scholarly journals Attitudes Regarding the Use of Ventilator Support Given a Supposed Terminal Condition among Community-Dwelling Mexican American and Non-Hispanic White Older Adults: A Pilot Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
M. Rosina Finley ◽  
Johanna Becho ◽  
R. Lillianne Macias ◽  
Robert C. Wood ◽  
Arthur E. Hernandez ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
End Of Life ◽  
Mexican Americans ◽  
Mexican American ◽  
Terminal Illness ◽  
Second Generation ◽  
Terminal Condition ◽  
Community Dwelling ◽  
Ventilator Support ◽  
Iadl Disability

Purpose. To determine the factors that are associated with Mexican Americans’ preference for ventilator support, given a supposed terminal diagnosis.Methods. 100 Mexican Americans, aged 60–89, were recruited and screened for MMSE scores above 18. Eligible subjects answered a questionnaire in their preferred language (English/Spanish) concerning ventilator use during terminal illness. Mediator variables examined included demographics, generation, religiosity, occupation, self-reported depression, self-reported health, and activities of daily living.Results. Being first or second generation American (OR = 0.18, CI = 0.05–0.66) with no IADL disability (OR = 0.11, CI = 0.02–0.59) and having depressive symptoms (OR = 1.43, CI = 1.08–1.89) were associated with preference for ventilator support.Implications. First and second generation older Mexican Americans and those functionally independent are more likely to prefer end-of-life ventilation support. Although depressive symptoms were inversely associated with ventilator use at the end of life, scores may more accurately reflect psychological stress associated with enduring the scenario. Further studies are needed to determine these factors’ generalizability to the larger Mexican American community.

scholarly journals THE IMPACT OF INTERGENERATIONAL SUPPORT ON DEPRESSIVE SYMPTOMS AMONG OLDER MEXICAN AMERICANS: DOES GENDER MATTER?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S817-S817
Author(s):  
Yaolin Pei ◽  
Zhen Cong ◽  
Bei Wu
Keyword(s):  
Depressive Symptoms ◽  
Mexican Americans ◽  
Mexican American ◽  
Adult Child ◽  
Living Alone ◽  
Intergenerational Support ◽  
West Texas ◽  
Different Types ◽  
The Impact ◽  
Gender Specific

Abstract The study examined gender differences in the impact of living alone and intergenerational support on depressive symptoms among Mexican American older adults. The sample included 335 parent-adult child dyads which were nested within 92 Mexican American respondents in a city in West Texas. Each respondent reported their specific relationships with each child. The results from clustered regression showed that men provided and received less intergenerational support than women, but their depressive symptoms were more susceptible to living alone and different types of intergenerational support. Factors such as living alone, and receiving instrumental support were related to higher levels of depressive symptoms among Mexican American older men than among in their female counterparts, whereas emotional closeness with children was associated with lower level of depressive symptoms in men than in women. The findings can be used to develop and target a gender-specific approach for depression interventions among older Mexican Americans.

Gender Differences in End-of-Life Care in Older Mexican American Adults

2020 ◽  
Vol 35 (4) ◽  
pp. 256-266
Author(s):  
Evangeline M. Ortiz-Dowling ◽  
Janice D. Crist ◽  
Kimberly Shea ◽  
Linda R. Phillips
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Health Care Professionals ◽  
Mexican Americans ◽  
Mexican American ◽  
A Priori ◽  
The United States ◽  
Review Articles ◽  
And Gender ◽  
Eol Care

Mexican Americans (MAs), 1 of 10 subgroups of Latinos, are the largest and fastest growing Latino subgroup in the United States; yet, their access to end-of-life (EOL) care using hospice services is low. An investigation was needed into extant research-based knowledge about factors influencing EOL care decisions among MAs to guide health-care professionals in assisting MAs to make timely, acceptable, and satisfactory EOL care decisions. To determine whether gender was an influence on EOL decision-making among older MAs, CINAHL and PubMed were searched for articles published between 1994 and 2018. Relevant sources were also identified through the reference lists of review articles. Reports were included if they were written in English, involved participants aged 50 years and older who identified themselves as MA, and data derived directly from participants. Reports in which MAs were not equally represented in the sample, large databases, and instrumentation development and testing articles were excluded. Of the 345 unduplicated articles identified in our electronic search and the 47 identified through review articles, 22 met the inclusion criteria. Content analysis was conducted using a priori codes from the Ethno-Cultural Gerontological Nursing Model (ECGNM). Only 8 (36%) of the 22 articles reported on MA older adults’ gendered experiences related to EOL decision-making. Results indicate an association between gender and EOL decision-making. As the older MA population grows, tackling disparities in EOL services use requires attention to how culture and gender influence EOL decision-making and care.

