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The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.

Purpose: There is a strong connection between marriage and well-being, with evidence suggesting that the well-being of one spouse is closely correlated with that of the other. However, among older Mexican Americans, there is little information about this phenomenon. To address this, we explore two research questions: Does one spouse's well-being predict the other spouse's well-being? Are there gender differences in these effects? Design and Methods: We assess information from 553 couples who participated in Wave 1 (1993-1994) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly. Using structural equation models, we examined three aspects of well-being among older Mexican American couples: depressive symptoms, life satisfaction, and self-rated health. Results: The findings revealed evidence of an association between the well-being of one spouse and that of the other. Specifically, the self-rated health of husbands and wives predicts that of their partners. However, there is evidence that husbands' depressive symptoms and life satisfaction influence wives' well-being, but not the reverse. Implications: The findings from this study are important because they add to the literature on the connection of well-being among spouses, point to important gender differences, focus on an understudied minority group with unique cultural characteristics, and have implications for the examination of well-being within a marriage framework. (Contains 2 tables and 1 figure.)

Purpose: The Medical Outcomes Study (MOS) Item Short-Form Health Survey (SF-36) has been validated in many diverse samples. This measure of health-related quality of life, however, has not yet been examined among older Mexican Americans, a rapidly growing subset of the older population. Design and Methods: We address the validity of the SF-36 in a sample of older Mexican Americans (N = 621) selected from the Hispanic Established Populations for Epidemiologic Study of the Elderly. Using confirmatory factor analysis through structural equation modeling, we evaluate the construct validity of this scale. Results: The results indicate evidence for a model with eight first-order factors consistent with previous research on the SF-36 and two second-order factors representing mental and physical health. Implications: This, in addition to other evidence given here, leads us to the conclusion that the SF-36 is a valid measure of health-related quality of life in this sample of older Mexican Americans.

Considers race differences in the determinants of social support network characteristics using data from Established Populations for Epidemiological Studies of the Elderly. Focuses on the extent to which race differences in network dimensions are present and whether variations can be attributed to social structural positions held. Results indicate that several race differences persist even when controlling for social structural variables. (JDM)

Objectives. We investigated ethnic differences in allostatic load in a population-based sample of adults living in Texas City, TX, and assessed the effects of nativity and acculturation status on allostatic load among people of Mexican origin. Methods. We used logistic regression models to examine ethnic variations in allostatic load scores among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin. We also examined associations between measures of acculturation and allostatic load scores among people of Mexican origin only. Results. Foreign-born Mexicans were the least likely group to score in the higher allostatic load categories. Among individuals of Mexican origin, US-born Mexican Americans had higher allostatic load scores than foreign-born Mexicans, and acculturation measures did not account for the difference. Conclusions. Our findings expand on recent research from the National Health and Nutrition Examination Survey with respect to ethnicity and allostatic load. Our results are consistent with the healthy immigrant hypothesis (i.e., newer immigrants are healthier) and the acculturation hypothesis, according to which the longer Mexican immigrants reside in the United States, the greater their likelihood of potentially losing culture-related health-protective effects. (Am J Public Health. 2010;100:940-946. doi: 10.2105/AJPH.2007.129312)

Background. Aging is one factor believed to contribute to processes that underlie chronic low-grade inflammation in older adults. Moreover, more recent studies have suggested that cytokine levels are influenced by ethnicity. Methods. In this study, we determined plasma cytokine profiles in a population-based sample (n = 1,411; aged25-91 years) to determine the relationship between circulating cytokine levels, aging, and ethnicity. We measured interleukin-1 receptor antagonist (IL-1ra), interleukin (IL)-6, -10, C-reactive protein (CRP), and tumor necrosis factor-receptor 1 (TNF-r1). Results. IL-6 and TNF-r1 significantly increased with age, whereas IL-1ra, IL-10, and CRP did not significantly increase with age. After adjusting for age, non-Hispanic whites had significantly higher levels of IL-1ra than Mexican Americans, whereas non-Hispanic blacks had significantly higher levels of IL-6 and CRP than Mexican Americans as well as non-Hispanic whites. CRP levels in non-Hispanic blacks were no longer significantly higher after adjusting for body mass index (BMI), indicating that BMI is an important predictor of this inflammatory marker. Conclusions. These results demonstrate that cytokine levels are influenced by both age and ethnicity. Furthermore, these results show that inflammatory profiles for Mexican Americans are lower than non-Hispanic whites and nonHispanic blacks. Key Words: IL-6--IL-10--IL-1--TNF--CRP. doi: 10.1093/gerona/glp198

Background. Very few studies have examined how disability develops among older Mexican Americans. To determine how disability develops, we explored the Disablement Process model, which posits that impairment, measured by muscle strength, leads to functional limitations, which lead to disability, which ultimately is associated with health related quality of life (HRQOL). Methods. A structural equation model approach was used (AMOS 4) with data collected on 622 Mexican Americans aged 71 or older residing in the Southwest. Results. Our results show preliminary support for the Disablement Process model. Impairment is significantly associated with functional limitation ([beta] = .36, z value = 7.2), which is significantly associated with disability ([beta] = -.53, z value = 16.1). Finally, disability is significantly related to both physical and mental components of HRQOL ([beta] = -.69, z value 23.4; [beta] = -.26, z value = 6.5. respectively). Conclusions. Muscle strength as a measure of impairment and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) score as a measure of HRQOL are important factors in understanding disability in older Mexican Americans.

