Older Mexican Research Articles

Glycemic Control and Bone Turnover in Older Mexican Americans with Type 2 Diabetes.

Altered bone quality, caused by underlying metabolic changes of type 2 diabetes (T2D), has been hypothesized to cause altered bone strength and turnover leading to increased fracture risk in T2D patients. Current understanding about changes in bone turnover markers in T2D patients is mainly based on studies focused on Caucasian men and women. However, Hispanic populations have the highest prevalence of both T2D and osteoporosis in the US. We investigated associations of glycemic control (in terms of glycated hemoglobin [HbA1c]) and bone turnover rate in 69 older (≥50 years) Mexican American Cameron County Hispanic Cohort (CCHC) participants with T2D. Multivariable analyses were conducted to assess the associations between HbA1c (%), serum osteocalcin (OC), and serum sclerostin. In agreement with published reports from other racial/ethnic populations, our study found that lower bone turnover (indicated by lower serum OC) occurred in Mexican American men with T2D who had poorer glycemic control. For the women in our study, we found no significant association between glycemic control and OC. In contrast, HbA1c was positively associated with sclerostin for women, with near significance (p = 0.07), while no association was found in men. We recommend screening Mexican American individuals with T2D, specifically those with poor glycemic control, for bone loss and fracture risk.

Association Between Immigration History and Inflammatory Marker Profiles Among Older Adult Mexican Americans

Association Between Immigration History and Inflammatory Marker Profiles Among Older Adult Mexican Americans

Factor structure and measurement invariance of a neuropsychological test battery designed for assessment of cognitive functioning in older Mexican Americans

IntroductionThe present study sought to investigate the measurement invariance of commonly used neuropsychological tests in an ethnically (Hispanic vs. non-Hispanic) and linguistically (Spanish vs. English) diverse sample. MethodsParticipants were 736 middle-aged and older adults (MAge = 62.1, SD = 9.1) assessed at baseline. Measurement invariance testing was performed using multiple-group confirmatory factor analysis. ResultsA five-factor model (memory, attention/executive functioning/processing speed, language, visuospatial, and motor) fit the data well (CFI = 0.979, RMSEA = 0.047) and the composite reliability of the factors ranged from .76 (visuospatial) to .97 (motor). The five-factor model was found to possess strict measurement invariance for ethnicity and language without a decrement in fit compared to a strong (scalar) invariance model (ΔCFI = .000, ΔRMSEA = .002). DiscussionThese results indicate that a five-factor model is suitable for estimating cognitive functioning in Mexican Americans and non-Hispanic whites without bias by ethnicity or language.

Sarcopenia, But Not Sarcopenic Obesity, is Associated with Clinically Significant Depressive Symptoms in Older Mexican Adults

Background: Sarcopenia and obesity have a high prevalence in Mexico. Evidence suggests that there is an association between these disorders and clinically significant depressive symptoms. Objective: The aim of the study is to provide the rate and association of depressive symptoms in subjects with sarcopenia and sarcopenic obesity in elderly Mexican. Methods: This study is a cross-sectional analysis of data obtained from the FraDySMex study conducted in Mexico City (n=513). Depressive symptoms were assessed with the short version of the Center for Epidemiological Studies- Depression scale, and a cut-off point ≥ 5 indicated the presence of clinically significant depressive symptoms. A body mass index ≥ 30 defined obesity. Sarcopenia was assessed with the SARC-F questionnaire; a score ≥ 4 indicated the presence of sarcopenia. Sarcopenic obesity was defined as obesity along with sarcopenia. Two models were used to determine the association: one model assessed sarcopenia and depressive symptoms; the other one assessed them with sarcopenic obesity. Results: The analysis included 513 subjects, and the mean age of the subjects was 71.7 ± 9.4; 80.1% were female. The prevalence of CSDS, sarcopenia and sarcopenic obesity was 40.5%, 10% and 7.9%, respectively. Sarcopenia was associated with depressive symptoms (OR 2.64, 95% CI 1.35–5.14, p=0.004), but sarcopenic obesity was not associated with them (OR 1.86, 95% CI 0.89–3.89, p=0.09). Conclusion: Our study found that subjects with only sarcopenia were more likely to have depressive symptoms than subjects with sarcopenic obesity. However, properly prospective studies are needed to better understand this association.

