Older Mexican Research Articles

Economic disadvantage during childhood, obesity, and diabetes across three birth cohorts of older Mexicans.

Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in three cohorts of Mexican adults. Data on those 60-69 years old from the 1930-39, 1940-49, and 1950-59 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent reports. Supplementary analyses using HbA1c as a criterion for diabetes were conducted. A regression-decomposition approach was implemented. Logistic regression models included adjustments for sociodemographic characteristics and access to medical care. Diabetes prevalence was 23% overall and 11%, 25%, and 26% in the 1930-39, 1940-49, and 1950-59 cohorts, respectively. EDDC declined across successive cohorts, while the prevalence of overweight/obesity at age 50 increased. EDDC and overweight/obesity were associated with higher odds of reporting diabetes. A scenario that eliminates disadvantaged EDDC reduced diabetes prevalence by 11% in a pooled sample, while eliminating overweight/obesity reduced it by 30%. Overweight/obesity explained 42% of the rise in diabetes prevalence between the 1930-39 and 1950-59 cohorts. Improvement in EDDC explained 18% of the rise in diabetes prevalence between 1930-39 and 1950-59 cohorts. High body weight across Mexican birth cohorts seemed to offset the potential benefits from improvements in childhood conditions on adult diabetes risk.

The Role of Inflammation and Psycho-Behavioral Factors as Mediators Between Acculturation and Time to Incident Dementia Among Older Mexican Americans.

The mechanisms through which acculturation influences the onset of cognitive impairment and dementia are not well understood, especially among older Hispanics. To investigate whether inflammation and psycho-behavioral factors mediate the relationship between acculturation and incident dementia among older Mexican Americans. We analyzed the Sacramento Area Latino Study on Aging (1998-2007, SALSA), a longitudinal study (N = 1,194) with 10 years of follow-up, and used g-computation for mediation analysis with pooled logistic regression to evaluate whether acculturation (assessed by the Revised Acculturation Rating Scale for Mexican Americans [ARSMA-II]) affected dementia or cognitive impairment but not dementia (CIND) through inflammation (i.e., interleukin 6 [IL-6], tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein [hs-CRP]), smoking, alcohol consumption, and depressive symptoms. The potential mediators were assessed at baseline. The 10-year average adjusted risk ratio (aRR) for the effect of high U.S. acculturation and dementia/CIND was 0.66, 95% CI (0.36, 1.30). The indirect effects were: IL-6 (aRR = 0.98, 95% CI (0.88, 1.05)); TNF-α (aRR:0.99, 95% CI (0.93, 1.05)); hs-CRP: (aRR = 1.21, 95% CI (0.84, 1.95)); current smoking: aRR = 0.97, 95% CI (0.84, 1.16); daily/weekly alcohol consumption (aRR = 1.00, 95% CI (0.96, 1.05)); and depressive symptom score (aRR = 1.03, 95% CI (0.95, 1.26)). Hs-CRP yielded a proportion mediated of -26%, suggesting that hs-CRP could suppress the potential effect of high U.S. acculturation. The other factors explored resulted in little to no mediation. The effect of acculturation on time to incident dementia/CIND varied over time. Our study suggests that inflammation could suppress the effect between high U.S. acculturation and dementia risk.

Cardiovascular Risk Factors as Predictors of Nutritional Status in Older Mexican Adults.

Aging is commonly accompanied by increased cardiovascular risk and diet plays a crucial role in health condition. The aim of this study was to determine cardiovascular risk factors as predictors of nutritional risk in Mexican older adults. A cross-sectional study on Mexican patients aged ≥60 years with cardiovascular risk factors affiliated with a medical unit in Northeast Mexico was performed from July to December 2021. The nutritional risk evaluations were performed using the Mini Nutritional Assessment (MNA) questionnaire. After a multivariate analysis, the cardiovascular risk factors identified as independent predictors of risk of malnutrition were hypertriglyceridemia (adjusted OR (AOR): 1.8; 95% CI: 1.03-3.14; p = 0.04) and systolic hypertension I (AOR: 2.28; 95% CI: 1.04-5.02; p = 0.041); age over 80 years (AOR: 5.17; 95% CI: 1.83-14.65, p = 0.002) and elementary school education (AOR: 2.34; 95% CI: 1.20-4.55; p = 0.013) were also related. The cross-sectional design and single-center approach of this study limits the generalizability of the results; however, conducting timely evaluations of blood pressure, triglyceride levels, and risk of malnutrition using the MNA tool for patients aged ≥60 years could prevent illness and reduce mortality within this population group.

