RESUMO
OBJECTIVE: Functional limitations are prevalent among aging demographics, especially women. Structural and health factors, which vary worldwide, influence rates of functional limitations. Yet, gender disparities in functional limitation remain unclear in a global context. METHODS: We use 2018 data from the Health and Retirement Study (HRS) international family of studies with respondents ages 50-64 and (n = 87,479) and 65-89 (n = 92,145) to investigate gender disparities in large muscle functional limitation (LMFL) across 10 countries/regions using mixed effects logistic regression, with special attention to structural indicators of inequality and health. RESULTS: Among both women and men, LMFL was generally higher in China, India, Mexico, United States, and Baltic States than in England, Scandinavia, Southern Europe, Eastern Europe, and Western Europe. The gender disparity in LMFL gradually declined at older ages in India, China, Mexico, and United States, while this disparity gradually increased at older ages throughout Europe. Among middle age respondents, the greater risk of LMFL for women in countries/regions with a high GII was no longer observed after accounting for comorbidities. Among older respondents, a lower risk of LMFL for women in countries/regions with a high GII was not observed until accounting for comorbidities. DISCUSSION: Our findings suggest that rates of LMFL are higher in middle-income countries than high-income countries, especially among women, and in countries with a higher GII. In addition, consideration of comorbidities was integral to these relationships. Thus, national/regional contexts inform differential rates of functional limitation, particularly as it relates to gender.
Assuntos
Disparidades nos Níveis de Saúde , Humanos , Masculino , Idoso , Feminino , Pessoa de Meia-Idade , Fatores Sexuais , Idoso de 80 Anos ou mais , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Atividades Cotidianas , México/epidemiologiaRESUMO
OBJECTIVES: Mexico is aging rapidly, which makes identification of life-course factors influencing cognition a public health priority. We evaluate how the number of children one has relates to cognition in Mexico, a rapidly aging country that experienced fertility declines across recent cohorts of older people. METHOD: We analyze older adults (age 50+, n = 11,380) from the 2015 Mexican Health and Aging Study. Respondents were categorized by number of children ever born (0-1, 2-3, 4-5, 6+). Using ordinary least squares regression, we estimate independent associations between fertility history and cognition accounting for demographic, socioeconomic, health, and psychosocial factors. RESULTS: We observed an inverse U-shaped relationship between number of children (peaking at 2-3 children) and cognitive function, regardless of gender. In regression analyses adjusted for confounding variables, having 0-1 (vs 2-3 children) was associated with poorer cognitive function only for females. Regardless of gender, having 6+ (vs 2-3 children) was associated with poorer cognitive function. These associations remained significant even after accounting for socioeconomic, health, employment, and psychosocial factors. DISCUSSION: Our results suggest fertility history may play a role in late-life cognitive health and provide evidence that both low and high fertility may relate to poorer cognitive function. We discuss differences by gender.
Assuntos
Cognição , Envelhecimento Cognitivo/psicologia , Fertilidade , Paridade , Psicologia , Fatores Socioeconômicos , Correlação de Dados , Demografia , Feminino , Nível de Saúde , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Gravidez , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , História ReprodutivaRESUMO
Mexico has experienced changes in its demographic and epidemiologic profile accompanied by recent changes in nutrition and income. Thus, the old and the young have experienced very different environments. Using data from the Mexican National Health Nutrition Survey 2006, we examine age and sex differences in physiological status and dysregulation and assess how socioeconomic factors associate with variability in biological indicators of health. Results indicate that young people have experienced better physical development as evidenced by their being taller and having less stunting. There is currently little under-nutrition in Mexico, but there is evidence of over-nutrition as indicated by high prevalence of overweight across the age range. Physiological dysregulation across multiple systems is higher in Mexicans than Americans across all ages. Mexicans have: higher levels of blood pressure, plasma glucose, and especially for women, dysregulated cholesterol and higher body weight. Low education is associated with both being stunted and overweight, and with adverse levels of HDL cholesterol and more physiological risk factors. Rural dwelling males are less likely to be overweight as are females living in poor states. Living in a poor state among females and having rural residence among males is associated with a higher number of high-risk factors. Overweight is a strong predictor of hypertension. Age differences in indicators of physiological development suggest that the epidemiological and demographic transitions in Mexico were accompanied by improved physical development; however, increases in nutrition may have reached a point of diminishing returns as Mexico switched from a state of under-nutrition to over-nutrition.
