RESUMO
STUDY OBJECTIVE: Research suggests that economically disadvantaged neighbourhoods confer an increased risk of depression to their residents. Little research has been reported about the association between ethnic group concentration and depression. This study investigated the association between neighbourhood poverty and neighbourhood percentage Mexican American and depressive symptoms for older Mexican Americans in the south western United States. DESIGN: A population based study of older non-institutionalised Mexican Americans from the baseline assessment (1993/94) of the Hispanic established population for the epidemiologic study of the elderly (H-EPESE) merged with 1990 census data. SETTING: Five south western states in the United States. PARTICIPANTS: 3050 Mexican Americans aged 65 years or older. MAIN RESULTS: There was a strong correlation between the percentage of neighbourhood residents living in poverty and the percentage who were Mexican American (r = 0.62; p<0.001). Percentage neighbourhood poverty and percentage Mexican American had significant and opposite effects on level of depressive symptoms among older Mexican Americans. After adjusting for demographic and other individual level factors, each 10% increase in neighbourhood population in poverty was associated with a 0.763 (95% CI 0.06 to 1.47) increase in CES-D score, while each 10% increase in Mexican American neighbourhood population was associated with a -0.548 (95% CI -0.96 to -0.13) unit decrease in CES-D score among older Mexican Americans residing in their neighbourhoods. CONCLUSIONS: The findings suggest a sociocultural advantage conferred by high density Mexican American neighbourhoods, and suggest the need to include community level factors along with individual level factors in community based epidemiological health studies.
Assuntos
Depressão/etnologia , Americanos Mexicanos/psicologia , Características de Residência , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Depressão/etiologia , Feminino , Humanos , Masculino , Áreas de Pobreza , Fatores de Risco , Meio Social , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
OBJECTIVES: To describe the prevalence of tooth loss, to examine risk factors for having fewer teeth or no teeth, and to describe the use of dental services in an older Mexican-American population. DESIGN: Data from the baseline phase of the Hispanic Established Population for the Epidemiological Study of the Elderly survey conducted from 1993 to 1994, a cross-sectional survey of older Mexican Americans. SETTING: Five southwestern states: Texas, California, Arizona, New Mexico, and Colorado. PARTICIPANTS: 3,050 noninstitutionalized Mexican Americans age 65 to 99. RESULTS: Twenty-seven percent of the sample was completely edentulous and 22% reported visiting or speaking with a dental care professional in the preceding year. Logistic regression analyses showed that being older or being female was significantly associated with tooth loss, adjusting for education, income, smoking status, and diabetes mellitus. Current smokers (odds ratio (OR) = 1.69; 95% CI = 1.31-2.20) and diabetics (OR = 1.53; 95% CI = 1.27-1.84) were more at risk for tooth loss, as were persons of lower socioeconomic status. CONCLUSIONS: The prevalence of tooth loss and use of dental services in this population of older Mexican Americans is lower than what has been previously found among older people in the general population.
Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Perda de Dente/etnologia , Perda de Dente/etiologia , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Arizona/epidemiologia , California/epidemiologia , Colorado/epidemiologia , Estudos Transversais , Inquéritos de Saúde Bucal , Complicações do Diabetes , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Modelos Logísticos , Masculino , Avaliação das Necessidades , New Mexico/epidemiologia , Razão de Chances , Vigilância da População , Prevalência , Fatores de Risco , Fumar/efeitos adversos , Fatores Socioeconômicos , Texas/epidemiologiaRESUMO
OBJECTIVE: To estimate the impact of self-reported diagnosis of arthritis at baseline on the two year incidence of limitation in activities of daily living and instrumental activities of daily living in initially non-disabled Mexican-American elderly. DESIGN: Longitudinal study. SETTING Southwestern United States (Texas, New Mexico, Colorado, Arizona and California). SUBJECTS: A probability sample of 2,167 non-institutionalized Mexican-American men and women, aged 65 or older. MEASURES: Having ever been told by a doctor that a subject had arthritis, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), depressive symptomatology, presence of chronic diseases (diabetes mellitus, heart attack, stroke, cancer), and body mass index (BMI). RESULTS: Among non-disabled persons at baseline, 11.2% of subjects with arthritis reported at least one ADL limitation after two years, compared to 6.9% of subjects without arthritis. Similarly, among non-disabled persons at baseline, 34.7% of subjects with arthritis reported at least one IADL limitation after two years, compared to 27.0% of subjects without arthritis. In logistic regression analysis, depression, diabetes, and arthritis were found to be predictive of the development of ADL disability, controlling for sociodemographic variables. Depression was the only condition that significantly predicted IADL disability. CONCLUSIONS: Subjects with arthritis were more likely to develop ADL and IADL disability over a two-year period than those without arthritis.