scholarly journals Body Mass Index and Frailty Among Older Mexican Americans: Findings From an 18-year of Follow-up

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 820-820
Author(s):  
Megan Rutherford ◽  
Brian Downer ◽  
Chih-Ying Li ◽  
Soham Al Snih
Keyword(s):  
Body Mass Index ◽  
Depressive Symptoms ◽  
Body Mass ◽  
Mexican Americans ◽  
Mexican American ◽  
Normal Weight ◽  
Healthy Weight ◽  
Weight Category ◽  
Over Time

Abstract The objective of this study was to examine body mass index (BMI) as predictor of frailty among non-frail Mexican American older adults at baseline. Data are from an 18-year prospective cohort of 1,647 non-institutionalized Mexican American aged ≥ 67 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/1996-2012/13). BMI (Kg/m2) was grouped according to the National Institutes of Health obesity standards (<18.5=underweight, 18.5–24.9=normal weight, 25.0–29.9=overweight, 30.0–34.9=obesity category I and ≥ 35=obesity category II and extreme obesity). Frailty was defined as meeting three or more of the following: unintentional weight loss of >10 pounds, weakness, self-reported exhaustion, low physical activity, and slow walking speed. Covariates included socio-demographics, comorbidities, cognitive function, depressive symptoms, and limitations in activities of daily living (ADL). General Estimating Equations were performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of frailty as a function of BMI categories. All variables were analyzed as time varying except for gender and education. Participants in the underweight or obesity type II / morbidity obesity category had increased OR of frailty over time than those in the normal weight category (2.68, 95% CI=1.46-4.9 vs.1.55, 95% CI=1.02-2.35, respectively) after controlling for all covariates. Those who reported arthritis, hip fracture, depressive symptoms, or ADL disability had increased odds of frailty over time. This study showed a U-shaped relationship between BMI and frailty over an 18-year period of follow-up which has implications for maintaining a healthy weight to prevent frailty in this population.

scholarly journals Factors Contributing to 50-ft Walking Speed and Observed Ethnic Differences in Older Community-Dwelling Mexican Americans and European Americans

2015 ◽  
Vol 95 (6) ◽  
pp. 871-883 ◽  
Author(s):  
Myla U. Quiben ◽  
Helen P. Hazuda
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
Ethnic Differences ◽  
Mexican Americans ◽  
Mexican American ◽  
Walking Speed ◽  
Community Dwelling ◽  
Functional Health ◽  
European Americans

Background Mexican Americans comprise the most rapidly growing segment of the older US population and are reported to have poorer functional health than European Americans, but few studies have examined factors contributing to ethnic differences in walking speed between Mexican Americans and European Americans. Objective The purpose of this study was to examine factors that contribute to walking speed and observed ethnic differences in walking speed in older Mexican Americans and European Americans using the disablement process model (DPM) as a guide. Design This was an observational, cross-sectional study. Methods Participants were 703 Mexican American and European American older adults (aged 65 years and older) who completed the baseline examination of the San Antonio Longitudinal Study of Aging (SALSA). Hierarchical regression models were performed to identify the contribution of contextual, lifestyle/anthropometric, disease, and impairment variables to walking speed and to ethnic differences in walking speed. Results The ethic difference in unadjusted mean walking speed (Mexican Americans=1.17 m/s, European Americans=1.29 m/s) was fully explained by adjustment for contextual (ie, age, sex, education, income) and lifestyle/anthropometric (ie, body mass index, height, physical activity) variables; adjusted mean walking speed in both ethnic groups was 1.23 m/s. Contextual variables explained 20.3% of the variance in walking speed, and lifestyle/anthropometric variables explained an additional 8.4%. Diseases (ie, diabetes, stroke, chronic obstructive pulmonary disease) explained an additional 1.9% of the variance in walking speed; impairments (ie, FEV1, upper leg pain, and lower extremity strength and range of motion) contributed an additional 5.5%. Thus, both nonmodifiable (ie, contextual, height) and modifiable (ie, impairments, body mass index, physical activity) factors contributed to walking speed in older Mexican Americans and European Americans. Limitations The study was conducted in a single geographic area and included only Mexican American Hispanic individuals. Conclusions Walking speed in older Mexican Americans and European Americans is influenced by modifiable and nonmodifiable factors, underscoring the importance of the DPM framework, which incorporates both factors into the physical therapist patient/client management process.

