The Impact of Physical Activity on Disability Incidence among Older Adults in Mexico and the United States.

Evidence suggests that transitions among older adults towards healthy habits, such as physical activity, appear underway in developed countries such as the USA but not in developing countries such as Mexico. However, little is known about the potential benefit of physical activity in preventing disability among elders in countries at different stages of epidemiological transition. We explore the impact of physical activity on the disablement process among elders in Mexico compared to the USA. Data are from two waves of the Mexican Health and Aging Study and the Health and Retirement Study. We examine the impact of exercise on the transition from no disability to ADL limitations two years later. Findings indicate that exercise is more common in the U.S. than in Mexico. There is a positive effect of exercise on negative outcomes in both countries. However, the protective effect of exercise is stronger in the U.S. than in Mexico.

Protective neighborhoods: neighborhood proportion of Mexican Americans and depressive symptoms in very old Mexican Americans.

Research indicates that neighborhood context can have a significant effect on the health of older adults. The evidence suggests that there may be physical health benefits afforded to Mexican Americans living in ethnically homogenous neighborhoods, despite the relatively high economic risk in such neighborhoods, but few studies have considered the effect of neighborhood ethnic density on mental health outcomes in older adults. This study evaluated the association between neighborhoods with a high proportion of Mexican Americans and depressive symptoms in very old Mexican Americans. Hierarchical linear modeling was used to examine data from Wave 5 (2004/05) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Subjects included 1,875 community-dwelling Mexican Americans aged 75 and older living in 386 neighborhoods in five states in the southwestern United States (Arizona, California, Colorado, New Mexico, Texas). Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (α=0.88). Results showed that, in very old men, there was a significant negative association between percentage of Mexican Americans in the neighborhood and depressive symptoms (P=.01). In women, the direction of the association was the same, but the effect was not significant. These findings suggest that the proportion of Mexican Americans in the neighborhood matter more for very old Mexican American men than women. Further research may inform screening and treatment for depressive symptoms based on differences in neighborhood composition. Recommendations include culturally customized programs that offer older Mexican Americans greater mobility and access to programs and opportunities in culturally identifiable neighborhoods.

Patterns of residential crowding among Hispanics in later life: immigration, assimilation, and housing market factors.

OBJECTIVE: We describe patterns of residential crowding among older Hispanics and non-Hispanic Whites. We also examine hypotheses about the relationship of residential crowding with assimilation (language and duration of residence) and housing market characteristics. METHODS: We employ a multilevel research design, using data from the 2000 U.S. Census of Population. Hierarchical linear models are utilized to estimate the association between residential crowding and both individual and housing market factors. RESULTS: Approximately one third of older Hispanics in metropolitan areas live in crowded housing compared with only one tenth of older non-Hispanic Whites. Foreign-born older persons report higher levels of crowding than U.S.-born older persons. Residential crowding differences between older Hispanics and non-Hispanics are not eliminated after controls are included. Older Hispanics who report better English language skills and a longer duration of residence in the United States live in less crowded housing. We do not find evidence for a relationship between crowding and residential segregation, but we find consistent evidence for an association between residential crowding and relative size of the Hispanic population. DISCUSSION: The forces that shape household composition and access to housing among older Hispanics appear to result in higher levels of residential crowding for this population.

High depressive symptomatology among older community-dwelling Mexican Americans: the impact of immigration.

OBJECTIVES: This analysis explores nativity differences in depressive symptoms among very old (75+) community-dwelling Mexican Americans. DESIGN: Cross-sectional analysis using the fifth wave (2004-2005) of the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE). PARTICIPANTS: The sample consisted of 1699 non-institutionalized Mexican American men and women aged 75 years and above. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D). Logistic regression was used to predict high depressive symptoms (CES-D score 16 or higher) and multinomial logistic regression was used to predict sub-threshold, moderate, and high depressive symptoms. RESULTS: Results showed that elders born in Mexico had higher odds of more depressive symptoms compared to otherwise similar Mexican Americans born in the US. Age of arrival, gender, and other covariates did not modify that risk. CONCLUSION: The findings suggest that older Mexican American immigrants are at higher risk of depressive symptomatology compared to persons born in the US, which has significant implications for research, policy, and clinical practice.

Trends in diabetes prevalence and diabetes-related complications in older Mexican Americans from 1993-1994 to 2004-2005.

OBJECTIVE: Evidence has shown that Mexican Americans have a higher prevalence of diabetes and a greater risk for diabetes-related complications than non-Hispanic whites. However, no studies have described the changes in prevalence among older Mexican Americans. The purpose of this study was to expand on the current literature by examining the trends in diabetes prevalence and diabetes-related complications in Mexican Americans aged >or=75 years from 1993-1994 to 2004-2005. RESEARCH DESIGN AND METHODS: The prevalences of self-reported diabetes and diabetes-related complications were estimated in the original cohort (1993-1994) and the new cohort (2004-2005) of the Hispanic Established Population for the Epidemiologic Study of the Elderly (Hispanic EPESE) and were compared across the two surveys. RESULTS: The prevalence of diabetes among Mexican Americans aged >or=75 years has nearly doubled between 1993-1994 and 2004-2005 from 20.3 to 37.2%, respectively (P < 0.001). The increase in the prevalence of diabetes was similar across all sociodemographic factors. Diabetes complications did not change significantly between the two cohorts. However, the prevalence of having any lower-extremity function disability did increase between the two cohorts. CONCLUSIONS: The prevalence of diabetes in older Mexican Americans has increased dramatically. At the same time, there has been no improvement in diabetes-related complications as has been found in the general older population. These findings heighten the urgency for more effective public health interventions targeted to this population. As diabetes and obesity become more prevalent in older adults, physicians should encourage appropriate management in older patients, including early detection and glycemic control.

Supplemental security income among older immigrants from Central and South America: the impact of welfare reform.

This article explores the impact of federal welfare policy changes on older immigrants born in Central and South America. Using data from the 1990 and 2000 US. Census 5% Public-Use Microdata Samples, the study examines (1) the change in Supplemental Security Income (SSI) uptake rate after welfare reform for noncitizens from Latin America, naturalized Latin Americans, and U.S.-born Hispanics and (2) how much of the change can be attributed to a change in behavior rather than to a change in eligibility rates. Findings show that the decline in SSI receipt after welfare reform was greater for Latin American noncitizens compared to naturalized citizens and Hispanic U.S.-born citizens. Decomposition analyses show that among eligible elderly noncitizens, the decline in recipiency rate was due mostly to a change in behavior rather than a change in eligibility. This pattern is not found for U.S.-born and naturalized citizens, where changes were mostly due to a decline in the proportion of persons eligible for SSI. This suggests that as a result of legislative changes, older immigrants may not be applying for benefits for which they may be legally entitled. Policy implications are discussed.