Vision Impairment and Activities of Daily Living Disability among Older Mexican Americans: Nativity Differences

Vision Impairment and Activities of Daily Living Disability among Older Mexican Americans: Nativity Differences

Vision Impairment and Frailty Among Mexican American Older Adults: A Longitudinal Study.

We examined the relationship between vision impairment (VI) and new-onset frailty among non-frail Mexican American older adults (≥70years) at baseline and determined the differential impact of VI on each frailty criteria. Data were from an 18-year prospective cohort from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1998/1999, N = 1072 to 2016, N = 175). Frailty was defined as ≥3 criteria: unintentional weight loss of >10 pounds, weakness, exhaustion, low physical activity, and slowness. VI was defined as difficulty in recognizing a friend at arm's length's away, across the room, or across the street. We found that participants with VI (near or distant) and distant VI had greater odds of frailty (near or distant VI, OR = 1.89, 95% CI = 1.30-2.73 and distant VI, OR = 1.95, 95% CI = 1.34-2.86, respectively) after controlling for covariates over time. Early screening (optimal management) of VI may prevent or delay onset of frailty among older Mexican Americans.

The Effect of Financial Strain on the Health Outcomes of Older Mexican-Origin Adults: Findings From the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE).

Predictors of health across the life-course do not maintain the same significance in very late life and the role of financial strain in health outcomes of very old adults remain unclear. Data from adults aged 74 + in waves 5 and 7 of the Hispanic Established Population for the Epidemiological Study of the Elderly (n = 772) study was used to evaluate the role of financial strain on the health of older Mexican Americans who have the highest poverty rate of any racial or ethnic group in the United States. We evaluate the association between episodic (one wave) and persistent financial strain (two waves), with follow-up health outcomes (self-rated health, ADL (limitations in activities of daily living)/IADL (limitations in instrumental activities of daily living) disability, and depressive symptoms). Adults with persistent strain were twice as likely to experience depressive symptoms and three times more likely to experience IADL limitations than the unstrained. Our findings highlight the role of stress proliferation and allostatic load processes leading to deteriorated health over time.

SLEEP DISORDERS AND MUSCLE STRENGTH IN OLDER MEXICAN AMERICANS: SEX DIFFERENCES

Abstract We used data from the Hispanic Established Population for the Epidemiological Study for the Elderly to examine sex differences in the relationship between sleep duration and handgrip strength (HGS) among Mexican Americans aged ≥ 77 years with normal or high HGS (≥ 17 in women and ≥ 27 in men) at baseline over a 9-year period (2007/08 to 2012/13; N=1542). Measures included socio-demographics, sleep duration, HGS (Kg), body mass index, medical conditions, depressive symptoms, physical function, cognitive function, disability, and pain. We categorized sleep duration as ≤ 7, 8, 9, and ≥ 10 hours/night and used linear mixed models to estimate the changes in HGS as a function of sleep duration by sex, adjusting for covariates. Both men and women in the highest sleep duration group (≥10 hours/night) had on average the greatest decline in HGS (1.54 kg and 0.95 kg, respectively) compared to those who slept 8 hours/night, after controlling for all covariates over the follow-up period. Older age, time (years), depressive symptoms, one or more falls in the last year, and low physical function were associated with greater decline in HGS among women. Older age and time (years) were associated with greater decline in HGS among men. In conclusion, longer sleep duration was associated with greater loss of HGS over time in older Mexican Americans. Sleep health promotion and sleep behavioral interventions may reduce the risk of decline in HGS, which has been associated with disability, institutionalization, and mortality in this population.