Assuntos
Epidemiologia , Indicadores Básicos de Saúde , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México , Pessoa de Meia-Idade , Medição de Risco , Fatores Sexuais , Adulto JovemRESUMO
While deleterious consequences of smoking on health have been widely publicized, in many developing countries, smoking prevalence is high and increasing. Little is known about the dynamics underlying changes in smoking behavior. This paper examines socio-economic and demographic characteristics associated with smoking initiation and quitting in Mexico between 2002 and 2010. In addition to the influences of age, gender, education, household economic resources and location of residence, changes in marital status, living arrangements and health status are examined. Drawing data from the Mexican Family Life Survey, a rich population-based longitudinal study of individuals, smoking behavior of individuals in 2002 is compared with their behavior in 2010. Logistic models are used to examine socio-demographic and health factors that are associated with initiating and quitting smoking. There are three main findings. First, part of the relationship between education and smoking reflects the role of economic resources. Second, associations of smoking with education and economic resources differ for females and males. Third, there is considerable heterogeneity in the factors linked to smoking behavior in Mexico indicating that the smoking epidemic may be at different stages in different population subgroups. Mexico has recently implemented fiscal policies and public health campaigns aimed at reducing smoking prevalence and discouraging smoking initiation. These programs are likely to be more effective if they target particular socio-economic and demographic sub-groups.
Assuntos
Fumar/epidemiologia , Fatores Socioeconômicos , Adolescente , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: This study examines sex differences in the association between migration and exposure to an urban environment and overweight, hypertension and diabetes in later life. METHODS: Interviews were conducted with 3,604 adults aged 50 and older in the Mexican Family Life Survey (MxFLS). Logistic regression analyses were used to examine the association between previous migration, urban exposure, and risk of overweight, hypertension, and diabetes. RESULTS: Migration itself was not associated with health outcomes after controlling for urban exposure. The risk of overweight and diabetes associated with urban exposure appeared to be greater for men. Sex differences were found in the covariates that helped explain differences in health between those with high and low urban exposure. DISCUSSION: These findings underscore the need to consider heterogeneity in health by urban exposure and by sex.
Assuntos
Diabetes Mellitus/epidemiologia , Emigração e Imigração/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Hipertensão/epidemiologia , Sobrepeso/epidemiologia , Migrantes/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Distribuição por Sexo , Fatores de TempoRESUMO
OBJECTIVES: This study examines links between early life circumstances and adult socioeconomic status and obesity and hypertension in the adult Mexican population. METHOD: We use data from the Mexican Family Life Survey (MxFLS) collected in 2002 for people aged 20 or older (N = 14,280). RESULTS: We found that men with low education and women with more education have significantly lower obesity. Women with higher education also have significantly less hypertension. Obesity triples the likelihood of hypertension among both men and women. Better childhood experiences are associated with less hypertension among women, but more hypertension among men in rural areas. DISCUSSION: Recent changes in income, nutrition, and infection in Mexico may be responsible for the observed high prevalence of overweight and obesity and the extremely high odds of hypertension among obese young adults.
Assuntos
Hipertensão/epidemiologia , Obesidade/epidemiologia , Adulto , Escolaridade , Feminino , Humanos , Hipertensão/etiologia , Estudos Longitudinais , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Características de Residência/estatística & dados numéricos , Fatores de Risco , Distribuição por Sexo , Classe Social , Adulto JovemRESUMO
The Tsimane of lowland Bolivia are an indigenous forager-farmer population living under conditions resembling pre-industrial European populations, with high infectious morbidity, high infection and inflammation, and shortened life expectancy. Analysis of 917 persons ages 5 to 60+ showed that allele frequencies of 9 SNPs examined in the apolipoprotein E (apoE), C-reactive protein (CRP), and interleukin-6 (IL-6) genes differed from some European, African, and north Asian-derived populations. The apoE2 allele was absent, whereas four SNPs related to CRP and IL-6 were monomorphic: CRP (rs1800947, rs3093061, and rs3093062) and IL-6 (rs1800795). No significant differences in apoE, CRP, and IL-6 variants across age were found CRP levels were higher in carriers of two CRP proinflammatory SNPs, whereas they were lower in carriers of apoE4. Taken together the evidence for (1) different allele frequencies between the Tsimane and other populations and (2) the correlations of CRP and apoE alleles with blood CRP may suggest that these variants are under selection in response to a high infection environment.