Cognitive decline, mortality, and organophosphorus exposure in aging Mexican Americans

BackgroundCognitive impairment is a major health concern among older Mexican Americans, associated with significant morbidity and mortality, and may be influenced by environmental exposures. ObjectivesTo investigate whether agricultural based ambient organophosphorus (OP) exposure influences 1) the rate of cognitive decline and mortality and 2) whether these associations are mediated through metabolic or inflammatory biomarkers. MethodsIn a subset of older Mexican Americans from the Sacramento Area Latino Study on Aging (n = 430), who completed modified mini-mental state exams (3MSE) up to 7 times (1998–2007), we examined the relationship between estimated ambient OP exposures and cognitive decline (linear repeated measures model) and time to dementia or being cognitively impaired but not demented (CIND) and time to mortality (cox proportional hazards model). We then explored metabolic and inflammatory biomarkers as potential mediators of these relationships (additive hazards mediation). OP exposures at residential addresses were estimated with a geographic information system (GIS) based exposure assessment tool. ResultsParticipants with high OP exposure in the five years prior to baseline experienced faster cognitive decline (β = 0.038, p = 0.02) and higher mortality over follow-up (HR = 1.91, 95% CI = 1.12, 3.26). The direct effect of OP exposure was estimated at 241 (95% CI = 27–455) additional deaths per 100,000 person-years, and the proportion mediated through the metabolic hormone adiponectin was estimated to be 4% 1.5–19.2). No other biomarkers were associated with OP exposure. ConclusionsOur study provides support for the involvement of OP pesticides in cognitive decline and mortality among older Mexican Americans, possibly through biologic pathways involving adiponectin.

Associated factors with the use of dentures or reported dental and gum problems with oral prosthesis use among Mexican American older adults

The objective of this study was to determine factors associated with using dental prosthesis or oral problems related to their use among older Mexican Americans of the Hispanic Established Populations for Epidemiologic Studies of the Elderly EPESE) in the United States. A cross-sectional analysis was made with data of 2992 men and women aged 65 years and older inter-viewed during 1993-1994. Forty four % of subjects reported the use of partial or total dental prosthesis. Among those using dental prosthesis, 21% reported problems with teeth or gums when eating. In multivariate analyses, instrumental activities of daily living (IADL) limitations were associated with using dental prosthesis (OR = 1.23, 95% confidence interval - CI =1.04-1.45). Also, among subjects using dental pros-thesis, increased depressive symptoms (OR = 1.42, 95% CI 1.04-1.95) and IADL limitations (OR = 1.58, 95% CI 1.15-2.17) were associated with problems with teeth or gums when eating. In conclusion, factors usually affecting quality of life in older persons such as functional dependency and depression are associated with using dental prosthesis or oral problems with teeth or gums when eating.

The Impact of 10-Year Physical Activity Changes on 7-Year Mortality in Older Mexican Americans.

We investigated the association between 10 years of change in physical activity (PA) levels and 7-year all-cause mortality. Mexican American adults aged 67 and older (N = 803) participating in the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/1996-2012/2013) were included. All-cause mortality was our outcome. Participants were divided into 4 groups based on their difference in overall PA between 1995/1996 and 2005/2006 measured by the Physical Activity Scale for the Elderly. Participants were classified as having unchanged low PA (n = 339), decreased activity (n = 233), unchanged high activity (n = 166), and increased activity (n = 65). Change in the frequency of PA domains was also investigated. PA domains included leisure, household, sedentary, and walking activities. After controlling for all covariates, results from the Cox proportional hazards regression found a 43% lower mortality risk in the increased PA group (hazards ratio = 0.57; 95% confidence interval, 0.34-0.97) compared with the unchanged low PA group. In the entire sample, a significantly lower mortality risk was also present among walking (hazards ratio = 0.88) and household (hazards ratio = 0.88) activities. Our results suggest that, independent of other factors, increasing PA is most protective of mortality among older Mexican Americans.

Healthcare professionals' perceptions of neglect of older people in Mexico: A qualitative secondary analysis.

