Life-space mobility and post-hospitalization outcomes among older Mexican American Medicare beneficiaries.

Background: Older adults with limited mobility are at an increased risk of adverse health outcomes, an outcome inadequately investigated in older Mexican Americans. We explored whether pre-admission life-space mobility predicts post-hospitalization outcomes among hospitalized Mexican American Medicare beneficiaries.

Methods: Life-space mobility, using the Life-Space Assessment (LSA), was analyzed using quartiles and 5-point intervals.

Social Engagement and Cognitive Function of Older Adults in Mexico and the United States: How Universal Is the Interdependence in Couples?

Objectives: Increased social engagement in older adults has been linked to positive cognitive outcomes; however, it is unclear if the social engagement of husbands and wives influences their own cognition as well as each other's cognition. Moreover, it is unknown if any such patterns persist in different country contexts.

Methods: Data from the 2001 Mexican Health and Aging Study (MHAS) and the 2000 Health and Retirement Study (HRS) were combined, and comparable samples of married couples without cognitive impairment at baseline were drawn.

Gender differences in activity-limiting pain trajectories over a 17-year period in the Mexican Health and Aging Study.

Pain increases with age, disproportionately affects women, and is a major contributor to decreased quality of life. Because pain is dynamic, trajectories are important to consider. Few studies have examined longitudinal trajectories of pain, by gender, in Mexico.

Association between vision impairment and cognitive decline in older adults with stroke: Health and Retirement Study.

Stroke survivors may experience multiple residual symptoms post-stroke, including vision impairment (VI) and cognitive decline. Prior studies have shown that VI is associated with cognitive decline, but have not evaluated the contribution of VI to post-stroke cognitive changes. We used data from four waves (2010-2016) of the Health and Retirement Study to investigate the cognitive trajectories of stroke survivors with and without VI.

Trajectories of Frailty and Cognitive Decline Among Older Mexican Americans.

Background: Progressive physical frailty and cognitive decline in older adults is associated with increased risk of falls, disability, institutionalization, and mortality; however, there is considerable heterogeneity in progression over time. We identified heterogeneous frailty and cognitive decline trajectory groups and examined the specific contribution of health conditions to these trajectories among older Mexican origin adults.

Methods: We use a sample from the Hispanic Established Population for the Epidemiological Study of the Elderly (HEPESE) with at least two measures of frailty criteria during 18 years follow-up: slow gait, weak handgrip strength, exhaustion, and unexplained weight loss (n = 1362, mean age 72).

Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans.

Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans. Data for this analysis came from the 2006-2007 and 2010-2011 waves of the Hispanic EPESE.

Measuring Social Participation in the Health and Retirement Study.

Background And Objectives: Large data sets have the potential to reveal useful information regarding social participation; however, most data sets measure social participation via individual items without a global assessment of social participation.

Research Design And Methods: We used data from the Health and Retirement Study (HRS) to assess whether 8 items from questionnaire pertaining to social participation (religious attendance, caring for an adult, activities with grandchildren, volunteering, charity work, education, social clubs, nonreligious organizations) formed a reliable, cohesive scale and to explore the predictive validity of this scale. We included respondents 65 years and older in the HRS who returned the psychosocial questionnaire in 2010 and 2012 with responses to the social participation items (n = 4,317 and n = 3,978).

Frailty and diabetes among Mexican American older adults.

Purpose: Progressive physical frailty in older adults is associated with increased risk of falls, disability, institutionalization, and mortality. Although associations between diabetes and frailty have been observed, the impact of diabetes on frailty in older Hispanics is largely unexplored. We examine the association of diabetes on the odds of frailty among older Mexican Americans.

Physical Performance Trajectories and Mortality Among Older Mexican Americans.

Background: We sought to identify distinct trajectory classes of physical performance in Mexican Americans aged 75 years and older and to examine whether these trajectories predict mortality.

Methods: We used four waves of Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) data for adults 75 years and older from 2004-2005 to 2013. Latent growth curve analysis was used to identify distinct trajectory classes.

The Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) Study: Self-Reported Health Effects.

Unlabelled: The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S.

History: We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill.

Trajectories of Functional Change After Inpatient Rehabilitation for Traumatic Brain Injury.

Objective: To examine trajectories of functional recovery after rehabilitation for traumatic brain injury (TBI).

Design: Prospective study.

Setting: Inpatient rehabilitation hospitals in the Uniform Data System for Medical Rehabilitation.

Associations Among Neighborhood Characteristics, Mobility Limitation, and Social Participation in Late Life.

Objectives: Although emerging research suggests neighborhood characteristics can support and restrict social participation in older adults, further research regarding a wider range of neighborhood characteristics and interactions between individual and neighborhood characteristics is needed. This study explored associations between neighborhood characteristics and frequency of participation in three social activities among older adults and interactions between neighborhood characteristics and mobility limitation as they relate to participation.

Method: Data from the 2008 wave of the Health and Retirement Study linked with American Community Survey data were used.

Stability and Change in Activities of Daily Living Among Older Mexican Americans.