Assuntos
Atividades Cotidianas , Artrite , Americanos Mexicanos , Idoso , Artrite/etnologia , Avaliação da Deficiência , Feminino , Humanos , Estudos Longitudinais , MasculinoRESUMO
BACKGROUND: The purpose of this analysis was to examine the differential impact of performance-based and self-reported lower body measures on 2-year mortality in Mexican American elderly persons. METHODS: Data employed are from the Hispanic Established Population for Epidemiological Studies of the Elderly, a probability survey of 3050 community-dwelling Mexican Americans aged 65 and older from the five Southwestern states interviewed in 1993 and 1994. Of the baseline sample with complete data, 198 persons were confirmed deceased 2 years later. A three-task, performance-based, lower body function measure consisting of a short walk, balance, and repeated chair stands tests was used. Self-reported lower body function was measured by a 4-item Activities of Daily Living (ADL) measure involving the lower body. RESULTS: The three-task, lower body function measure was a significant predictor of 2-year mortality. The short walk alone was as predictive as the summary measure. The predictive ability of both measures was minimally reduced by the inclusion of the self-reported ADL measure and life-threatening medical conditions. Finally, the ADL measure was not a significant predictor of mortality with all the other variables in the analysis. CONCLUSION: Objective measures of lower body function were significant predicators of mortality in Mexican American elderly persons, as found in the general population. Unlike previous studies, the ADL measure was not an independent predictor of mortality after controlling for the objective measure and other risk factors. Additional research is needed to address why objective measures of function are such strong predictors of death.
Assuntos
Atividades Cotidianas , Envelhecimento/fisiologia , Americanos Mexicanos , Mortalidade , Equilíbrio Postural , Caminhada , Idoso , Estudos de Coortes , Estado Terminal , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Fatores de RiscoRESUMO
Medical rehabilitation researchers are increasingly interested in investigating complex, multivariate problems. Logistic regression analysis is a statistical tool that may be useful in exploring the relationship between multiple explanatory factors and a categorical outcome. The purpose of this article is to describe logistic regression analysis in nontechnical terms.
Assuntos
Modelos Logísticos , Reabilitação/estatística & dados numéricos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Análise Multivariada , Razão de Chances , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Sudoeste dos Estados Unidos/epidemiologiaRESUMO
The objective of this analysis was to determine the prevalence of obesity and its association with selected medical conditions in a non-institutionalized elderly Mexican-American population. Data employed are from a representative sample of 3050 elderly Mexican Americans from the five Southwestern states: Texas, California, Colorado, New Mexico, and Arizona. Complete Body Mass Index (BMI) data were available for 2769 individuals. The in-home survey obtained socio-demographic data, anthropometric measurements, including height and weight, blood pressure readings, self-reported health conditions and depressive symptomatology. It was found that 23% of men and 35% of women were obese (BMI > or =30 kg/m2). Using a weighted logistic regression model, a BMI of > or =26 kg/m2 was associated with a significantly higher risk of diabetes; a BMI of > or =30 kg/m2 was significantly associated with arthritis and measured hypertension and a BMI<22 kg/m2 was associated with a higher likelihood of self-reported cancer. In addition, the prevalence of obesity was found to be much higher in this elderly Mexican-American population than in the general population.
Assuntos
Envelhecimento/fisiologia , Americanos Mexicanos , Obesidade/etnologia , Obesidade/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Nível de Saúde , Humanos , Masculino , Prevalência , Classe Social , Sudoeste dos Estados UnidosRESUMO
BACKGROUND: Disability measures among elderly non-Hispanic White populations have traditionally been associated with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). More recently, performance-based measures have increasingly been used to predict the onset of disability in initially nondisabled elderly populations. METHODS: We used data from two waves (1993-94 and 1995-96) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (EPESE) to assess the degree with which lower mobility performance measures predict future disability in a representative sample of older Mexican Americans from the Southwestern United States. RESULTS: Performances on an 8-foot walk, repeated chair stands, and standing balance among nondisabled subjects at baseline were significantly associated with the onset of ADL and lower body disability 2 years later, controlling for age, gender, and the presence of medical conditions. The results were significant for each performance measure and for a measure combining all three. CONCLUSION: This study offers further evidence that performance-based measures of lower body function are able to predict future disability in older Mexican Americans, as has been found with other elderly populations. These measures were able to detect changes over a relatively short period of time (2 years). In addition, the study found that the short (8-foot) walk was the most sensitive measure in predicting future disability.