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Objectives: To examine the contribution of predisposing, enabling, and need factors in Andersen behavioral model of health services use among older Mexican Americans, and to assess the factors associated with health services use over a 2-year period. Design: A two-year prospective cohort study. Participants: Data for the analysis includes 2066 noninstitutionalized Mexican American men and women aged 65 or older from the Hispanic Established Population for the Epidemiological Study of the Elderly (EPESE) who reside in five Southwestern states. Measures: Predisposing, enabling, and need factors as independent variables. Number of physician visits, number of hospitalizations, and number of hospital days as dependent variables. Ordinary least square regression analysis was used to estimate the parameters of health services use. Results: Ordinary least square regression analysis explain 2% to 26% of the variance in physician utilization, 2% to 14% of the variance in number of hospitalizations, and 2% to 14% of the variance in number of hospital days. Age, female gender, insurance coverage by Medicare and Medicaid, usual source of care, medical conditions, number of medications, and ADL disability were consistent factors associated over time with physician utilization. Age, medical conditions, number of medications, and ADL disability were consistent factors associated with number of hospitalizations, and with number of hospital days over 2-year period. Conclusions: The need factors explain the largest variance in health services use. Age and need factors were consistent predictors of health services use over 2-year period.

This study was designed to examine the prevalence, incidence, and mortality of self-reported heart attack in older Mexican Americans, and to identify associated factors for heart attack. Data on 3,050 Mexican Americans aged 65 and older came from baseline in 1993-94 and three follow-up interviews (95-96, 98-99, 00-01) of the Hispanic Established Populations for the Epidemiological Studies of the Elderly (EPESE), conducted in five Southwestern states of the United States. Prevalence of heart attack was 9.1% at baseline. Incidence of heart attack was 4.8%, 4.4%, and 3.3%, respectively, for three subsequent follow-ups. Age, being male, having diabetes, hypertension, and stroke were significantly associated with heart attack at baseline. Stroke was a significant predictor for new heart attack at 7-year follow-up. The risk of having ADL and IADL disabilities was significantly associated with heart attack. Subjects with heart attack were significantly more likely to die at 7 years than those without heart attack. Of those with heart attack, 42.4% died of heart attack at 7-year follow-up. In conclusion, among Mexican Americans, heart attack was associated with being older, male, having diabetes, hypertension, stroke, increased ADL and IADL disabilities, and 7-year mortality. Prevention and control for this disease would be especially important in this population to avoid early mortality.

PARTICIPANTS: D. Chiriboga (University of South Florida, Tampa, FL). Domains of Acculturation and Their Relevance to Depressive Symptoms Among Mexican American Elders. B. Yee (University of South Florida, Tampa, FL~. Acculturation and Adaptive Aging Among Vietnamese Adults. J. Kalavar (Penn State University, Upper Burrell, PA). Elderly Asian Indian Immigrants to the United States. Acculturation has sometimes been said to represent a construct with little current relevance to older minorities, many of whom emigrated to the United States decades before they reached the 'golden' years. At the same time there is evidence from a number of studies and cultural groups that acculturation does having an ongoing relationship to mental and physical health and may have indirect relationships as well. Adding to the contradictory evidence, approaches to the assessment of acculturation are varied and often to not fully represent its breadth. This symposium presents empirical findings from studies of three differing populations, and seeks to explore commonalities and differences in the meaning and measurement of acculturation.

The emerging literature on neighborhoods and health has by and large ignored older adults, a population potentially vulnerable to poor neighborhood conditions. We examined neighborhood characteristics and 2-year incidence of ADL disability in 2,127 older Mexican Americans without disability at baseline. Data from the 1990 U.S. Census were merged with the Hispanic EPESE, a large epidemiologic study in 5 southwestern states. A factor analysis of tract level indicators identified an economic factor with fN=0.90. An additional contextual factor considered is neighborhood assimilation (tract % Mexican Americans). Using a multilevel logit model, we regressed 2-year incidence of ADL disability on the neighborhood economic index and neighborhood assimilation in quartiles, individual-level measures of SES, and potential health confounders. In reference to the top neighborhood economic quartile, subjects living in bottom quartile neighborhoods with