THE ASSOCIATION OF AIR POLLUTION AND CLIMATE FACTORS WITH DEPRESSIVE SYMPTOMS AMONG OLDER MEXICAN AMERICAN ADULTS

Abstract Air pollution, drought, and extreme heat are associated with elevated depressive symptoms. Older Mexican American adults experience high levels of depressive symptoms compared to other demographic groups, but little is known about the role of environmental factors in depressive symptoms for this population. Mexican American adults are resilient to the harmful health effects of socioeconomic disadvantage, but it is unclear if this resilience extends to air pollution and climate change. This study uses data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) linked to air pollution and climate data from the Centers for Disease Control and Prevention, to assess the association of air pollution (PM2.5 and ozone) and climate factors (drought and extreme heat) with elevated depressive symptoms. We used data from the 2005 H-EPESE which includes Mexican American adults aged 75 and older. We used generalized estimation equations to test the association between air pollution and climate factors and depressive symptoms, adjusting for sociodemographic and health characteristics. Our sample (n=1,699) was 62.0% female with a mean age of 81.6 (standard deviation: 5.0). About 19% of participants reported elevated depressive symptoms. PM2.5 concentration was associated with higher odds of depressive symptoms (odds ratio: 1.11; 95% confidence interval: 1.04, 1.19). Ozone concentration, drought, and extreme heat were not associated with depressive symptoms. Our results suggest PM2.5 is a risk factor for elevated depressive symptoms. It is unclear if older Mexican American adults are resilient to the effects of environmental risk factors relative to other demographic groups.

DO DEPRESSIVE SYMPTOMS MEDIATE SEGREGATION’S IMPACT ON COGNITIVE AGING IN OLDER MEXICAN AMERICANS?

Abstract Segregation in the United States has important implications for cognitive aging among Mexican Americans as a social determinant of health. Because segregation is systemically engrained, identifying more immediately modifiable mechanisms, such as depressive symptoms, that may underly segregation-cognition associations could point to intervention targets to reduce cognitive aging disparities. We used path mediation modeling to test whether depressive symptoms mediated (indirect effect) the segregation-cognition associations. We used H-EPESE data on older Mexican Americans from the first (n=3,050) wave and returning at wave 5 (n=1,167) combined with Census data from the National Neighborhood Data Archive, which provided indicators for county level segregation (isolation, interaction, dissimilarity). Cognition was operationalized as baseline MMSE, MMSE at wave 5, and change between baseline and wave 5. Depressive symptoms were measured by the CESD at baseline. Covariates included age, sex, and years of education. The sample was 58% female with an average age of 73.6 (SD=6.2) and an average 5-years education (SD=3.9). Higher dissimilarity (i.e., less exposure to non-Hispanic Whites) was associated with better baseline (B=.078, SE=.031, p=.012) and wave 5 cognition (B=.130, SE=.037, p<.001), independent of depressive symptoms. More depressive symptoms were associated with worse baseline and wave 5 cognition, independent of segregation indices (CESD B values range from -.063 to -.142, ps <.05). Depressive symptoms did not mediate segregation-cognition associations. Results suggest that there may be an enclave effect that is protective for both depressive symptoms and cognition in older Mexican Americans. Future research should examine additional biopsychosocial mechanisms underlying segregation-cognition associations.

THE JOINT EFFECTS OF PAIN AND ELEVATED DEPRESSIVE SYMPTOMS AMONG MEXICAN AMERICANS AGED 80 AND OLDER

Abstract Pain and depression are common among older Hispanic adults and their combined effects may increase mortality. We examined the joint effects of pain and depressive symptoms on mortality. We used data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2010-2016), which included Mexican Americans aged 80 and older in the Southwestern US. Participants were categorized into four groups based on self-reported pain on weight-bearing and depressive symptoms: no pain or elevated depressive symptoms, pain only, elevated depressive symptoms only, or both pain and elevated depressive symptoms. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression scale. A score of 16 or more was considered elevated depressive symptoms. Cox proportional hazards models were used to estimate the joint relationship of pain and depressive symptoms with mortality. We examined social support as a potential effect modifier. At baseline, 35.9% reported pain only, 8.6% of participants reported elevated depressive symptoms only, and 16.9% reported pain and elevated depressive symptoms (n=836). Over 6 years of follow-up, 46.2% of the sample died. Those with pain and elevated depressive symptoms had 1.41 times the risk of mortality compared to those without pain or elevated depressive symptoms (95% confidence interval: 1.05, 1.09). Having pain or elevated depressive symptoms only was not significantly associated with mortality. Social support was not a significant effect modifier. Our findings highlight the importance of screening for pain and elevated depressive symptoms among older Mexican Americans.

