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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. [ABSTRACT FROM AUTHOR]

The article discusses the growth and changes in the Hispanic population's health status in the U.S. as of July 2024. Topics covered include the observed Hispanic paradox on health outcomes, overall life expectancy, and adult mortality, the Hispanic paradox's future, and how demographic changes, social dynamics, cultural diversity, acculturation, and uneven population distribution may affect it. Also noted is the role of indigeneity in Hispanic population diversity.

This article explores the relationship between social engagement and dementia risk among Mexican Americans. The study suggests that social engagement, particularly frequent contact with family, can help protect against dementia. However, the study has limitations, such as relying on self-report measures and a small sample size. The article also discusses the importance of incorporating health and health equity into decision-making through approaches like Health in All Policies. It emphasizes the need for culturally tailored approaches in healthcare systems to address disparities in dementia treatment and support among different cultural groups. The text also highlights the impact of the digital divide on social isolation, particularly among older adults, and suggests strategies to address this issue. Additionally, the article mentions the role of age-friendly cities in supporting social engagement and provides recommendations for creating age-friendly environments. Overall, the article underscores the significance of social support and engagement in promoting health and well-being, and calls for the integration of these principles into various sectors and policies. [Extracted from the article]

Background: Studies have investigated the association between pain and cognitive impairment among older adults, but the findings are mixed. We assessed the relationship of activity‐limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged ≥80. Methods: Data were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010–2016). Pain interference, or pain that limited daily activities in the last 12 months, was categorized into none, untreated pain interference, and treated pain interference. Cognitive impairment was defined as scoring <21 on the Mini‐Mental State Examination and difficulty with at least one instrumental activity of daily living. We used general estimation equations to assess this relationship between pain and incident cognitive impairment over the 6‐year period (n = 313). Results: Participants reporting both untreated and treated pain interference had higher odds of incident cognitive impairment than those reporting no pain or pain interference (untreated adjusted odds ratio [aOR]: 2.18; 95% confidence interval [CI]: 1.09–4.36; treated aOR: 1.99; 95% CI: 1.15–3.44). Depressive symptoms explained 15.0% of the total effect of untreated pain and 25.3% of treated pain. Conclusions: Among very old Mexican American adults, both treated and untreated pain interference was associated with incident cognitive impairment. This association was partially mediated by depressive symptoms, underscoring a need for depression screening in patients with chronic pain. Future work is needed to examine mechanistic/causal pathways between pain and subsequent cognitive impairment and the role of pharmacological and non‐pharmacological treatments in these pathways. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Asian Americans (AAs) are the fastest-growing racial/ethnic minority group in the United States. While otherwise highly heterogeneous, AAs overall value filial piety and eldercare. This study compared the health and caregiving experiences of AA caregivers of older adults to AA non-caregivers and caregivers of older adults across racial/ethnic groups. We used 2015–2020 Behavioral Risk Factor Surveillance System data for 315 AA caregivers and 3822 AA non-caregivers, plus 395 American Indian/Alaska Native, 1883 Black, 1292 Hispanic, and 20,321 non-Hispanic White caregivers. Among AAs, 4.3% were caregivers, a lower proportion than in other racial/ethnic groups. Most AA caregivers were female (59%), married (71%), in excellent/very good/good health (76%), and with at least one chronic health condition (66%). Other than relationship to care recipients, caregivers' experiences were similar across racial/ethnic groups: most cared for <20 hours/week and provided household and personal care. Efforts to support AA caregivers should be attentive to cultural practices. [ABSTRACT FROM AUTHOR]

Context: Mexico. Purpose: Using the health care service utilization model as a framework, this paper will analyze the differences in health care service use among older Mexicans living in urban and rural areas in Mexico. Methods: The Mexican Health and Aging Survey (MHAS) data were used to test the applicability of Andersen's "model of health services" of predisposing (ie, age, sex, etc.), enabling (education, insurance coverage, etc.) and need factors (diabetes, hypertension, etc.) to predict ever being in the hospital and physician visits in the past year by place of residence (urban, rural, semi-rural). Findings: Results showed that older Mexicans living in the most rural areas (populations of 2,500 or fewer) were significantly less likely to have been hospitalized in the previous year and visited the physician less often (P less than 0.0001) than their urban counterparts. The significant difference in hospitalization between rural and urban residing older Mexicans was largely accounted for by having health care coverage. Certain need factors such as diabetes, previous heart attack, hypertension, depression, and functional limitations predicted frequency of physician visits and hospitalization, but they did not explain variations between rural and urban older Mexicans. Conclusions: Not having insurance coverage was associated with a lower likelihood of spending an overnight visit in the hospital and visiting a physician for older Mexicans. This lower utilization may be due to barriers to access rather than better health.

