The disablement process among elderly Puerto Ricans: Findings from the Boston Puerto Rican Center on Population Health and Health Disparities

Abstract

Puerto Ricans on the U.S. mainland have been shown to have excess disability. We examined the prevalence of impairment (handgrip strength ≤ 22kg), functional limitation (summary score of timed chair stands, gait, foot taps and balance, ranging from 0=most to 4=least limitation), and disability (self-reported difficulty with ≥1 Activity of Daily Living) in Puerto Rican adults 45–75 years of age living in Massachusetts. 73% were women; 53% had <8thgrade education; and mean income was $17,000±$19,000.50% were impaired and had some functional limitation; 73% reported some degree of disability. Functional ability was associated with strength (r= 0.28) and disability (r= −0.27), P<0.001. Using logistic regression, obesity, hypertension, arthritis, depression, diabetes, and self-reported heart disease were associated with 2–4x greater likelihood of disability, after adjusting for age, sex, education, income, smoking, alcohol use, and estimated total energy expenditure. Low serum albumin and high C-reactive protein, glycosylated hemoglobin, triglycerides, glucose and insulin concentrations were also associated with disability. This study illustrates the magnitude of the disablement process in Puerto Ricans. Further studies are needed to define and intervene on specific factors that contribute to this important health disparity. Support: NIH P01-AG02339, GCRC M01 RR000054, USDA CRIS 51530-007-02A