Cross‐cultural adaptation, validity and reliability of the Everyday Cognition Scale in Mexico M‐ECog in Older Adults with Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer’s Dementia

AbstractBackgroundThe Everyday Cognition (ECog) scale was created to assess the functional abilities of older adults across a wide range of abilities between normal aging and dementia. The original ECog was shown to have convergent and divergent external validity. Developed in 2008 by Farias et al and updated in 2021. This scale screens early cognitive alterations such as Subjective Cognitive Decline (SCD), Mild Cognitive Impairment (MCI) and Alzheimer’s dementia (AD) through the decline of basic activities and instruments of daily life (DLA)To establish validity, reliability, and cross‐cultural adaptation of the ECog in Spanish (M‐ECog) to identify: SCD, MCI, and Alzheimer’s‐type dementia in older Mexican adults.Method200 patients and 200 informants in a memory clinic of a third level hospital in Mexico City. Four groups were formed: 50 cognitively healthy (CH), 50 SQD, 50 MCI and 50 AD. The clinical evaluation included: sociodemographic aspects, cognitive status by the Mini‐Mental State Evaluation (MMSE) and Montreal Cognitive Evaluation Spanish version (MoCA‐E). The informants rated the functional status measured through the KATZ and Lawton & Brody scales, as well as the ECog Spanish version (M‐ECog).ResultThe internal consistency of the overall function of the M‐ECog (Cronbach’s alpha) was 0.881. The intraclass correlation coefficient was 0.877 (95% CI, 0.850‐0.902; p<0.001). M‐ECog was significantly correlated with DLA 0.40 (95% CI, 0.320‐0.471; p<0.001), MMSE 0.68; (95% CI, 0.650‐0.710; p<0.001) and MoCA‐E 0.70 (95% CI, 0.620‐0.892; p<0.001). And it differentiated patients with SCD, MCI and AD from CH (p < 0.002). The area under the curve (AUC) for SQD was 0.70 (95% CI, 0.58‐0.82), p < 0.005 with a cut‐off value of 46 points, (Sensitivity (S) 99%, and Specificity (E) of 96%; the AUC for MCI was 0.94 (95% CI, 0.89‐0.99), p < 0.001 with a cut‐off point of 52 points, (S: 97%, E: 27%); and for the dementia group, the AUC was 0.86 (95% CI, 0.79‐0.92), p <0.001 with a cut‐off value of 85 points, with (S: 97%, E: 51%).ConclusionM‐ECog is a valid, reliable, useful instrument that measures daily skills mediated by cognition in older Mexican adults, self‐applicable (patients and informants) with SCD, MCI and Alzheimer’s Dementia

Food Insecurity and Executive Function among Older Mexican Adults: Indirect Effects through Depressive Symptoms

AbstractBackgroundRecent work has linked food insecurity with worse cognitive outcomes, with executive function being a domain affected most consistently. The mechanisms underlying this association are largely unknown and few have investigated how changes in food insecurity over time (never food insecure, newly food insecure, formerly food insecure, or chronically food insecure) relate with cognitive outcomes. Food insecurity is also related with worsening depressive symptoms, which may impact executive function. This study evaluates how changes in food insecurity in late‐life relate with executive function, and whether this association is mediated by depressive symptoms among older adults in Mexico.MethodData includes the 2012‐2015 Mexican Health and Aging Study (MHAS) and 2016 Mex‐Cog subsample of the MHAS (n = 1,581 age 55+). Food insecurity was classified as never food insecure (not food insecure in 2012 or 2015), newly food insecure (food insecure in 2015 but not 2012), formerly food insecure (food insecure in 2012 but not 2015), or chronically food insecure (food insecure in 2012 and 2015). Executive function and depressive symptoms (CES‐D) were obtained from the Mex‐Cog. Direct/indirect (through depression) effects of food insecurity were tested using structural equation modeling with bootstrap confidence intervals controlling for demographic and socioeconomic confounders.ResultApproximately half of the sample were never food insecure, 16% were newly food insecure, 15% were chronically food insecure, and 18% were formerly food insecure. SEM results indicated partial mediation. Significant direct effects were observed, with chronic and former food insecurity related with 0.12 and 0.11 standard deviations lower executive function, respectively, compared to the never food insecure. Both chronic and former food insecurity exhibited significant indirect effects via depressive symptoms with indirect effects making up 21% and 15% of the total effects of chronic and former food insecurity on executive function.ConclusionFood insecurity may represent an important modifiable risk factor for poorer executive function outcomes. Although food insecurity had a direct impact on executive function, part of its detrimental effect was through worsening depressive symptoms. This study highlights the importance of considering experiences of food insecurity over time and the co‐existence of both food insecurity and depressive symptoms.

