998-9, and 2000-2001). The study's original aims were to provide basic data on the health and health care needs of Mexican American elderly in the Southwestern United States. The baseline cohort of 3,050 subjects was followed up two years later. Additional follow-ups are requested at five and seven years to enable the assessment of changes in health and well-being over time. Key health outcomes include mortality, physical functioning, and depression. Of particular interest is how the latter three outcomes are interrelated in predicting each other over time as well as predicting mortality over time. In addition to investigating trajectories of change, we examine how medical conditions, such as diabetes, obesity and arthritis, and social factors, such as migration status, social support and acculturation are associated with changes in health outcomes over time. Our two-year follow-up data indicate that very few elderly Mexican Americans enter nursing homes despite having high rates of physical disability, cognitive dysfunction, and depression. Thus, many disabled elderly Mexican Americans are cared for in the home. In addition to investigating circumstances under which some Mexican Americans become institutionalized over time, we plan to assess the role of the family in caring for disabled elderly members in the home. The third and fourth waves of data collection requested will repeat interview measures on key health outcomes and predictor variables as well as in-home medical assessments that include blood pressures, measures of height and weight, and performance measures of physical functioning. A variety of statistical procedures are planned for analyzing trajectories of change in health outcomes and how these changes are associated with medical conditions and social factors over time. The longitudinal research proposed will provide essential information necessary for addressing the health care needs of older Mexican Americans.
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