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Aims: This report is the first study of the possible relationship between extremely low frequency (50-60 Hz, ELF) magnetic field (MF) exposure and severe cognitive dysfunction. Earlier studies investigated the relationships between MF occupational exposure and Alzheimer’s disease (AD) or dementia. These studies had mixed results, depending upon whether the diagnosis of AD or dementia was performed by experts and upon the methodology used to classify MF exposure. Study Design: Population-based case-control. Place and Duration of Study: Neurology and Preventive Medicine, Keck School of Medicine, University of Southern California, 2 years. Methodology: The study population consisted of 3050 Mexican Americans, aged 65+, enrolled in Phase 1 of the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) study. Mini-Mental State Exam (MMSE) results, primary occupational history, and other data were collected. Severe cognitive dysfunction was defined as an MMSE score below 10. The MF exposure methodology developed and used in earlier studies was used. Results: Univariate odds ratios (OR) were 3.4 (P< .03; 95% CI: 1.3-8.9) for high and 1.7 (P=.27; 95% CI: 0.7-4.1) for medium or high (M/H) MF occupations. In multivariate main effects models, the results were similar. When interaction terms were allowed in the models, the interactions between M/H or high occupational MF exposure and smoking history or age group were statistically significant, depending upon whether two (65-74, 75+) or three (65-74, 75-84, 85+) age groups were considered, respectively. When the analyses were limited to subjects aged 75+, the interactions between M/H or high MF occupations and a positive smoking history were statistically significant. Conclusion: The results of this study indicate that working in an occupation with high or M/H MF exposure may increase the risk of severe cognitive dysfunction. Smoking and older age may increase the deleterious effect of MF exposure.
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En este artículo se discute el papel de la familia y el vecindario en la salud de los ancianos méjico-americanos del estudio EPESE (Established Populations for Epidemiologic Studies of the Elderly) hispano. La paradoja epidemiológica consiste en que, a pesar de estar en desventaja socioeconómica, los ancianos hispanos tienen mortalidad relativamente menor que los ancianos de raza blanca. Esto es especialmente cierto cuando el anciano vive en los vecindarios donde hay un porcentaje alto de méjico-americanos. La familia también juega un papel importante en estos ancianos al disminuir el riesgo de institucionalización o de morbilidad. Asimismo, el estrés originado en problemas económicos o al depender económicamente de la familia, habiendo inmigrado en edades tardías, puede sobrepasar la capacidad de amortiguamiento del estrés y afectar la salud del anciano méjico-americano.
In this article, the roles of the family and the neighborhood on the health of Mexican American older people of the Hispanic EPESE (Established Populations for Epidemiologic Studies of the Elderly) are discussed. The epidemiologic paradox consists on, in despite of socioeconomic disadvantage; Hispanic older people have a relatively low mortality than white older people. This is especially true when the older people live in neighborhoods with high percentages of Mexican Americans. The family has also an important role in these older people for decreasing the risk of institutionalization or morbidity. On the other hand, stress from economic problems or family dependency among older Mexican immigrants can overcome capacity for coping stress, this may affect the health of Mexican American older people.
Assuntos
Idoso , Idoso , Epidemiologia , Família , Hispânico ou Latino , Americanos Mexicanos , Estresse PsicológicoRESUMO
Objetivo. Estimar la prevalencia de caídas y de sus factores de riesgo en ancianos que habitan en el seno de la comunidad en América Latina y el Caribe y en ancianos mexicanoestadounidenses que viven en la zona sudoeste de Estados Unidos. Métodos. Los datos usados para el estudio procedieron del proyecto Salud, Bienestar y Envejecimiento en América Latina y el Caribe (proyecto "SABE") (encuestas en siete ciudades que abarcaron a un total de 9 765 personas) y de las Poblaciones Hispanas Establecidas para Estudios Epidemiológicos en Ancianos [Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE)] (1 483 personas). Resultados. La prevalencia general de caídas en personas de edad en las siete ciudades que participaron en el proyecto SABE varió de 21,6% en Bridgetown, Barbados, a 34,0% en Santiago, Chile. Según análisis de regresión logística, el ser de sexo femenino, tener más edad, y tener síntomas de depresión profunda o alguna limitación funcional fueron factores de riesgo asociados de forma independiente y estadísticamente significativa con las caídas en personas de edad en la mayor parte de las ciudades estudiadas, así como en ancianos mexicanoestadounidenses. En varias ciudades también fueron factores de riesgo estadísticamente significativos la diabetes, la incontinencia urinaria y la artritis. Conclusiones. La prevalencia de caídas varió mucho entre los países estudiados. Algunos de los factores de riesgo identificados se podrían modificar a fin de prevenir las caídas en personas de edad avanzada en estas poblaciones. Los factores a los que se debe prestar atención son los síntomas de depresión, las limitaciones funcionales, la diabetes y la incontinencia urinaria
Objective. To estimate the prevalence of and risk factors for falls among communitydwelling elders in Latin America and the Caribbean and among elderly Mexican-Americans in the southwestern United States. Methods. Data for the study came from a project called Health, Well-Being, and Aging in Latin America and the Caribbean (Salud, Bienestar y Envejecimiento en América Latina y el Caribe) (the "SABE project") (surveys from seven cities, with a total of 9 765 subjects) and from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (1 483 subjects). Results. The overall prevalence of falls across the seven SABE cities and the H-EPESE ranged from 21.6% in Bridgetown, Barbados, to 34.0% in Santiago, Chile. In multiple logistic regression analyses, female gender, increased age, high depressive symptoms, and having any functional limitations were significant independent risk factors for falls in most of the cities studied as well as among the elderly Mexican-Americans. In several of the cities, significant risk factors also included diabetes, urinary incontinence, and arthritis. Conclusions. The prevalence of falls had a large variation among the countries studied. Some of the risk factors that we identified could be modified so as to help prevent falls in older people in these populations. The factors deserving attention include depressive symptoms, functional limitations, diabetes, and urinary incontinence