Depression, Inflammation, and the Moderating Role of Metformin: Results From the Midlife in the United States Study and Sacramento Area Latino Study on Aging.

Depression can promote inflammation and accelerate aging. Metformin, a widely prescribed antidiabetic, has shown promising preclinical evidence of aging-related health benefits, including decreased inflammation. The current study examined whether metformin usage buffers the association between depressive symptoms and inflammatory markers in two large samples of middle-aged and older, primarily White adults, and older Latino adults. Data from the Midlife in the United States Study ( N = 1255) and the Sacramento Area Latino Study on Aging ( N = 1786) included information on medication use, depressive symptoms, and inflammatory markers, namely, interleukin 6 (IL-6), tumor necrosis factor α, and C-reactive protein (CRP). These data were merged into a harmonized sample, and the sample group variable was included in a three-way interaction for analysis. Specifically, in the Midlife in the United States Study sample, metformin buffered the association between depressive symptoms and CRP ( b = -0.029, standard error [SE] = 0.013, p = .007) and IL-6 ( b = 0.21, SE = 0.010, p = .046), whereas no significant association was found with tumor necrosis factor α. Metformin nonusers displayed higher depressive symptoms associated with elevated CRP ( b = 0.01, SE = 0.003, p < .001) and IL-6 ( b = 0.011, SE = 0.003, p < .001), whereas this association was not present among metformin users ( p values > .068). Conversely, in the Sacramento Area Latino Study on Aging sample, metformin use did not show a significant protective link. Results from mostly White, highly educated adults supported a mitigating role of metformin in ties between depression, a well-known behavioral risk factor, and inflammation, a key source of biological aging. However, the benefits did not extend to a large sample of older Mexican Americans. The findings reveal a hidden potential benefit of this therapeutic agent and raise important questions around its health equity. The study was preregistered on OSF ( https://osf.io/c92vw/ ).

A - 2 The Effect of English Language Fluency, Acculturation, and Length of Stay in the U.S. on Cognitive Functioning in Mexican Americans.

Evidence suggests that Hispanic and Latino individuals perform worse on some measures of cognitive functioning than non-Hispanic White individuals. Given this finding, several possible explanations have been posited, including differences in English fluency and acculturation. The purpose of this study was to investigate the effect of English fluency and acculturation on older Mexican American individuals' cognitive testing performance. Participants (M age = 63.44; 66.1% female) were Mexican American (n = 899) community members participating in the Health and Aging Brain Study: Health Disparities study. Information gathered included demographic information, attained education level, language use/fluency, acculturation level, and estimated premorbid functioning (reading score) in addition to cognitive functioning performance (MMSE). Controlling for education and estimated premorbid functioning, both longer stay in the U.S. (β= 1.12, p = 0.006) and more acculturation (β= 1.00, p = 0.035) significantly predicted better cognitive testing performance. Furthermore, after controlling for education and estimated premorbid functioning, using English as a primary language resulted in significantly better testing performance than using Spanish as a primary language and being English fluent (p = 0.006) or non-fluent (p < 0.001). English fluent individuals that used Spanish as their primary language performed significantly better (p < 0.001) than those that were not English fluent and used Spanish as their primary language. Our findings suggest that factors associated with U.S. acculturation, including stay in the U.S. and English fluency, influence cognitive testing performance. Additional cultural considerations and adaptions may be needed for current neuropsychology measures, such as cognitive testing instruments.

