Abstract
BackgroundMore than six million American Indians live in the United States, and an estimated 1.6 million will be aged ≥65 years old by 2050 tripling in numbers since 2012. Physical functioning and related factors in this population are poorly understood. Our study aimed to assess lower body functioning and identify the prevalence and correlates of “good” functioning in a multi-tribe, community-based sample of older American Indians.MethodsAssessments used the Short Physical Performance Battery (SPPB). “Good” lower body functioning was defined as a total SPPB score of ≥10. Potential correlates included demographic characteristics, study site, anthropometrics, cognitive functioning, depressive symptomatology, grip strength, hypertension, diabetes mellitus, heart disease, prior stroke, smoking, alcohol use, and over-the-counter medication use for arthritis or pain. Data were collected between 2010 and 2013 by the Cerebrovascular Disease and Its Consequences in American Indians Study from community-dwelling adults aged ≥60 years (n = 818).ResultsThe sample’s mean age was 73 ± 5.9 years. After adjustment for age and study site, average SPPB scores were 7.0 (95% CI, 6.8, 7.3) in women and 7.8 (95% CI, 7.5, 8.2) in men. Only 25% of the sample were classified with “good” lower body functioning. When treating lower body functioning as a continuous measure and adjusting for age, gender, and study site, the correlates of better functioning that we identified were younger age, male gender, married status, higher levels of education, higher annual household income, Southern Plains study site, lower waist-hip ratio, better cognitive functioning, stronger grip strength, lower levels of depressive symptomatology, alcohol consumption, and the absence of hypertension, diabetes mellitus, and heart disease. In our fully adjusted models, correlates of “good” lower body functioning were younger age, higher annual household income, better cognitive functioning, stronger grip, and the absence of diabetes mellitus and heart disease.ConclusionsThese results suggest that “good” lower body functioning is uncommon in this population, whereas its correlates are similar to those found in studies of other older adult populations. Future efforts should include the development or cultural tailoring of interventions to improve lower body functioning in older American Indians.
Highlights
More than six million American Indians live in the United States, and an estimated 1.6 million will be aged ≥65 years old by 2050 tripling in numbers since 2012
Data source Our data were collected as part of the Cerebrovascular Disease and its Consequences in American Indians (CDCAI) Study known as the Strong Heart Stroke Study
After adjustment for age and study site, average Short Physical Performance Battery (SPPB) scores were 7.0 in women and 7.8 in men, and scores for the balance, gait, and chair stand tasks declined with increasing age
Summary
More than six million American Indians live in the United States, and an estimated 1.6 million will be aged ≥65 years old by 2050 tripling in numbers since 2012. More than six million American Indians live in the United States with an estimated 600,000 who are aged ≥65 years old [1]. Two studies that examined the 2000 US Census data demonstrated that older American Indians experience higher rates of disability than their same-aged counterparts of other races and ethnicities [7, 8]. This research found that American Indians aged ≥55 years had higher prevalence of self-reported disability than same-aged Whites (functional limitation: 36% vs 25%; mobility disability: 21% vs 17%; and, self-care disability: 12% vs 9%) [7]. The second study examined American Indians who were aged ≥65 years and the researchers found that 58% had a disability compared to 42% in all other racial/ethnic groups aged ≥65 years [8]
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