Mexican-American Educational Stagnation

2018 ◽  
Vol 52 (1) ◽  
pp. 159-182 ◽  
Author(s):  
Richard Neil Turner ◽  
Brian Thiede
Keyword(s):  
Mexican Americans ◽  
Mexican American ◽  
Parental Education ◽  
Second Generation ◽  
Negative Influence ◽  
Third Generation ◽  
Sibship Size ◽  
Current Population Survey Data ◽  
High School Dropout Rates ◽  
Regression Decomposition

High school dropout rates among Mexican Americans decline markedly between the first and second immigrant generations and, consequently, move closer to non-Hispanic white levels. However, the third generation makes little progress in closing the remaining gap with whites despite their parents having more schooling on average than those of the second generation. Utilizing 2007–2013 Current Population Survey data, we examine whether an inter-generational shift away from two-parent families contributes to this educational stagnation. We also consider the effect of changes in sibship size. The analysis involves performing a partial regression decomposition of differences between second- and third-generation Mexican-American adolescents (aged 16–17 years) in the likelihood of having dropped out. We find that Mexican third-generation teens are close to nine percentage points less likely than second-generation peers to live with two parents. The decomposition results suggest that this change in family structure offsets a substantial portion of the negative influence of rising parental education on third-generation dropout risk.

scholarly journals The Protective Effect of Neighborhood Composition on Increasing Frailty Among Older Mexican Americans

2011 ◽  
Vol 23 (7) ◽  
pp. 1189-1217 ◽  
Author(s):  
María P. Aranda ◽  
Laura A. Ray ◽  
Soham Al Snih ◽  
Kenneth J. Ottenbacher ◽  
Kyriakos S. Markides
Keyword(s):  
Protective Effect ◽  
Mexican Americans ◽  
Mexican American ◽  
Cardiovascular Health ◽  
Private Insurance ◽  
Frailty Index ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Protective Effects

Objective: Little is known about the nature of the frailty syndrome in older Hispanics who are projected to be the largest minority older population by 2050. The authors examine prospectively the relationship between medical, psychosocial, and neighborhood factors and increasing frailty in a community-dwelling sample of Mexican Americans older than 75 years. Method: Based on a modified version of the Cardiovascular Health Study Frailty Index, the authors examine 2-year follow-up data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) to ascertain the rates and determinants of increasing frailty among 2,069 Mexican American adults 75+ years of age at baseline. Results: Respondents at risk of increasing frailty live in a less ethnically dense Mexican-American neighborhood, are older, do not have private insurance or Medicare, have higher levels of medical conditions, have lower levels of cognitive functioning, and report less positive affect. Discussion: Personal as well as neighborhood characteristics confer protective effects on individual health in this representative, well-characterized sample of older Mexican Americans. Potential mechanisms that may be implicated in the protective effect of ethnically homogenous communities are discussed.

scholarly journals The impact of comorbid depression–diabetes on proteomic outcomes among community-dwelling Mexican Americans with mild cognitive impairment

2019 ◽  
Vol 32 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Leigh Ann Johnson ◽  
Fan Zhang ◽  
Stephanie Large ◽  
James Hall ◽  
Sidney E. O’Bryant
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mexican Americans ◽  
Mexican American ◽  
Neuropsychological Test ◽  
Community Dwelling ◽  
Support Vector ◽  
Aging Brain ◽  
Comorbid Depression ◽  
The Impact