Objectives: Assessment of the predictive ability of the Mini-Mental Status Exam (MMSE) domains (orientation to time, orientation to place, registration, attention and calculation, recall, language, and visual construction) for falls in Mexican American elders tested the hypothesis that low MMSE domain scores are related to an increased number of falls.Design: Data were obtained from the 1998-99 re-survey (Wave 3) Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE), a population-based study of older Mexican Americans residing in the southwestern United States.Methodology: We used a retrospective case control study design; 926 subjects who were aged > or = 77 years at Wave 3 were examined. MMSE scores were utilized to predict falls two years later. Measurements included sociodemographic characteristics, MMSE scores, activities of daily living (ADL), instrumental activities of daily living (IADL), and fall rates.Main Outcome Measures: Relationships between MMSE domain scores and falls.Results: Of the 681 subjects examined two years later, 35.7% experienced at least one fall. Subjects with errors on orientation to place (OR = 2.01) and visual construction (OR = 1.9) were most likely to fall.Conclusions: MMSE domains with poor scores and most predictive of falls in Mexican Americans elders were orientation to place and visual construction. Further evaluation for confusion level and visual ability in elders presenting with dysfunction on these domains may lead to a reduction of falls in this ethnic group. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIMS: To identify the prevalence and characteristics of gall bladder disease (GBD) that has been self-reported in Mexican American Elders. METHODS: A prospective survey of a regional probability sample of self-identified Mexican Americans aged 65 and over. The Hispanic Established Population for the Epidemiologic Studies of the Elderly (H-EPESE), a probability sample of non-institutionalized, Mexican Americans, aged 65 and over, residing in Southwestern states of Texas, New Mexico, Colorado, Arizona, and California. In 1993- 1994 (Wave 1), 3050 Mexican Americans, aged 65 and over, were selected at baseline as a weighted probability sample. In 1995-1996 (Wave 2), 2895 remained. Sample weights were used to extrapolate to the estimated 498,176 older Mexican Americans residing in the Southwest United States. Self-reported GBD was collected via in-home interviews. RESULTS: The prevalence of self-reported GBD in Mexican American elders was found to be 18.8% with an average age of 75.05 years. The findings indicate that older Mexican Americans have an increased rate of GBD if they are female, have history of arthritis or hypertension and have more acculturation to the United States. However, the rate decreases when they score poorly on the Mini Mental State Exam. One major limitation was reliance on self-report, as GBD and other co-morbid illnesses may be under-, or overestimated. CONCLUSIONS: Age is not protective in the prevalence of GBD in elder Mexican Americans. Persistent underlying genetics and dietary habits most likely attribute to this consistent high percentage, even in the elderly. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIMS: Impaired physical performance in older adults has been shown to vary by ethnic groups. The objective of this study is to examine ethnic differences in physical performance in older Americans. METHODS: We conducted a crosssectional analysis using a sample of 4456 non-institutionalized Americans aged 60 and above (2712 non- Hispanic Whites, 861 non-Hispanic Blacks and 883 Mexican Americans) from a large national representative survey (The Third National Health and Nutrition Examination Survey (NHANES III) conducted in 1988- 1994). Measurements included socio-demographic variables; self-reported physician diagnosed medical conditions, body mass index (BMI) and physical performance examination (tandem stand balance, timed chair stand, and timed 8-foot walk). RESULTS: Of 4456 study participants, 60.9% (n=2712) subjects were non-Hispanic white, 19.3% (n=861) were non-Hispanic black, and 19.8% (n=883) were Mexican American. About 35% (n=1573) of subjects could not hold the tandem balance test for 10 seconds. Older age, diabetes, stroke and arthritis were significantly associated with decreased performance on the balance test. Older age, female gender, being Mexican American or non-Hispanic black, hip fracture and high BMI were significantly associated with decreased performance on 8- foot walking test, while older age, female gender, being non-Hispanic black, low education, stroke, cancer, arthritis and high BMI were significantly associated with decreased performance on the chair stand test. CONCLUSIONS: With some ethnic variation, older age, female gender, being non-Hispanic black, being Mexican American, low education, high BMI, diabetes, stroke, cancer and arthritis were associated with decreased physical performance in elderly Americans. [ABSTRACT FROM AUTHOR]

