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We investigated the relationship between physical activity and physical function on the risk of falls over time in a cohort of Mexican-American adults aged 75 and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE). Participants were divided into four groups according to their level of physical activity and physical function: low physical activity and low physical function (n = 453); low physical activity and high physical function (n = 54); high physical activity and low physical function (n = 307); and high physical activity and high physical function (n = 197). Using generalized linear equation estimation, we showed that participants with high physical activity and low physical function had a greater fall risk over time, followed by the high physical activity and high physical function group. Participants seldom took part in activities that improve physical function. To prevent falls, modifications to physical activity should be made for older Mexican Americans. [ABSTRACT FROM AUTHOR]

Hispanic-Americans are one of the fastest growing minority groups in the United States, numbering more than 28 million and making up about 11 percent of the U.S. population (U.S. Bureau [...]

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.

The factor structure of the Center for Epidemiological Studies-Depression Scale (CES-D) has not been well defined among elderly Mexican Americans. Although most prior research suggests the CES-D has four factors, prior research also suggests that the factor structure of the CES-D may vary with culture. In addition, previous theory and research on other depression inventories suggest only two factors: a general depression factor and a psychological well-being factor. The current study determines the number of factors for the CES-D in the Hispanic Established Populations for Epidemiologic Studies (H-EPESE) survey (N = 2,536) and in a previous study of elderly Mexican Americans living in San Antonio, Texas (N = 330). The factor analytic results argue strongly for the two-factor model, and this model is the only structure that yielded consistent results across subgroups (e.g., male vs female or Spanish vs English language of interview). We conclude that the CES-D has only two factors among elderly Mexican Americans.

Data from the Hispanic Health and Nutrition Examination Survey were used to examine the influence of acculturation on alcohol consumption among Puerto Rican, Cuban-American, and Mexican-American women in the United States. Acculturation was found to be positively related to frequency of consumption and probability of being a drinker among all three groups. A positive relationship was also evident for total drinks consumed among Cuban-American women, and volume (drinks per occasion) and total drinks consumed among Mexican-American women. (Am J Public Health. 1993;83:890-893), Hispanic American women may drink more alcohol as they become more acculturated to life in the United States. Data from the Hispanic Health and Nutrition Examination Survey, covering the years 1982 to 1984, were extracted for 775 Puerto Rican, 488 Cuban-American and 1861 Mexican-American women between the ages of 20 and 74. Levels of alcohol consumption were analyzed with socioeconomic variables such as education, employment and marital status. Acculturation was rated by a scale based on language use. In all three groups of women, acculturation was positively associated with drinking alcohol. Women with more education and employed women were also more likely to drink.

The validity of physician's rating of health was evaluated against data collected from self-reported health suveys of middle-aged and elderly Mexican Americans from ages 45 to 74. There were discrepancies found in physician assessments and self-ratings wherein the physicians were generally optimistic with with their assessments while respondents underrated themselves. Discrepancies, likewise, were noted in assessments of subjects between two different physicians.

A model separating and relating dimensions of intergenerational solidarity with measures of psychological distress was investigated for older Mexican Americans. Solidarity consisted of measures of similarity, affection, and association. Measures of psychological distress were somatic/retarded symptoms, depressed affect, and positive affect. To evaluate whether emotional closeness with a particular child modified the linkages, the model was analyzed separately based on whether or not the elderly participant reported that the child included in the intergenerational study was her or his closest child. The findings indicated that the impact of affection and association was a function of the particular dimension of distress and the emotional closeness of the child. Although the proposed model needs expanding, it provides some support for the expectation that family solidarity has important consequences for elderly Mexican Americans.

Recent studies have suggested that traditional predictors of health status are not as useful in the elderly as in other groups. One reason might be that in old age there is somewhat of a natural selection process, whereby those with various risk factors are the survivors who are the exceptions to the rule. Thus, they may not be at particular risk despite the presence of risk factors. Using data from the Hispanic Health and Nutrition Examination Survey, employment status, education, income, and marital status were investigated with regard to their relationship to health status in middle-aged and older Mexican Americans. Socioeconomic factors are traditionally seen as predictors of health status in middle age. Overall, there was a greater association between socioeconomic factors and health status in middle-aged than in older men. Most significant was the relationship between employment and health status. For women, there was no significant age-related influence on the relationship between socioeconomic variables and health status. It is suggested that this might be due to greater longevity in women despite risk factors, that is, natural selection. Other notable findings were lacking in the analysis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cigarette smoking ranks first as a cause of preventable death in the United States, and is responsible for about 390,000 deaths each year. Cigarette smoking is more prevalent among men than women, and rates of smoking increase to a maximum in middle age, and decrease with advancing age. The rates of cigarette smoking are around 40 percent in Mexican American and Black American males, and around 25 to 27 percent in Mexican American and Caucasian women. However, heavy cigarette smoking is less prevalent among Mexican Americans than other ethnic groups. The relation between cigarette smoking and other risk factors, such as alcohol and caffeine consumption, elevated cholesterol levels, high blood pressure, and obesity, has been studied but not well documented in Mexican Americans. The differences in health behaviors, risk factors, and health indicators between smokers and nonsmokers were assessed among Mexican Americans using data from the Hispanic Health and Nutrition Examination Survey (HHANES). Smokers were also grouped by number of cigarettes consumed each day, age, and gender. Smoking was associated with heavy coffee and alcohol consumption, lower body weight, low blood pressure in middle-aged subjects, and symptoms of depression in women. Subjects who smoked more than 10 cigarettes each day tended to consume more coffee, and young men within this group were less active due to poor health. However, middle-aged subjects who smoked more than 10 cigarettes per day were more healthy than persons who smoked fewer cigarettes. These findings are consistent with previous studies showing a relation between smoking, health behaviors, and risk factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

There is an activity theory that comes into play in considering the elderly; it holds that the more active one is, the longer one will live and be happy. This theory may not be true. While the activity theory has been discussed for more than 30 years and has influenced researchers, no one has formally studied the link between activity levels and long life; nor has research examined this theory within different ethnic groups. This study, based on data from an eight-year study of elderly Mexican Americans and Anglos, and involving 508 people examines the relationship between activity levels and subsequent mortality. There is a second theory that social support, thought to buffer the negative impact of stress on health, helps to reduce mortality rates, and this theory may or may not be valid. If activity alone is considered, activity levels and longevity seem to be associated. When variables such as age, gender, education, marital status, ethnicity, and poorer self-rated health are added, activity levels are no longer predictive of mortality. Using crude markers of social support, the results of this study did not support the concept that social support is predictive of long life, but the authors note that further research, using more refined measures of stress, will prove or disprove the social network theory. This study was also unable to predict mortality across two ethnic groups, but this lack of correlation may not be valid, since the number of sampled Mexican Americans was considerably larger than Anglos. (Consumer Summary produced by Reliance Medical Information, Inc.)