Cognitive life expectancy by educational attainment in Mexican adults aged 60 and older.

OBJECTIVE: To estimate cognitively healthy life expectancy (CHLE), cognitive impairment life expectancy (CILE), and dementia life expectancy (DLE) in Mexican adults aged 60 and older stratified by educational attainment. MATERIALS AND METHODS: The data were obtained from Waves 1 (2001) to 5 (2018) of the Mexican Health and Aging Study. The life expectancy was estimated using a multistate life table analysis. RESULTS: CHLE at age 60 increased with higher educational attainment and ranged from 17.9 to 24.4 years in female participants, and 17.2 to 21.3 in male participants. The CILE and DLE decreased with greater educational attainment. The CILE ranged from 0.7 to 2.8 years in female participants and 0.7 to 2.6 in male participants. CONCLUSIONS: Older adults in Mexico with higher education live more years with good cognitive health and fewer years with cognitive impairment and dementia. Education has a stronger effect on the length of cognitively healthy life expectancies than on total life expectancies.

Differences in the Cognitive Function of Mexican Adults Aged 60 and Older with Self-Reported Diabetes in 2001 and 2018.

BACKGROUND: The prevalence of type 2 diabetes in Mexico has nearly doubled for adults aged ≥60. Increases in education and healthcare resources to manage chronic conditions have contributed to population-level increases in the cognitive functioning of older adults. However, research has not focused on older adults with chronic conditions such as diabetes. OBJECTIVE: Our objective was to compare the cognitive functioning of Mexican adults aged ≥60 with diabetes in 2001 and 2018. METHODS: Data came from Mexican Health and Aging Study. Our study used a cross-sectional design and included participants aged ≥60 with self-reported diabetes during the 2001 (n = 1,052, mean age = 68.4, female = 59.6%) and 2018 (n = 2,469, mean age = 70.6, female = 62.0%) observation waves. Five cognitive tests were used to create a score of global cognition. Generalized estimating equations were used to compare global cognition in 2001 to 2018. RESULTS: Older adults in 2018 had more education and were more likely than older adults in 2001 to take oral medication for diabetes, insulin, and to check blood sugar weekly. Older adults in 2018 had higher global cognition than in 2001 when adjusting for age, gender, education, and health insurance coverage (b = 0.38, SE = 0.02). This statistically significant difference remained after adjusting for health conditions, health behaviors, and diabetes management behaviors. CONCLUSIONS: Older adults in Mexico with self-reported diabetes in 2018 had higher cognitive function than in 2001. Future research is needed to investigate causes of the cohort differences in cognitive functioning among Mexican older adults with self-reported diabetes.

Transitions of disability, disability-free life expectancy and health insurance among adults aged 50 and older in Mexico: a multistate life table analysis.

OBJECTIVES: To analyse the transitions of disability onset and recovery, estimate life expectancy (LE) with and without disability and explore the relation between insurance and disability patterns in the population aged 50+ in Mexico. DESIGN: Multistate life table analysis of data from a longitudinal cohort survey. SETTING: Data came from the Mexican Health and Aging Study, a longitudinal and representative survey of older adults in Mexico. PARTICIPANTS: 10 651 individuals aged 50+ interviewed in 2012 and 2015, including those who died between waves. PRIMARY AND SECONDARY OUTCOME MEASURES: Disability is measured using the activities of daily living (ADL) scale. Transition rates between disability free, ADL disabled and death were employed to estimate total life expectancy (TLE) and disability-free life expectancy (DFLE). RESULTS: 46% of the individuals who reported an ADL limitation in 2012 recover from disability by 2015. TLE at age 60 for people without ADL limitations is 30 years (95% CI 28.9 to 31), out of which 4.7 years (95% CI 4.1 to 5.4) are lived with ADL limitations, while TLE at age 60 in the initially disabled is 18.7 years (95% CI 17.3 to 20), with 9.4 years (95% CI 8.4 to 10.3) lived with disability. DFLE at age 60 in people with social security is 24.2 years (95% CI 23.3 to 25.2), in people with public insurance is 24.6 years (95% CI 23.7 to 25.4) and in uninsured people is 26.9 years (95% CI 25.9 to 27.9). CONCLUSIONS: In Mexico, a substantial proportion of ADL disabled individuals recover from disability. Nevertheless, initially disabled individuals have a considerably lower DFLE regardless of age when compared with initially active individuals. There appeared to be no differences in terms of disability and LEs between the individuals with social security and public insurance.

Transiciones de la discapacidad según afiliación a instituciones de salud en adultos mayores en México / Transitions of disability according to health insurance enrollment among older adults in Mexico

Resumen: Objetivo: Estudiar las transiciones de la discapacidad de acuerdo con la afiliación a servicios de salud en adultos mayores de 50 años en México, así como el conjunto de variables socioeconómicas y de salud asociadas. Material y métodos: La información proviene de la Encuesta Nacional de Salud y Envejecimiento en México (Enasem-encuesta). Se ajustaron 20 modelos de regresión para las transiciones de la discapacidad medida a través de actividades básicas de la vida diaria en el periodo 2012-15, usando variables socioeconómicas y de salud. Resultados: Los afiliados al Seguro Popular tuvieron la mayor frecuencia de transición hacia la discapacidad con 13.26%. La afiliación a instituciones de salud no tuvo relación con ninguna de las cuatro transiciones estudiadas. Las enfermedades asociadas con el desarrollo de discapacidad varían de acuerdo con la afiliación. Conclusiones: Los factores socioeconómicos y de salud asociados con las transiciones de la discapacidad son diferentes entre afiliaciones.

Abstract: Objective: To study the transitions of disability according to health insurance in the population of adults over 50 in Mexico, as well as the set of socioeconomic and health variables associated with these transitions. Materials and methods: Data comes from the Mexican Health and Aging Study (MHAS). Twenty regression models were fitted for the transitions of disability measured through activities of daily living in the period 2012-15, using socioeconomic and health as explanatory variables. Results: Enrollees with Seguro Popular had the highest frequency of transition to disability with 13.26%. Health insurance was not found to be related to any of the four transitions studied. Diseases associated with the development of disability vary according to health insurance. Conclusions: The socioeconomic and health factors associated with disability transitions are different between health insurance enrolees.

Transitions of disability according to health insurance enrollment among older adults in Mexico / Transiciones de la discapacidad según afiliación a instituciones de salud en adultos mayores en México

Objective: To study the transitions of disability according to health insurance in the population of adults over 50 in Mexico, as well as the set of socioeconomic and health variables associated with these transitions. Materials and methods: Data comes from the Mexican Health and Aging Study (MHAS). Twenty regression models were fitted for the transitions of disability measured through activities of daily living in the period 2012-15, using socioeconomic and health as explanatory variables. Results: Enrollees with Seguro Popular had the highest frequency of transition to disability with 13.26%. Health insurance was not found to be related to any of the four transitions studied. Diseases associated with the development of disability vary according to health insurance. Conclusions: The socioeconomic and health factors associated with disability transitions are different between health insurance enrollees.