Arthritis is a common chronic condition in the ageing population. Its impact on physical function varies according to sociodemographic and race/ethnic factors. The study objective was to examine the impact of arthritis on physical function and disability among non-disabled older Mexican Americans over time. A 23-year prospective cohort study of 2230 Mexican Americans aged 65 years and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993/94–2016). The independent variable was self-reported physician-diagnosed arthritis, and the outcomes included Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), mobility, Short Physical Performance Battery (SPPB), and handgrip strength. Covariates were sociodemographic, medical conditions, body mass index, depressive symptoms, and cognitive function. General linear mixed models were performed to estimate the change in SPPB and muscle strength. General Equation Estimation models estimated the odds ratios (OR) of becoming ADL- or IADL- or mobility – disabled as a function of arthritis. All variables were used as time-varying except for sex, education, and nativity. Overall, participants with arthritis had higher odds ratio (OR) of any ADL [OR = 1.35, 95% Confidence Interval (CI) = 1.09–1.68] and mobility (OR = 1.34, 95% CI = 1.18–1.52) disability over time than those without arthritis, after controlling for all covariates. Women, but not men, reporting arthritis had increased risk for ADL and mobility disability. The total SPPB score declined 0.18 points per year among those with arthritis than those without arthritis, after controlling for all covariates (p-value <.010). Our study demonstrates the independent effect of arthritis in increasing ADL and mobility disability and decreased physical function in older Mexican Americans over 23-years of follow-up. [ABSTRACT FROM AUTHOR]

Objectives Sensory disabilities, including vision disability and hearing disability, increase risk for social isolation, which is associated with multiple negative health outcomes. Existing literature suggests that the cultural value of familism may provide a buffer against social isolation. We examined the longitudinal trajectory of social isolation among Hispanic older adults with self-reported vision disability (SRVD) and self-reported hearing disability and tested a modified measure of social isolation incorporating familism. Methods We compared 8-year trajectories of social isolation among Hispanics (n = 445) and non-Hispanic Whites (n = 4,861) from the National Health and Aging Trends Study. We used structural equation modeling to explore the longitudinal relationships between sensory disability and social isolation while comparing 2 measures of social isolation. Results Social isolation increased longitudinally for both groups, with SRVD significantly associated with higher initial levels. Social isolation started and remained higher across time among Hispanics. Using an adjusted measure of social isolation (added familial support), neither initial levels nor trajectories of social isolation differed between Hispanic and non-Hispanic White participants. Discussion Initially, Hispanics appeared more socially isolated, reporting less social support from outside the home. Yet, we found that they were more likely to report family social connections. Traditional measures of social isolation focusing on social support outside of the home (neglecting support by family) may lack content validity among Hispanic groups. Culturally sensitive measures of social isolation will be increasingly consequential for future research and health policy to meet the needs of a diverse older population. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been a major source of stress for informal caregivers for people with dementia. Studies show the unique challenges caregivers face, such as social isolation, extended work hours, and adherence to public health guidelines. We conducted a narrative review of factors impacting well-being of informal caregivers of older adults with dementia during the COVID-19 pandemic. Sixty-four papers were identified as published between June 2020 and December 2021. All studies were conducted in the U.S. or other Western countries and were cross-sectional and conducted prior to COVID-19 vaccines. Articles highlighted increasing burdens such as financial and physical stress, as well as worsened psychological well-being from anxiety and depression. Protective factors such as social support and telehealth interventions also emerged. Limitations include lack of longitudinal information to identify broader themes on caregiving during the pandemic. Studies not only identified new, pandemic-related risk factors, but also a heightened effect of pre-existing risk factors (e.g., income, living situation) on caregiver burden. [ABSTRACT FROM AUTHOR]

Objective: We examined the association between care recipient's physical, mental, and cognitive health conditions and caregivers' psychological distress in Vietnamese older care recipients and their caregivers. Methods: The Vietnamese Aging and Care Survey was developed for care recipients, and adult-child and spousal caregivers, and inquired about their sociodemographics and health-related variables. Results: Data were collected on 58 caregiver-care recipient dyads. Adult-child and spousal caregivers were on average 43 and 70 years-old respectively. The vast majority were female (76%) and born in Vietnam (97%). Adult-child caregivers reported more caregiver burden than spousal caregivers. Care recipients were on average 75 years-old. Care recipients of adult-child caregivers reported more depressive symptoms than care recipients of spousal caregivers and were more likely to have mild dementia. Care recipients' health had no effect on caregiver depressive symptoms but their educational attainment was associated with caregiver burden and depressive symptoms. Conclusions: This study showed care recipients and caregivers' years of education were positively associated with caregivers' psychological distress. Vietnamese families lived in ethnic enclaves and shared caregiving responsibilities within the family. However, using available outside resources may alleviate psychological distress of not only caregivers but also families as a whole. Clinical Implications: Healthcare professionals should encourage educated caregivers and educated care recipients to use outside resources to ease caregiving duties. [ABSTRACT FROM AUTHOR]