Although the association between marriage and well-being is well established, few studies have focused on learning more about the context of marriage and mental health. Recent research studying the mechanisms of marriage and health has focused on contagion of well-being among spouses. This study examined the association of depression with self-esteem, social support, life satisfaction, concern for independence, and cognitive function using baseline data for 553 older, Mexican American couples. Overall, we found evidence to suggest an interdependent relationship between husbands’ and wives’ emotional states, but the association was not equal for couples. Husbands’ depression was significantly associated with the well-being of their wife, but the wife's depression was rarely associated with the husband's well-being. The findings from this study add to the increasing literature on spousal contagion by focusing on an under studied minority group, examining how depression affects well-being, and highlighting unequal effects of marriage on spousal well-being. [ABSTRACT FROM AUTHOR]

The article summarizes three of the data collection studies that can assist researchers in examining population aging processes in the Latin America and Caribbean region with an emphasis on cross-national comparisons, including the population of Mexican immigrants in the United States. These are the Survey on Health and Wellbeing of Elders conducted in seven urban centers of the region, the national Mexican Health and Aging Study, and the Hispanic Established Populations for Epidemiologic Studies of the Elderly in the United States. The article describes the studies and marks them as informative, comprehensive, and still underanalyzed in particular for the purpose of cross-national analyses of aging among Latin American and Caribbean populations. [ABSTRACT FROM AUTHOR]

Several studies have shown that involvement in religious activity appears to benefit health. To estimate the association between church attendance and fear of falling, we used a sample of 1341 non-institutionalized Mexican-Americans aged 70 and over from the third wave (1998–1999) of the Hispanic Established Population for the Epidemiological Study of the Elderly, followed until 2000–2001. Baseline potential predictors of fear of falling were church attendance, socio-demographics, history of falls, summary measure of lower body performance (tandem balance, eight-foot walk, and repeated chair stands), functional status, depressive symptoms, cognitive status, and medical conditions. Fear of falling at the two-year follow-up was measured as no fear, somewhat afraid, fairly afraid, and very afraid. Chi-square statistic and multiple logistic regression analysis were used to estimate associations between the outcome and the potential predictors. Multiple logistic regression analysis showed that frequent church attendance was an independent predictor of lower fear of falling (odds ratio  =  0.73, 95% confidence interval 0.58–0.92, P   =  0.008) two years later. Other independent predictors of fear of falling were female gender, poorer objective lower body performance, history of falls, arthritis, hypertension, and urinary incontinence. Frequent church attendance is associated with decreased fear of falling in older Mexican-Americans. [ABSTRACT FROM AUTHOR]

Background: This report describes the prevalence and correlates of functional blindness and visual impairment among older Mexican Americans, using data on 2800 respondents from the Hispanic Established Populations for the Epidemiological Study of the Elderly.Methods: Bivariate and multivariate logistic regression analyses were used to examine the associations between corrected bilateral distant vision and sociodemographic characteristics, selected health conditions, self-reported health status, health care utilization, and functional dependence on the basis of assistance needed for basic and instrumental activities of daily living (ADLs).Results: Using a modified Snellen test for distance visual acuity, 5% of older Mexican Americans were found to be functionally blind, and 13.5% were found to be visually impaired. Vision loss was significantly associated with older age, lower education, hypertension, diabetes, poor self-rated health, and hospitalization during the year prior to the interview. Over 50% of functionally blind subjects required assistance with at least one basic ADL, compared with 15% of those who were visually impaired and 8% of those who were not visually impaired.Conclusions: The prevalence of functional blindness in this sample of elderly Mexican Americans was higher than reported for the general elderly population, yet they also have higher rates of adequate vision because of the low prevalence of visual impairment. The results suggest a need for more research on the prevalence and impact of functional blindness and visual impairment on the health of older Mexican Americans. [ABSTRACT FROM AUTHOR]