Assuntos
Apolipoproteínas E/genética , Proteína C-Reativa/genética , Doenças Transmissíveis/etnologia , Doenças Transmissíveis/genética , Indígenas Sul-Americanos/genética , Interleucina-6/genética , Adolescente , Adulto , Apolipoproteínas E/sangue , Bolívia/epidemiologia , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Predisposição Genética para Doença/genética , Humanos , Interleucina-6/sangue , Análise dos Mínimos Quadrados , Expectativa de Vida/etnologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Despite a myriad of studies examining the relationship between socioeconomic status and health outcomes, few have assessed the extent to which biological markers of chronic disease account for social disparities in health. Studies that have examined this issue have generally been based on surveys in wealthy countries that include a small set of clinical markers of cardiovascular disease. The availability of recent data from nationally representative surveys of older adults in Costa Rica and Taiwan that collected a rich set of biomarkers comparable to those in a recent US survey permits us to explore these associations across diverse populations. Similar regression models were estimated on three data sets - the Social Environment and Biomarkers of Aging Study in Taiwan, the Costa Rican Study on Longevity and Healthy Aging, and the Health and Retirement Study in the USA - in order to assess (1) the strength of the associations between educational attainment and a broad range of biomarkers; and (2) the extent to which these biomarkers account for the relationships between education and two measures of health status (self-rated health, functional limitations) in older populations. The estimates suggest non-systematic and weak associations between education and high risk biomarker values in Taiwan and Costa Rica, in contrast to generally negative and significant associations in the US, especially among women. The results also reveal negligible or modest contributions of the biomarkers to educational disparities in the health outcomes. The findings are generally consistent with previous research suggesting stronger associations between socioeconomic status and health in wealthy countries than in middle-income countries and may reflect higher levels of social stratification in the US. With access to an increasing number of longitudinal biosocial surveys, researchers may be better able to distinguish true variations in the relationship between socioeconomic status and health across different settings from methodological differences.
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Biomarcadores , Disparidades nos Níveis de Saúde , Indicadores Básicos de Saúde , Biomarcadores/sangue , Biomarcadores/urina , Pressão Sanguínea , Índice de Massa Corporal , Colesterol/sangue , Costa Rica , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Taiwan , Estados UnidosRESUMO
OBJECTIVES: Little is known about blood cholesterol (blood-C) levels under conditions of infection and limited diet. This study examines blood-C and markers of infection and inflammation in the Tsimane of the Bolivian Amazon, indigenous forager farmers living in conditions that model preindustrial European populations by their short life expectancy, high load of infections and inflammation, and limited diets. METHODS: We use multivariate models to determine the relationships between lipid levels and markers of infection and inflammation. Adult Tsimane (N = 418, age 20-84) were characterized for blood lipids, cells, and inflammatory markers in relation to individual loads of parasites and village region. RESULTS: Most of the Tsimane (60%) carried at least one parasite species, averaging 1.3 species per person. Serum high-density lipoprotein cholesterol (HDL-C), total cholesterol (total-C), and low-density lipoprotein cholesterol (LDL-C) were below the U.S. norms and varied inversely with markers of infection and inflammation: C-reactive protein (CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), immunoglobulin (Ig) E and eosinophil count. Although no relationship of parasite load to blood-C was found, there was an association between anemia and parasite prevalence. CONCLUSIONS: We conclude that the highly infected environment of the Tsimane is related to low levels of blood total-C, HDL-C, and LDL-C. This may suggest a potential reason why arterial disease is largely absent in the Tsimane.
Assuntos
Indígenas Sul-Americanos , Lipídeos/sangue , Doenças Parasitárias/etnologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Pesos e Medidas Corporais , Bolívia/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Doenças Parasitárias/sangue , Fatores SexuaisRESUMO
Humans evolved in a world with high levels of infection resulting in high mortality across the life span and few survivors to advanced ages. Under such conditions, a strong acute-phase inflammatory response was required for survival; however, inflammatory responses can also promote chronic diseases of aging. We hypothesize that global historical increases in life span at older ages are partly explained by reduced lifetime exposure to infection and subsequent inflammation. To begin a test of this hypothesis, we compare C-reactive protein (CRP); levels in two populations with different epidemiological environments: the Tsimane of Bolivia and persons in the United States. High CRP is significantly more prevalent among the Tsimane up through middle age; by age 35, the Tsimane have spent more years with high CRP than have Americans at age 55. Further testing of the links among infection, inflammation, and chronic diseases of aging among the Tsimane requires collection of age-specific indicators of atherosclerosis and cardiac function.
Assuntos
Envelhecimento/sangue , Proteína C-Reativa/análise , Adolescente , Adulto , Biomarcadores/sangue , Bolívia/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Indígenas Sul-Americanos , Infecções/mortalidade , Expectativa de Vida , Masculino , Inquéritos Nutricionais , Prevalência , Estados Unidos/epidemiologiaRESUMO
Anthropometric measures including height provide an indication of childhood health that allows exploration of relationships between early life circumstances and adult health. Height can also be used to provide some indication of how early life health is related to selection of migrants and the Hispanic paradox in the United States. This article joins information on persons of Mexican nativity ages 50 and older in the United States collected in the National Health and Nutrition Examination Survey IV (NHANES IV 1999-2002) with a national sample of persons of the same age living in Mexico from the Mexican Health and Aging Survey (MHAS 2001) to examine relationships between height, education, migration, and late-life health. Mexican immigrants to the United States are selected for greater height and a high school, rather than higher or lower, education. Return migrants from the United States to Mexico are shorter than those who stay. Height is related to a number of indicators of adult health. Results support a role for selection in the Hispanic paradox and demonstrate the importance of education and childhood health as determinants of late-life health in both Mexico and the United States.