To describe healthcare professionals' perceptionsof neglect of older people in Mexico. Mistreatment of older people, particularly neglect, has emerged as a significant public health concern worldwide. However, few studies have been conducted to examine neglect of older people in low- and middle-income countries. Most research has focused on estimating the prevalence of neglect in older populations with little emphasis on the perceptions of healthcare professionals and their role in addressing neglect of older people. Qualitative secondary analysis. The parent study consisted of nine focus groups conducted with healthcare professionals at five public hospitals in Mexico. The purpose of the parent study was to perform a needs assessment to determine the feasibility of adapting the Nurses Improving Care for Healthsystem Elders programme to Mexico. A qualitative secondary analysis with directed content analysis approach was used to extract data related to neglect of older people. A total of 89 participants representing healthcare professionals from several disciplines were interviewed. Three themes emerged: (i) The main point is not here; (ii) We feel hopeless; and (iii) We need preparation. Participants reported distress and hopelessness related to neglect of older people. Lack of community-based resources was noted as contributing to neglect. Increased education regarding care of older people for both caregivers and healthcare professionals and greater interdisciplinary collaboration were identified as potential solutions to combat neglect. Community-based services and resource allocation need to be re-evaluated to improve the care of older Mexicans. Interdisciplinary models of care should be developed to address concerns related to neglect of older people. Neglect negatively impacts healthcare professionals' ability to adequately care for older patients. There is a need to invest in community-based services and models of care to address these concerns.

Relationship between Social Support Networks and Physical Functioning in Older Community-Dwelling Mexicans.

Some studies have demonstrated the relationship between social support networks (SSNs) and health status. In this sense, it has been considered that physical and mental functioning is a key indicator of the health in the age people. The aim of this study was to determine the association between social support networks and physical functioning. A cross-sectional study was carried out including a convenience sample of 150 older community-dwelling Mexicans. We assessed the familial, extra-familial and institutional SSNs; social contacts; the activities of daily living (ADL); the instrumental activities of daily living (IADLs); and physical functioning task (PFT) performance among study participants. Of the 150 older subjects, 53 reported living alone (35%), 113 (75%) reported having few SSNs, and 37 (25%) reported having enough SSNs. Persons with few familial SSNs were at increased odds of demonstrating dependence in at least one of the ADL (OR = 3.25, 95% CI 1.06–9.92, p < 0.05). Likewise, persons with few institutional SSNs and few social contacts were at increased odds of demonstrating dependence in at least one of the IADL (OR = 6.96, 95% CI 1.57–30.7, p < 0.01; OR = 5.02, 95% CI 1.44–17.5, p < 0.01, respectively). We also observed that having few extra-familial SSNs and few social contacts were the main risk factors for PFT dependence, with ORs of 3.70 (95% CI 1.21–11.2, p < 0.05) and 3.85 (95% CI 1.10–13.5, p < 0.05), respectively. Our findings suggest that having few SSNs could be a significant risk factor for reduced physical functioning in older adults.

RETRACTED: Association Between Frailty and Cognitive Impairment: Cross-Sectional Data From Toulouse Frailty Day Hospital

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editors-in-Chief. The authors have plagiarized part of a paper that had already appeared in Samper-Ternent R, Al Snih S, Raji MA, et al. Relationship Between Frailty and Cognitive Decline in Older Mexican Americans. J Am Geriatr Soc 2008; 56(10): 1845-1852. One of the conditions of submission of a paper for publication is that authors declare explicitly that their work is original and has not appeared in a publication elsewhere. Re-use of any data should be appropriately cited. As such this article represents a severe abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.

Physical activity modifies the influence of apolipoprotein E ε4 allele and type 2 diabetes on dementia and cognitive impairment among older Mexican Americans

IntroductionThe etiologies of dementia are complex and influenced by genetic and environmental factors including medical conditions. MethodsWe used Cox regression model to estimate the individual and joint effects of physical activity (PA), apolipoprotein E (APOE) ε4, and diabetes status on risk of dementia and cognitive impairment without dementia (CIND) among 1438 cognitively intact Mexican American elderly who were followed up to 10 years. ResultsThe risk of developing dementia/CIND was increased more than threefold in APOE ε4 carriers or diabetics with low levels of PA compared with ε4 noncarriers or nondiabetics who engaged in high PA (ε4: hazard ratio [HR] = 3.44, 95% confidence interval [CI] = 1.85–6.39; diabetes: HR = 3.11, 95% CI = 1.87–5.18); the presence of all three risk factors increased risk by nearly 10-fold (HR = 9.49, 95% CI = 3.57–25.3). DiscussionPA in elderly Hispanics protects strongly against the onset of dementia/CIND, especially in APOE ε4 carriers and those who have diabetes.