Objective: Individuals with high levels of depressive symptoms have an increased risk of many illnesses, including stroke. Measures of depressive symptoms include questions about the presence of negative affect, such as sadness, as well as the absence of positive affect, such as happiness and optimism. We assessed whether positive or negative affect, or both, predicted risk of stroke.Methods: Data were from a 6-year prospective cohort study of a population-based sample of 2478 older whites and blacks from five counties in North Carolina who reported no history of stroke at the baseline interview. Baseline, in-person interviews were conducted to gather information on sociodemographic, psychosocial, and health-related characteristics of subjects. Thereafter interviews were conducted annually for 6 years.Results: Increasing scores on the modified version of the Center for Epidemiological Studies Depression Scale (CES-D) were significantly associated with stroke incidence for the overall sample (relative risk [RR] = 1.04 for each one-point increase, 95% confidence interval [CI] = 1.01-1.09) over the 6-year follow-up period after adjusting for sociodemographic characteristics, blood pressure, body mass index, smoking status, and selected chronic diseases. Positive affect score demonstrated a strong inverse association with stroke incidence (RR = 0.74, 95% CI = 0.62-0.88).Conclusions: Increasing scores on the modified CES-D are related to an increased risk of stroke, whereas high levels of positive affect seem to protect against stroke in older adults. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence in older adults has many distinct etiologies and is associated with lower self-reported health. However, it is unclear whether the new onset of urinary incontinence marks newly emergent frailty.Methods: Using a longitudinal population-based survey of older Mexican Americans (N = 2660) across five south-western states, this study compared the strength of association between markers of physical frailty such as activities of daily living (ADLs), instrumental activities of daily living (IADLs), and performance (timed walk, timed chair rise, and tandem balance) with baseline incontinence (prevalent disease) and new-onset incontinence (incident disease).Results: We found that 14.1% of the participants (n = 329) were incontinent at baseline (prevalent cases) and 11.6% (n = 208) were newly incontinent 2 years later (incident cases). Controlling for other covariates, prevalent incontinence was only associated with a 60% increased risk of having difficulty walking 8 ft. Incident incontinence was associated with a twofold increased risk of impairment in ADLs and IADLs, and poor performance on all three physical measures.Conclusions: Incident incontinence is associated with an increased risk of more global functional impairment. Thus, incident disease may be an important early marker for signaling the onset of frailty among persons who become incontinent after the age of 65 years. [ABSTRACT FROM AUTHOR]

Background: Although it has been demonstrated that physical performance measures predict incident disability in previously nondisabled older persons, the available data have not been fully developed to create usable methods for determining risk profiles in community-dwelling populations. Using several populations and different follow-up periods, this study replicates previous findings by using the Established Populations for the Epidemiologic Study of the Elderly (EPESE) performance battery and provides equations for the prediction of disability risk according to age, sex, and level of performance.Methods: Tests of balance, time to walk 8 ft, and time to rise from a chair 5 times were administered to 4,588 initially nondisabled persons in the four sites of the EPESE and to 1,946 initially nondisabled persons in the Hispanic EPESE. Follow-up assessment for activity of daily living (ADL) and mobility-related disability occurred from 1 to 6 years later.Results: In the EPESE, compared with those with the best performance (EPESE summary performance score of 10-12), the relative risks of mobility-related disability for those with scores of 4-6 ranged from 2.9 to 4.9 and the relative risk of disability for those with scores of 7-9 ranged from 1.5 to 2.1, with similar consistent results for ADL disability. The observed rates of incident disability according to performance level in the Hispanic EPESE agreed closely with rates predicted from models developed from the EPESE sites. Receiver operating characteristic curves showed that gait speed alone performed almost as well as the full battery in predicting incident disability.Conclusions: Performance tests of lower extremity function accurately predict disability across diverse populations. Equations derived from models using both the summary score and the gait speed alone allow for the estimation of risk of disability in community-dwelling populations and provide valuable information for estimating sample size for clinical trials of disability prevention. [ABSTRACT FROM AUTHOR]

Background: Disability measures among elderly non-Hispanic White populations have traditionally been associated with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). More recently, performance-based measures have increasingly been used to predict the onset of disability in initially nondisabled elderly populations.Methods: We used data from two waves (1993-94 and 1995-96) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (EPESE) to assess the degree with which lower mobility performance measures predict future disability in a representative sample of older Mexican Americans from the Southwestern United States.Results: Performances on an 8-foot walk, repeated chair stands, and standing balance among nondisabled subjects at baseline were significantly associated with the onset of ADL and lower body disability 2 years later, controlling for age, gender, and the presence of medical conditions. The results were significant for each performance measure and for a measure combining all three.Conclusion: This study offers further evidence that performance-based measures of lower body function are able to predict future disability in older Mexican Americans, as has been found with other elderly populations. These measures were able to detect changes over a relatively short period of time (2 years). In addition, the study found that the short (8-foot) walk was the most sensitive measure in predicting future disability. [ABSTRACT FROM AUTHOR]