THU349 Association Of Non-alcoholic Fatty Liver Disease And Type 2 Diabetes Mellitus - A Cross-Sectional Study

Abstract Disclosure: M. Parvez: None. U.K. Patel: None. Introduction: Nonalcoholic fatty liver disease (NAFLD) and Type 2 diabetes mellitus (T2DM) commonly exist together and have been regarded as a manifestation of metabolic syndrome. But there are limited studies showing prevalence and association of NAFLD with T2DM patients in US populations. Aims and Objective: Primary outcome of the study was to identify the prevalence and association of NAFLD amongst patients with T2DM amongst the US populations. Methods: A cross-sectional study was performed using the National Health and Nutrition Examination Survey database from 2015 to 2018. Adults with diagnosis of NAFLD and non-NAFLD were identified. We ran univariate analysis using Mann Whitney U test and chi-square test. Multivariable survey logistic regression analysis was performed to find out the association between NAFLD and T2DM. Results: Out of a total 275,968 people, 0.26% had NAFLD. Older population (median: 62 years), male, Mexican American, and people with median household income &amp;gt;$100,000 had a higher prevalence of NAFLD. The diagnosis of NAFLD (40.31% vs 14.23%; p&amp;lt;0.0001) was more prevalent amongst patients with T2DM in comparison to those without NAFLD. In regression analysis, T2DM patients had significantly higher odds of having NAFLD (aOR: 10.40, 95%CI: 10.37- 10.42, p&amp;lt;.0001, c=0.736). Conclusion: Long term follow-up, early identification, and prompt treatment may mitigate the burden of NAFLD in T2DM patients. Presentation: Thursday, June 15, 2023

Assigning lifetime occupation domains for older Mexicans: MHAS-O*NET linkage protocol.

We developed a MHAS (Mexican Health and Aging Study) and O*NET (Occupational Information Network) linkage to allow global researchers using MHAS data to assign lifetime occupation domains for older Mexicans. Three bilingual raters independently matched 440 records with 132 unique occupation codes from the 2012 MHAS. We used a modified Delphi technique to reach agreements. To assess reliability, we compared the distribution of observations between the MHAS file and the MHAS-O*NET linked file across five job categories (upper white collar, lower white collar, upper blue collar, low blue collar, and agriculture/fishing/forestry). The Institutional Review Board at the University of Texas Medical Branch reviewed and approved the research (IRB # 21-0268). Using the developed 1:1 MHAS-ONET linkage, consistency between MHAS and ONET was 97.4% across the five job categories. This MHAS-O*NET linkage will allow researchers to analyze the association between lifetime occupation and multiple dimensions of health, functionality, and retirement determinants for a low-middle income country with a large proportion of workers in the informal sector.

Evaluation of Neighborhood-Level Disadvantage and Cognition in Mexican American and Non-Hispanic White Adults 50 Years and Older in the US