THE RELATIONSHIP BETWEEN SUBJECTIVE MEMORY COMPLAINTS AND AFFECTIVE SYMPTOMS IN MEXICAN AMERICANS WITH MILD COGNITIVE IMPAIRMENT

Subjective memory complaints (SMC) are common in older adults. Adults with SMC may be at risk for developing cognitive impairment. SMC can be found in older adults that are normal and those that have mild cognitive impairment (MCI). SMC had been found to be related to affective symptoms. This study examined emotional measures in older Mexican Americans (MA) who were normal or had MCI. A subgroup of MA participants N=559 was chosen from the Health and Aging Brain Study. MA were classified as normal without subjective memory complaints (SMC) N=232, normal with SMC N= 183, and MCI without SMC N =48 and MCI with SMC N= 52. A one-way analysis of variance (ANOVA) was calculated for Geriatric Depression Scores (GDS), Beck Anxiety Inventory (BAI) and the Penn State Worry Questionnaire (PSQW). ANOVAs were calculated (p< .05) to compare those with SMC and those without for the entire sample along with separate analyses for the NC groups and the MCI groups. A significant difference was found between those with SMC compared to those without SMC on GDS F (3,510) =22.572, p=.000, on BAI, F (3,505) =15.369, p=.000 and PSQW, F (3,509) = 15.336, p=.000. When analyzed separately it was found that for both normal and MCI groups there were significant differences between those with SMC and those without on the three emotional measures. Normal - GDS F (1,412) =29.691, p=.000, on BAI, F (1, 408) =40.382, p=.000 and PSQW, F (1,412) = 36.948, p=.000; MCI - GDS F (1, 98) = 13.032, p=.000, on BAI, F (1, 97) =4.874, p=.030 and PSQW, F (1, 97) = 14.794, p=.000). The results show that there are significant differences in the GDS, BAI, and PSQW scores in Mexican Americans with and without SMC. Understanding the relationship between SMC and affective symptoms will lead to the development of targeted interventions to improve cognition. The nature of the relationship between MCI and SMC is unclear and warrants future study because approximately half of the MCI group did not have SMC.

Prevalence of sarcopenia in community‐dwelling older people of Mexico City using the EGWSOP (European Working Group on Sarcopenia in Older People) diagnostic criteria

AbstractBackgroundThe aim of this study is to determine the prevalence of sarcopenia in community‐dwelling older people living in Mexico City using the EGWSOP (European Working Group on Sarcopenia in Older People) diagnostic criteria that include muscle mass, muscle strength and physical performance.MethodsThe sample population was based on older people (≥60 years) affiliated with the Mexican Institute of Social Security in Mexico City. Data were derived from the database of the “Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults” (COSFOMA). Sarcopenia was diagnosed using the EGWSOP criteria: gait speed (4 m) &lt;0.8 m/s; handgrip strength (using a dynamometer) &lt;20 kg in women or &lt;30 kg in men, and muscle mass index (MMI) &lt;6.1 kg/m2 in women or &lt;8.5 kg/m2 in men (using bioelectrical impedance analysis, BIA).ResultsThousand hundred seventy‐seven subjects were included (median age 68.4 years, 60.2% women). 20.5% had low gait speed (19.1% women and 22.6% men); 62.4% had low handgrip strength (69.9% women and 51.2% men) and 12.3% had low muscle mass (9.9% women and 16.0% men). Only 9.9% of older people with sarcopenia (9.0% women and 11.1% men): 1.9% with severe sarcopenia (1.4% women and 2.6% men) and 8.0% with moderate sarcopenia (7.6% women and 8.5% men).ConclusionsSarcopenia is present in one of ten community‐dwelling older people residing in Mexico City. According to what has been reported in the literature, the prevalence of sarcopenia in older Mexican adults is similar to the community‐dwelling population.

DEPRESSIVE SYMPTOMS IN CHILD CAREGIVERS OF VERY OLD MEXICAN AMERICANS

To study the effects of disability, cognitive impairment, and neuropsychiatric disturbance among older Mexican Americans on depressive symptoms in their children caregivers. This study utilizes dat...

Neighborhood perception and self-rated health among Mexican American older adults.