Background: Among the elderly population, the risk for psychological distress increases with the number of chronic diseases and accompanying functional disability. The prevalence of chronic medical conditions and functional disability varies substantially across ethnocultural groups, however. Using data from the Hispanic EPESE, we previously reported that among older Mexican Americans, the total number of chronic medical conditions and the presence of functional impairment are strong predictors of depressive symptoms.Methods: Using multiple regression, we examined the association between specific chronic diseases, individual functional disabilities, and depressive symptoms in this group of ethnic elders.Results: Multiple regression models indicated that diabetes (OR = 1.25, 95% CI = 1.03-1.56), arthritis (OR = 1.42, 95% CI = 1.17-1.72), urinary incontinence (OR = 1.94, 95% CI = 1.46-2.59), bowel incontinence (OR = 2.28, 95% CI = 1.15-4.55), kidney disease (OR = 3.11, 95% CI = 1.13-8.58), and ulcers (OR = 2.56, 95% CI = 1.23-5.29) were predictive of high levels of depressive symptoms. Hip fracture, although recognized as having a substantial impact on functional status, was not found to be associated with depressive symptoms. History of stroke was not significantly associated with depressive symptoms in bivariate or multivariate analyses, but history of stroke with residual speech problems was predictive (OR = 2.16, 95% CI = 1.01-4.79). Among specific activities of daily living, only impaired ability to walk across a room (OR = 1.65, 95% CI = 1.04-2.73) or to bathe oneself (OR = 1.87, 95% CI = 1.12-3.12) proved to be predictive in multivariate analyses.Conclusions: This constellation of chronic medical conditions and functional disabilities is very different from those reported to be associated with depressive symptoms in older non-Hispanic White and African Americans, and appears to comprise those conditions most associated with substantial physical impairment, pain, and discomfort. [ABSTRACT FROM AUTHOR]

Anokha Padubidri,1,2 Soham Al Snih,2,3 Rafael Samper-Ternent,2,4 Kyriakos S Markides,2,5 Kenneth J Ottenbacher,2,3 Mukaila A Raji2,6 1College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA; 2Sealy Center on Aging, 3Division of Rehabilitation Sciences, School of Health Professions, the University of Texas Medical Branch, Galveston, TX, USA; 4Department of Internal Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogota, Columbia; 5Department of Preventive Medicine and Community Health, 6Department of Internal Medicine, the University of Texas Medical Branch, Galveston, TX, USA Background: Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls–cognition association among cognitively intact Hispanic Elders. Methods: We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. Results: At baseline, participants’ mean age was 80.8 years (range, 74–109), mean ­education was 6.3 years (range, 0–17), and mean MMSE was 25.2 (range, 21–30). Of the 1,119 ­participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =–0.81, standard error =0.19, P

Abstract Background Previous research on frailty in older adults has focused on morbidity and mortality. The purpose of this study was to elicit the relationship between being non-frail, pre-frail, or frail and health related quality of life in a representative sample of older Mexican Americans surveyed in 2005–2006. Methods Data were from a representative subsample of the Hispanic Established Populations Epidemiologic Studies of the Elderly (EPESE) and included 1008 older adults living in the community (mean (sd) age = 82.3(4.3)). Multiple regression analyses examined the relationship between frailty status and the eight SF-36 health related quality of life subscales and two summary scales. Models also adjusted for the participants' sociodemographic and health status. Results We found that, after adjusting for sociodemographic and health related covariables, being pre-frail or frail was significantly associated (p < 0.001) with lower scores on all physical and cognitive health related quality of life scales than being non-frail. Conclusion When compared to persons who are not frail, older Mexican American individuals identified as frail and pre-frail exhibit significantly lower health related quality of life scores. Future research should assess potential mediating factors in an effort to improve quality of life for frail elders in this population.

