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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]

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]

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]

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