RESUMO
BACKGROUND: Limited data suggest that Puerto Ricans experience greater disability than other ethnic groups, but few studies have examined the factors associated with this apparent difference. METHODS: We describe the prevalence of functional limitation and disability in a representative sample of Puerto Rican and Dominican elders in Massachusetts, and in a neighborhood comparison group of non-Hispanic whites (NHWs). We then relate disability scores, based on both prevalence and severity of ADL or IADL limitation, with self-reported history of diagnosed health conditions--adjusting for age, sex, body mass index (BMI; weight kg/height m(2)), income, education, living alone, smoking, and alcohol use. RESULTS: Seventy-five percent of Dominican women and 73% of Puerto Rican women reported difficulty with at least one ADL, compared with 64% of NHW women. Puerto Rican men reported significantly more limitation than did NHW or Dominican men. Conditions significantly associated with at least two disability measures among the NHW included smoking, former heavy alcohol use, arthritis, cataract, respiratory disease, and high BMI, but not stroke, diabetes, history of heart attack, or depression. The patterns for Puerto Ricans differed, with the strongest associations between disability and stroke, arthritis, diabetes, and depression, followed by history of heart attack, high BMI, cataract, poverty status, and respiratory disease. Only arthritis and depression were consistently significantly associated with disability among this smaller sample of Dominican elders. CONCLUSIONS: Functional limitation and disability are more prevalent among Puerto Ricans and among Dominican women than among neighborhood NHWs in Massachusetts. Greater disability is associated with the presence of chronic health conditions, which differ by ethnic group. Additional research is needed to further define the social and health factors that contribute to these ethnic differences.
Assuntos
Atividades Cotidianas , Pessoas com Deficiência , Nível de Saúde , Hispânico ou Latino , População Branca , Fatores Etários , Idoso , Consumo de Bebidas Alcoólicas/etnologia , Índice de Massa Corporal , Doença Crônica , Doença/classificação , Doença/etnologia , República Dominicana/etnologia , Escolaridade , Família , Feminino , Humanos , Renda , Masculino , Massachusetts , Prevalência , Porto Rico/etnologia , Fatores Sexuais , Fumar/etnologiaRESUMO
To study issues of diet and health among Hispanic adults living in the northeastern United States, the authors adapted a version of the National Cancer Institute (NCI)/Block food frequency questionnaire. Foods that contributed to nutrient intake of Puerto Rican adults in the Hispanic Health and Nutrition Examination Survey (HHANES) were ranked to identify items to be added to the food list. Portion sizes were compared across HHANES and the Second National Health and Nutrition Examination Survey (NHANES II) to assess the adequacy of the assumed values. Within line items, frequencies of consumption of individual foods were ranked and these data were used to adjust the weighting factors within the database. To test the revised form, 24-hour recalls were collected from 90 elderly Hispanics and 35 elderly non-Hispanic whites. These data were coded into the original and revised food frequency forms and nutrient intake results were compared with recall results by paired t-test, and by Pearson and intraclass correlations. Added foods include plantains, avocado, mango, cassava, empanadas, and custard. Portion sizes differed significantly between HHANES and NHANES II, and were left open-ended. Estimated mean nutrient intakes and correlations with recall data were lower with the original versus the revised form. The authors conclude that the use in minority populations of food frequency questionnaires developed for the general population is likely to result in biased estimates of intake unless modifications are made in the questionnaires.