RESUMO
Predictors of health across the life-course do not maintain the same significance in very late life and the role of financial strain in health outcomes of very old adults remain unclear. Data from adults aged 74 + in waves 5 and 7 of the Hispanic Established Population for the Epidemiological Study of the Elderly (n = 772) study was used to evaluate the role of financial strain on the health of older Mexican Americans who have the highest poverty rate of any racial or ethnic group in the United States. We evaluate the association between episodic (one wave) and persistent financial strain (two waves), with follow-up health outcomes (self-rated health, ADL (limitations in activities of daily living)/IADL (limitations in instrumental activities of daily living) disability, and depressive symptoms). Adults with persistent strain were twice as likely to experience depressive symptoms and three times more likely to experience IADL limitations than the unstrained. Our findings highlight the role of stress proliferation and allostatic load processes leading to deteriorated health over time.
Assuntos
Atividades Cotidianas , Depressão , Nível de Saúde , Americanos Mexicanos , Humanos , Masculino , Idoso , Feminino , Americanos Mexicanos/estatística & dados numéricos , Americanos Mexicanos/psicologia , Atividades Cotidianas/psicologia , Idoso de 80 Anos ou mais , Depressão/epidemiologia , Depressão/etnologia , Depressão/psicologia , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Estresse Financeiro/etnologia , Estresse Financeiro/psicologiaRESUMO
OBJECTIVES: The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care. METHODS: We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (nâ =â 4,805) and 2018 (nâ =â 6,494). ADL tasks were dressing, walking, bathing, getting in and out of bed, and toileting. Participants who reported difficulty with an ADL were asked if anyone helped them with the task. Logistic regression was used to estimate adjusted odds ratios (aOR) for cohort differences in ≥1 ADL limitations and help with ≥1 ADL. We used a decomposition analysis to identify participant characteristics that mediated cohort differences in receiving help with ≥1 ADL. RESULTS: The 2018 cohort had higher odds for ≥1 ADL limitations (aORâ =â 1.85, 95% CIâ =â 1.60-2.14) but lower odds for help with ≥1 ADL (aORâ =â 0.66, 95% CIâ =â 0.49-0.89). Among participants with ADL disability, the 2018 cohort had fewer living children and a lower prevalence of probable dementia. The lower number of living children and lower prevalence of probable dementia explained 9.34% and 43.7% of the cohort effect on receiving help with ≥1 ADL, respectively. DISCUSSION: The declining percentage of older adults in Mexico with ADL disability receiving assistance may not reflect increasing unmet needs. However, the increased prevalence of ADL disability will increase the number of older adults needing informal care.