Background: Longitudinal studies of activities of daily living (ADL) in older adults have identified numerous factors associated with declining ability. Analyses based on population averages may not observe distinct subgroups whose ADL trajectories differ.

Methods: We used latent class models to identify subgroups of trajectories in a sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of noninstitutionalized Mexican Americans aged 65 and older from five Southwestern states (n = 2584).

Partnering With Patients, Families, and Communities.

Collaborating with patients, families, and communities is a core principle of family medicine. However, the health care system in the United States has grown increasingly complex, fragmented, and difficult to navigate. This system, focused on disease-specific care delivered by specialists, often treats patients as the objects of care rather than as partners in care.

Stability in Cognitive Function Over 18 Years: Prevalence and Predictors among Older Mexican Americans.

Purpose: Numerous studies have examined the association of physical, behavioral and social factors with cognitive decline in older adults. Less attention has been placed on factors associated with long-term maintenance of intact cognition even into very old age. A greater understanding of those factors can inform the development of activities for maintaining cognitive strength.

Chamomile Consumption and Mortality: A Prospective Study of Mexican Origin Older Adults.

Purpose: Approximately 20% of adults use some kind of herbal; however, little data exists from population-based study or clinical trials to support effectiveness of most herbal products. Chamomile is a commonly used herb among older adults of Mexican origin. We examined the effects of herbal chamomile consumption on mortality among older adults of Mexican origin.

Screening and monitoring in men prescribed testosterone therapy in the U.S., 2001-2010.

Objectives: The Endocrine Society recommends testosterone therapy only in men with low serum testosterone levels, consistent symptoms of hypogonadism, and no signs of prostate cancer. We assessed screening and monitoring patterns in men receiving testosterone therapy in the U.S.

Social support, stressors, and frailty among older Mexican American adults.

Background: There is little research on the effects of stressors and social support on frailty. Older Mexican Americans, in particular, are at higher risk of medical conditions, such as diabetes, that could contribute to frailty. Given that the Mexican American population is rapidly growing in the United States, it is important to determine whether there are modifiable social factors related to frailty in this older group.

Self-reported sleep characteristics and mortality in older adults of mexican origin: results from the Hispanic established population for the epidemiologic study of the elderly.

Objectives: To determine how poor sleep affects the health of older ethnic minorities.

Design: Cross-sectional study involving a population-based survey.

Setting: Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) survey conducted in the southwestern United States.

The impact of PSA screening on prostate cancer mortality and overdiagnosis of prostate cancer in the United States.

Background: The study assessed the impact of prostate-specific antigen (PSA) testing in the United States by comparing the rates of PSA testing in U.S. counties to the rates of prostate biopsies and newly treated prostate cancer and to deaths from prostate cancer.

Risk of continued institutionalization after hospitalization in older adults.

Background: Little is known about the role of hospitalization as a risk factor for placement into long-term care. We therefore sought to estimate the percentage of long-term care nursing home stays precipitated by a hospitalization and factors associated with risk of nursing home placement after hospitalization.

Methods: We studied a retrospective cohort of a 5% sample of Medicare enrollees aged ≥ 66 years.

Association of care by hospitalists on discharge destination and 30-day outcomes after acute ischemic stroke.

Objectives: The use of hospitalists is increasing. Hospitalists have been associated with reductions in length of stay and associated costs while not negatively impacting outcomes. We examine care for stroke patients because it requires complex care in the hospital and has high post discharge complications.

The effect of acculturation on frailty among older Mexican Americans.

Objective: To determine the effect of acculturation on becoming frail and prefrail over a 10-year period among older Mexican Americans.

Method: A nationally representative sample of 2,049 Mexican Americans aged 67 to 108 was analyzed. Adjusted for sociodemographics and health, longitudinal multinomial mixed models examined the effects of English language and frequency of contact with Anglo-Americans on transitions among deceased, nonfrail, prefrail, and frail statuses.

Multiple measurement of serum lipids in the elderly.

Background: Although there is considerable interest in underutilization of lipid testing, little is known about the prevalence and factors associated with overtesting of serum lipids.

Methods: We assessed the number of different days in which outpatient lipid testing was performed in a 5% national sample of patients with parts A and B Medicare in 2006. Covariates included patient characteristics (age, race, prior diagnosis of lipid disorder, and other indications for lipid testing), number of usual care physicians (UCP), type of UCP, total outpatient physician encounters, and health referral region (HRR) characteristics (average per-patient Medicare expenditures and percent of patients seeing multiple UCPs).

Lower stroke mortality among Hispanics: an exploration of potential methodological confounders.

Objectives: Stroke mortality rates are reported to be lower for Hispanics than non-Hispanic Whites. We investigate the degree to which this lower reported mortality is explained by inaccuracies introduced through omission of nativity, imprecise measurement of cause of death, and under-ascertainment of Hispanic ethnicity on death certificates. We used national vital registration data for the years 1989-1991 and 1999-2002, including foreign- and US-born Hispanics and non-Hispanic Whites.