Abstract Background The older Hispanic population of the U.S. is growing at a tremendous rate. While ethnic-related risk and complications of diabetes are widely-acknowledged for older Hispanics, less is known about how health related quality of life is affected in this population. Methods Cross-sectional study assessing differences in health related quality of life between older Mexican Americans with and without diabetes. Participants (n = 619) from the Hispanic Established Population for the Epidemiological Study of the Elderly were interviewed in their homes. The primary measure was the Medical Outcomes Study Short Form (SF-36). Results The sample was 59.6% female with a mean age of 78.3 (SD = 5.2) years. 31.2% (n = 193) of the participants were identified with diabetes. Individuals with diabetes had significantly (F = 19.35, p < .001) lower scores on the Physical Composite scale (mean = 37.50, SD = 12.69) of the SF-36 compared to persons without diabetes (mean = 43.04, SD = 12.22). There was no significant difference between persons with and without diabetes on the Mental Composite scale of the SF-36. Conclusion Diabetes was associated with lower health related quality of life in older Mexican Americans. The physical components of health related quality of life uniformly differentiated those with diabetes from those without, whereas mental component scores were equivocal.

Although social stressors have successfully predicted depressive symptomatology in a number of populations, few studies have examined the relevance of stressors for Mexican American elders. Results are reported here from a multistage probability sample of 3,050 Mexican Americans aged 65 and older drawn from a 5-state region. Participants reported low levels of education and income, and most reported difficulty in reading or writing in English. Deaths, illness of close other, and financial problems were the three most frequent life events, and many reported financial strains. Depressive symptoms were then regressed on demographic indicators, cognitive status, linguistic acculturation, social supports, and three types of stressors. Being a woman, lower income, decreased income, chronic financial strain, and several health stressors were associated with greater symptomatology. Results identified a cluster of economic stressors and conditions that may play a critical role in the etiology of depressive symptoms in this minority population. [ABSTRACT FROM AUTHOR]

Background: Little is known about use of herbal medicines by older Mexican Americans. The objective of this study was to determine the characteristics among older Mexican Americans that correlate with use of herbal medicines.Methods: We administered a cross-sectional regional sample survey, the 1993-1994 Hispanic Established Populations for the Epidemiologic Study of the Elderly of Mexican Americans, by in-home interviews of noninstitutionalized older Mexican Americans age 65 and over living in Texas, New Mexico, Colorado, Arizona, and California.Results: The use of herbal medicine in the 2 weeks prior to the interview was reported by 9.8% of the sample. Chamomile and mint were the two most commonly used herbs. Users of herbal medicines were more likely to be women, born in Mexico, over age 75, living alone, and experiencing some financial strain. Having arthritis, urinary incontinence, asthma, and hip fracture were also associated with an elevated use of herbal medicines, whereas heart attacks were not. We found that herbal medicine use was substantially higher among individuals reporting any disability in activities of daily living, poor self-reported health, and depressive symptoms. Herbal medicine use was associated with the use of over-the-counter medications but not with prescription medications. Herbal medicine use was particularly high among respondents who had over 24 physician visits during the year prior to interview.Conclusions: Herbal medication use is common among older Mexican Americans, particularly among those with chronic medical conditions, those who experience financial strain, and those who are very frequent users of formal health care services. [ABSTRACT FROM AUTHOR]

Background: Joint pain is a very common complaint among elderly persons and may lead to functional disability. The purpose of this study is to estimate the prevalence of self-reported pain on weight bearing and its impact on the 2-year incidence of limitation in lower-body activities of daily living (ADL) in initially nondisabled Mexican American elderly subjects.Methods: We studied a probability sample of 2167 noninstitutionalized Mexican American men and women aged 65 or older residing in five Southwestern states. Subjects were asked about pain on weight bearing, ADL, depressive symptomatology, and the presence of chronic diseases. The body mass index was computed using measured height and weight. Finally, a three-task (tandem balance, 8-foot walk, and repeated chair stands), performance-based, lower-body function test was performed.Results: The overall prevalence of pain on weight bearing in the sample was 31.9%, with 37.7% for women versus 24.0% for men (p <.001). The most prevalent sites of pain were knees (14.7%), followed by ankle/feet (12.1%). In a logistic regression analysis, pain was a significant independent predictor of subsequent disability and of the inability to perform tandem balance, 8-foot walk, and repeated chair stands.Conclusions: Pain on weight bearing is prevalent among older Mexican Americans and is a major independent risk factor for subsequent disability. [ABSTRACT FROM AUTHOR]