The aim of the present study was to assess the relationship between neighborhood perception and poor self-rated health among older Mexican Americans, adjusting for important background characteristics, such as neighborhood ethnic composition and other health conditions. Drawing on the 2004-2005 Hispanic Established Populations for the Epidemiologic Study of the Elderly data (n=1780), the present study used logistic regression to examine the effects of neighborhood perception on poor self-rated health of older Mexican Americans. The results show that participants with a greater positive perception of their neighborhood were less likely to report poor self-rated health, controlling for both socioeconomic status and health status covariates. The findings suggest that positive neighborhood perception serves as an important protective factor in overall health. Geriatr Gerontol Int 2017; 17: 2559-2564.

The Association Between Handgrip Strength and Diabetes on Activities of Daily Living Disability in Older Mexican Americans.

The aim of this study is to determine the independent and joint effects of muscle weakness and diabetes on incident activities of daily living (ADL) disability in older Mexican Americans. A subsample of 2,270 Mexican Americans aged at least 65 years at baseline were followed for 19 years. Handgrip strength was normalized to body weight (normalized grip strength [NGS]). Weakness was defined as NGS ≤0.46 in males and ≤0.30 in females. Diabetes and ADL disability were self-reported. Compared with participants that were not weak and did not have diabetes, those that had diabetes only, were weak only, and were both weak and had diabetes experienced a 1.94 (95% confidence interval [CI] = [1.89, 1.98]), 1.17 (CI = [1.16, 1.19]), and 2.12 (CI = [2.08, 2.16]) higher rate for ADL disability, respectively. Muscle weakness and diabetes were independently and jointly associated with higher rates for ADL disability in older Mexican Americans.

Frailty in community-dwelling older adults: association with adverse outcomes.

BackgroundThe study of frailty is important to identify the additional needs of medical long-term care and prevent adverse outcomes in community dwelling older adults. This study aimed to determine the prevalence of frailty and its association with adverse outcomes in community dwelling older adults.MethodsA cross-sectional study was carried out from April to September 2014. The population sample was 1,252 older adults (≥60 years) who were beneficiaries of the Mexican Institute of Social Security (IMSS) in Mexico City. Data were derived from the database of the “Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults” (COSFOMA). Operationalization of the phenotype of frailty was performed using the criteria of Fried et al (weight loss, self-report of exhaustion, low physical activity, slow gait, and weakness). Adverse outcomes studied were limitation in basic activities of daily living (ADLs), falls and admission to emergency services in the previous year, and low quality of life (WHOQOL-OLD).ResultsFrailty was identified in 20.6% (n=258), pre-frailty in 57.6% (n=721), and not frail in 21.8% (n=273). The association between frailty and limitations in ADL was odds ratio (OR) =2.3 (95% confidence interval [CI] 1.7–3.2) and adjusted OR =1.7 (95% CI 1.2–2.4); falls OR =1.6 (95% CI 1.2–2.1) and adjusted OR =1.4 (95% CI 1.0–1.9); admission to emergency services OR =1.9 (95% CI 1.1–3.1) and adjusted OR =1.9 (95% CI 1.1–3.4); low quality of life OR =3.4 (95% CI 2.6–4.6) and adjusted OR =2.1 (95% CI 1.5–2.9).ConclusionApproximately 2 out of 10 older adults demonstrate frailty. This is associated with limitations in ADL, falls, and admission to emergency rooms during the previous year as well as low quality of life.

Muscle Weakness Increases the Risk of Incident Diabetes in Older Mexican Americans

Muscle Weakness Increases the Risk of Incident Diabetes in Older Mexican Americans

Muscle Weakness and Diabetes Jointly Exacerbate the Rate of Functional Disability among Older Mexican Americans

Muscle Weakness and Diabetes Jointly Exacerbate the Rate of Functional Disability among Older Mexican Americans

Cognition and Context: Rural-Urban Differences in Cognitive Aging Among Older Mexican Adults.

To describe differences in cognitive functioning across rural and urban areas among older Mexican adults. We include respondents aged 50+ in the 2012 Mexican Health and Aging Study (MHAS). Cognitive functioning by domain is regressed as a function of community size. The role of educational attainment in explaining rural/urban differences in cognitive functioning is examined. Respondents residing in more rural areas performed worse across five cognitive domains. The majority, but not all, of the association between community size and cognitive functioning was explained by lower education in rural areas. Respondents residing in more rural areas were disadvantaged in terms of cognitive functioning compared with those residing in more urban areas. Poorer cognitive functioning in late life may be the result of historical educational disadvantage in rural areas or selection through migration from rural to urban regions for employment.