ABSTRACTBackground:Mexican Americans suffer from a disproportionate burden of modifiable risk factors, which may contribute to the health disparities in mild cognitive impairment (MCI) and Alzheimer’s disease (AD).Objective:The purpose of this study was to elucidate the impact of comorbid depression and diabetes on proteomic outcomes among community-dwelling Mexican American adults and elders.Methods:Data from participants enrolled in the Health and Aging Brain among Latino Elders study was utilized. Participants were 50 or older and identified as Mexican American (N = 514). Cognition was assessed via neuropsychological test battery and diagnoses of MCI and AD adjudicated by consensus review. The sample was stratified into four groups: Depression only, Neither depression nor diabetes, Diabetes only, and Comorbid depression and diabetes. Proteomic profiles were created via support vector machine analyses.Results:In Mexican Americans, the proteomic profile of MCI may change based upon the presence of diabetes. The profile has a strong inflammatory component and diabetes increases metabolic markers in the profile.Conclusion:Medical comorbidities may impact the proteomics of MCI and AD, which lend support for a precision medicine approach to treating this disease.

scholarly journals End-of-Life Healthcare Utilization of Older Mexican Americans With and Without a Diagnosis of Alzheimer’s Disease and Related Dementias

2019 ◽  
Vol 75 (2) ◽  
pp. 326-332 ◽  
Author(s):  
Christine Nguyen ◽  
Brian Downer ◽  
Lin-Na Chou ◽  
Yong-Fang Kuo ◽  
Mukaila Raji
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
End Of Life ◽  
Intensive Care Unit Stay ◽  
Acute Care ◽  
Mexican Americans ◽  
Mexican American

Abstract Background Little is known about the patterns of end-of-life health care for older Mexican Americans with or without a diagnosis of Alzheimer’s disease and related dementias (ADRD). Our objective was to investigate the frequency of acute hospital admissions, intensive care unit use, and ventilator use during the last 30 days of life for deceased older Mexican American Medicare beneficiaries with and without an ADRD diagnosis. Methods We used Medicare claims data linked with survey information from 1,090 participants (mean age of death 85.1 years) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly. Multivariable logistic regression models were used to estimate the odds for hospitalization, intensive care unit use, and ventilator use in the last 30 days of life for decedents with ADRD than those without ADRD. Generalized linear models were used to estimate the risk ratio (RR) for length of stay in hospital. Results Within the last 30 days of life, 64.5% decedents had an acute hospitalization (59.1% ADRD, 68.3% no ADRD), 33.9% had an intensive care unit stay (31.3% ADRD, 35.8% no ADRD), and 17.2% used a ventilator (14.9% ADRD, 18.8% no ADRD). ADRD was associated with significantly lower hospitalizations (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.50–0.89) and shorter length of stay in hospital (RR = 0.77, 95% CI = 0.65–0.90). Conclusion Hospitalization, intensive care unit stay, and ventilator use are common at the end of life for older Mexican Americans. The lower hospitalization and shorter length of stay in hospital of decedents with ADRD indicate a modest reduction in acute care use. Future research should investigate the impact of end-of-life planning on acute-care use and quality of life in terminally ill Mexican American older adults.

scholarly journals RISK AND RESILIENCY IN THE RELATIONSHIP BETWEEN WIDOWHOOD AND DEPRESSIVE SYMPTOMS AMONG OLDER MEXICAN AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S817-S818
Author(s):  
Zhen Cong ◽  
Yaolin Pei ◽  
Bei Wu
Keyword(s):  
Older Adults ◽  
Socioeconomic Status ◽  
Regression Analysis ◽  
Depressive Symptoms ◽  
Adverse Effects ◽  
Mexican Americans ◽  
Mexican American ◽  
Functional Limitations ◽  
Intergenerational Support ◽  
The Relationship

Abstract This study investigated the association between widowhood and depressive symptoms and the extent to which the association is contingent upon immigration status, functional limitations, financial strains, and intergenerational support, among older Mexican Americans. A sample of 344 parent-child dyads reported by 83 older adults in a city of West Taxes completed the measures for socioeconomic status and depressive symptoms. Clustered regression analysis showed that widowhood elevated the risk of depressive symptoms. Living with functional limitations, having more children and residing in the same city with children exacerbated the adverse effects of widowhood on depressive symptoms. Residing in the same city with children increased the detrimental effects of widowhood on the depressive symptoms among men, whereas this pattern did not appear among women. The findings highlight the heterogeneity of depressive symptoms among the widowed Mexican American older adults.

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