Background. Little is known regarding diabetes mellitus as a risk factor for stroke incidence and death in older Mexican Americans. The authors studied diabetes and other potential risk factors for stroke in a sample of community dwelling older Mexican Americans. Methods. A prospective cohort design was used that involved the Hispanic Established Population for the Epidemiologic Study of the Elderly, a longitudinal study using a weighted probability sample of Mexican Americans (aged older than 65 years) living in the southwestern United States. 3050 older Mexican American persons were originally interviewed and tested at baseline and then followed with reassessment at 2, 5, and 7 years. The incidence of stroke and stroke death were studied for the participants during a 7-year follow-up period. Results. 690 participants were identified at baseline with diabetes. 238 participants experienced a first time stroke during the follow-up period. 66 died as a result of a stroke. Cox proportional hazard regression analysis revealed an increased hazard ratio (HR) for stroke in persons with diabetes (HR, 1.80; 95% confidence interval [CI]. 1.32 to 2.44; p < .0002) when adjusted for age, sex, body mass index, smoking, systolic blood pressure, previous heart attack, and lower extremity function. The stroke mortality rate was also higher (HR, 2.02; 95% CI, 1.04 to 3.93) for persons with diabetes when adjusted for covariates. Conclusion. Diabetes was associated with an increased incidence of stroke and death in older Mexican Americans, particularly those taking insulin.

The Disablement Process model (Verbrugge and Jette, Social Science & Medicine 38 (1994) 1) describes a pathway leading from pathology to impairment to functional limitations, and, ultimately to disability. Components of this model have been examined among older White adults; however, very little research has examined the disablement process among older adults of other ethnic groups. Our goal in this research is to evaluate the Disablement Process model using Activities of Daily Living (ADL) disability as the outcome among a representative group of older Mexican American adults in the Southwestern United States. Respondents are from two waves of the Hispanic Established Populations Epidemiologic Study of the Elderly (EPESE) (n = 2439). Structural equation models (LISREL 8.30) are utilized to examine the Disablement Process model. We also investigate aspects of the original model that have potentially important effects on the process of becoming disabled, such as cognitive impairment and perceived emotional support. Findings from structural equation models suggest that the main pathway from pathology to ADL disability is through functional limitations among older Mexican Americans. Risk factors, especially age and gender, have significant indirect effects on ADL disability. The main pathway in the Disablement Process model receives preliminary support among older Mexican Americans. We discuss implications of this model for future research. Keywords: USA, Disability; Aging; Mexican American

Background. Hip fracture in older adults is a significant medical, social, and economic concern to society. Little is known regarding diabetes as a risk factor for hip fracture in the Mexican American population. The objective of this study was to examine diabetes and other potential risk factors for hip fracture in a sample of community-dwelling, older, Mexican American adults. Methods. The study was a prospective cohort design involving the Hispanic Established Population for the Epidemiologic Study of the Elderly, a longitudinal study involving a weighted probability sample of Mexican American adults (>65 years) living in the southwestern United States. Included in the study were 3050 older Mexican American subjects who were originally interviewed and tested at baseline and then followed with reassessment at 2, 5, and 7 years. Incidence of hip fracture was examined for subjects over 7-year follow-up. Results. At baseline, 690 subjects were identified with diabetes. One hundred and thirty-four subjects experienced a first-time hip fracture during follow-up. Cox proportional hazard regression revealed an increased hazard ratio for hip fracture in subjects with diabetes compared to those without diabetes (hazard ratio = 1.57, 95% confidence interval [[CI.sub.95]] = 1.03, 2.39, p < .04) when adjusted for age, body mass index, smoking, and previous stroke. The hazard ratio for Mexican Americans taking insulin was 2.84 ([CI.sub.95] = 1.49, 5.43, p < .002) when adjusted for covariates. Conclusions. We found diabetes was associated with increased risk for a hip fracture in older Mexican Americans, particularly subjects taking insulin. Diabetes has not previously been considered a risk factor for hip fracture in older adults. The high incidence of type 2 diabetes in the Mexican American population highlights the need for increased research on risk factors in this ethnic group.

Data from community-dwelling older adults (65+) with two or more chronic health conditions who participated in a 30-month longitudinal panel survey (N = 898) are used to examine the factors that are associated with the presence and development of functional disabilities. Both logistic regression and discrete time hazard models are used to address the risk factors associated with the presence and development of activities of daily living and instrumental activities of daily living disabilities. Results indicate that education, income, and age are consistent predictors of disability, and that arthritis and obesity have consistently stronger effects on disability than do other chronic conditions. A need for stronger conceptual models focusing on disability is discussed.

There are substantial uncertainties about key dimensions of the caregiving process as it is experienced by older adults from different racial groups. This investigation explores the care received from family members among a stratified random sample of community-dwelling older (65+) African Americans and Whites who reported difficulties performing daily living tasks. Findings support past research indicating that older African Americans are more likely to receive help from family members than are Whites when in need of assistance. However, this advantage does not extend across all types of family members but, rather, is only statistically significant in the final models with regard to the care received from grandchildren. Evidence is presented that indicates that the observed race differences in the receipt of care from children can be attributed to variations between racial groups in family and household structure. The findings suggest that coresidence may be a form of family caregiving among older African Americans.