Understanding how socioeconomic factors are associated with cognitive aging is important for addressing health disparities in Alzheimer disease. To examine the association of neighborhood disadvantage with cognition among a multiethnic cohort of older adults. In this cross-sectional study, data were collected between September 1, 2017, and May 31, 2022. Participants were from the Health and Aging Brain Study-Health Disparities, which is a community-based single-center study in the Dallas/Fort Worth area of Texas. A total of 1614 Mexican American and non-Hispanic White adults 50 years and older were included. Neighborhood disadvantage for participants' current residence was measured by the validated Area Deprivation Index (ADI); ADI Texas state deciles were converted to quintiles, with quintile 1 representing the least disadvantaged area and quintile 5 the most disadvantaged area. Covariates included age, sex, and educational level. Performance on cognitive tests assessing memory, language, attention, processing speed, and executive functioning; measures included the Spanish-English Verbal Learning Test (SEVLT) Learning and Delayed Recall subscales; Wechsler Memory Scale, third edition (WMS-III) Digit Span Forward, Digit Span Backward, and Logical Memory 1 and 2 subscales; Trail Making Test (TMT) parts A and B; Digit Symbol Substitution Test (DSST); Letter Fluency; and Animal Naming. Raw scores were used for analyses. Associations between neighborhood disadvantage and neuropsychological performance were examined via demographically adjusted linear regression models stratified by ethnic group. Among 1614 older adults (mean [SD] age, 66.3 [8.7] years; 980 women [60.7%]), 853 were Mexican American (mean [SD] age, 63.9 [7.9] years; 566 women [66.4%]), and 761 were non-Hispanic White (mean [SD] age, 69.1 [8.7] years; 414 women [54.4%]). Older Mexican American adults were more likely to reside in the most disadvantaged areas (ADI quintiles 3-5), with 280 individuals (32.8%) living in ADI quintile 5, whereas a large proportion of older non-Hispanic White adults resided in ADI quintile 1 (296 individuals [38.9%]). Mexican American individuals living in more disadvantaged areas had worse performance than those living in ADI quintile 1 on 7 of 11 cognitive tests, including SEVLT Learning (ADI quintile 5: β = -2.50; 95% CI, -4.46 to -0.54), SEVLT Delayed Recall (eg, ADI quintile 3: β = -1.11; 95% CI, -1.97 to -0.24), WMS-III Digit Span Forward (eg, ADI quintile 4: β = -1.14; 95% CI, -1.60 to -0.67), TMT part A (ADI quintile 5: β = 7.85; 95% CI, 1.28-14.42), TMT part B (eg, ADI quintile 5: β = 31.5; 95% CI, 12.16-51.35), Letter Fluency (ADI quintile 4: β = -2.91; 95% CI, -5.39 to -0.43), and DSST (eg, ADI quintile 5: β = -4.45; 95% CI, -6.77 to -2.14). In contrast, only non-Hispanic White individuals living in ADI quintile 4 had worse performance than those living in ADI quintile 1 on 4 of 11 cognitive tests, including SEVLT Learning (β = -2.35; 95% CI, -4.40 to -0.30), SEVLT Delayed Recall (β = -0.95; 95% CI, -1.73 to -0.17), TMT part B (β = 15.95; 95% CI, 2.47-29.44), and DSST (β = -3.96; 95% CI, -6.49 to -1.43). In this cross-sectional study, aging in a disadvantaged area was associated with worse cognitive functioning, particularly for older Mexican American adults. Future studies examining the implications of exposure to neighborhood disadvantage across the life span will be important for improving cognitive outcomes in diverse populations.

Profiles of COVID-19 Impact on Informal Caregivers of Older Mexican Americans.

Objectives: This manuscript is a descriptive exploratory study of the impact of the COVID-19 pandemic for caregivers of very old Mexican Americans. Methods: Using data from Wave 10 of the Hispanic Established Population for the Epidemiological Study of Elderly (2021), we examined the characteristics of caregivers of very old Mexican Americans by their perceived level of impact from the pandemic. We examined sociodemographic characteristics, COVID-19 testing and vaccination, stress and depression, and health of caregivers and care recipients. Results: Caregivers who reported the most impact were more likely to report financial and emotional stress. They reported more depressive symptoms and high levels of distress related to neuropsychological behavior symptoms of their care recipient. Discussion: High levels of depressive symptoms, financial stress, and neuropsychological behavior symptoms illustrate that the concerns of caregivers before the pandemic were heightened during the pandemic.

Temporal trends in obesity defined by the relative fat mass (RFM) index among adults in the United States from 1999 to 2020: a population-based study

ObjectivesThe body mass index (BMI) largely underestimates excess body fat, suggesting that the prevalence of obesity could be underestimated. Biologically, women are known to have higher body fat than men....

Resilience of Older Latinos and Mexicans Before and During the Pandemic.

This article introduces the special issue on Aging and Resilience in the Americas: Mexico and the United States. The article overviews the role that the annual International Conference on Aging in the Americas (ICAA) has played in the development of scholarship on aging of Latinos in the United States and older persons in Latin America and the Caribbean. A brief overview of the aging literature reveals a growing interest on the resiliency of older Latino and Latin American populations in the United States and more broadly the Americas. The article provides a short description of each of the five articles included in this special issue.