Population-level trends in self-reported healthcare utilization among older adults in Mexico with and without cognitive impairment.

Background: Older adults with cognitive impairment exhibit different patterns of healthcare utilization compared to their cognitively healthy counterparts. Despite extensive research in high-income countries, similar studies in low- and middle-income countries are lacking. This study aims to investigate the population-level patterns in healthcare utilization among older adults with and without cognitive impairment in Mexico.

Dual-Language Use and Cognitive Function Among Mexican Americans Aged 65 and Older.

Background: Better English proficiency and higher frequency of using English among non-native speakers are associated with lower dementia risk.

Objective: We investigated if Mexican American older adults who use English and Spanish to a more similar degree demonstrate better cognitive function than those who use one language more than the other.

Methods: We used data from waves one (1992/93) to eight (2012/13) of the Hispanic Established Population for the Epidemiological Study of the Elderly.

Association of cancer diagnosis with disability status among older survivors of colorectal cancer: a population-based retrospective cohort study.

Background: Older cancer survivors likely experience physical function limitations due to cancer and its treatments, leading to disability and early mortality. Existing studies have focused on factors associated with surgical complications and mortality risk rather than factors associated with the development of poor disability status (DS), a proxy measure of poor performance status, in cancer survivors. We aimed to identify factors associated with the development of poor DS among older survivors of colorectal cancer (CRC) and compare poor DS rates to an age-sex-matched, non-cancer cohort.

Does a Reduction in Receiving Assistance With Daily Activities Among Older Adults in Mexico Indicate An Increase in Unmet Needs or a Decrease in Needs for Care?

Objectives: The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care.

Methods: We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (n = 4,805) and 2018 (n = 6,494).

Successful Discharge to Community From Home Health Less Likely for People in Late Stages of Dementia.

Background And Purpose: Several studies have established the efficacy of home health in meeting the health care needs of people with Alzheimer disease and related dementias (ADRD) and helping them to remain at home. However, transitioning to the community after discharge from home health presents challenges to patient safety and quality of life. The severity of an individual's functional impairments, cognitive limitations, and behavioral and psychological symptoms may compound these challenges.

Achieving Functional Goals During a Skilled Nursing Facility Stay: A National Study of Medicare Beneficiaries.

Objectives: The aims of the study are to describe the frequency that functional goals are documented on the Minimum Data Set and to identify resident characteristics associated with meeting or exceeding discharge goals.

Methods: We selected Medicare fee-for-service beneficiaries admitted to a skilled nursing facility within 3 days of hospital discharge from October 1, 2018, to December 31, 2019 ( N = 1,228,913). The admission Minimum Data Set was used to describe the discharge goal scores for seven self-care and 16 mobility items.

Financial Performance is Associated With PPE Shortages in Chain-Affiliated Nursing Homes During the COVID-19 Pandemic: A Longitudinal Study.

Many nursing homes operated at thin profit margins prior to the COVID-19 pandemic. This study examines the role of nursing homes' financial performance and chain affiliation in shortages of personal protection equipment (PPE) during the first year of the COVID-19 pandemic. We constructed a longitudinal file of 79 868 nursing home-week observations from 10 872 unique facilities.

Cognitive life expectancy by educational attainment in Mexican adults aged 60 and older.

Objective: To estimate cognitively healthy life expectancy (CHLE), cognitive impairment life expectancy (CILE), and dementia life expectancy (DLE) in Mexican adults aged 60 and older stratified by educational attainment.

Materials And Methods: The data were obtained from Waves 1 (2001) to 5 (2018) of the Mexican Health and Aging Study. The life expectancy was estimated using a multistate life table analysis.

The Influence of Education and Occupation Type on Birth Cohort Differences in Cognitive Function of Mexican Older Adults.

Objectives: Mexico's population aging is occurring in the context of social changes such as increased educational attainment and occupational shifts from agriculture to service and industry. The current study compares cognitive function between two birth cohorts of Mexican adults aged 60-76 to determine if population-level changes in education and occupation type contribute to cohort differences in cognitive function.

Methods: We used the Mexican Health and Aging Study to examine adults aged 60-76 in 2001 (men: 2,309; women: 2,761) and 2018 (men: 2,842; women: 3,825).

Pain and incident cognitive impairment in very old Mexican American adults.

Background: Studies have investigated the association between pain and cognitive impairment among older adults, but the findings are mixed. We assessed the relationship of activity-limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged ≥80.

Methods: Data were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010-2016).

Addressing non-response data for standardized post-acute functional items.

Background: The post-acute patient standardized functional items (Section GG) include non-response options such as refuse, not attempt and not applicable. We examined non-response patterns and compared four methods to address non-response functional data in Section GG at nation-wide inpatient rehabilitation facilities (IRF).

Methods: We characterized non-response patterns using 100% Medicare 2018 data.

Differences in the Cognitive Function of Mexican Adults Aged 60 and Older with Self-Reported Diabetes in 2001 and 2018.

Background: The prevalence of type 2 diabetes in Mexico has nearly doubled for adults aged ≥60. Increases in education and healthcare resources to manage chronic conditions have contributed to population-level increases in the cognitive functioning of older adults. However, research has not focused on older adults with chronic conditions such as diabetes.

Subtyping Social Determinants of Health in : Network Analysis and Visualization Approach.

Background: Social determinants of health (SDoH), such as financial resources and housing stability, account for between 30-55% of people's health outcomes. While many studies have identified strong associations among specific SDoH and health outcomes, most people experience multiple SDoH that impact their daily lives. Analysis of this complexity requires the integration of personal, clinical, social, and environmental information from a large cohort of individuals that have been traditionally underrepresented in research, which is only recently being made available through the research program.

Social and Leisure Activities Predict Transitions in Cognitive Functioning in Older Mexican Adults: A Latent Transition Analysis of the Mexican Health and Aging Study.

Objectives: Mexico has a rapidly aging population at risk for cognitive impairment. Social and leisure activities may protect against cognitive decline in older adults. The benefits of these behaviors may vary by patterns of cognitive impairment.

Disability-Adjusted Life Expectancy and Cognitive Function among Community-Dwelling Adults.

We aimed to calculate disability-adjusted life expectancy (DALE) for Korean older adults based on their sex, educational attainment, and residential region across their cognitive status. We included 3,854 participants (aged 65-91 years) from the Korean Longitudinal Study of Aging's seventh survey data. The participant's cognitive function status (normal, moderately impaired, or severely impaired) was determined based on cognitive examination and physical function independence, which was used to calculate their DALE.

Association Between Cognitive Impairment and Repeat Fractures in Medicare Beneficiaries Recently Hospitalized for Hip Fracture.

Background: Repeat fractures contribute substantially to fracture incidents in older adults. We examined the association between cognitive impairment and re-fractures during the first 90 days after older adults with hip fractures were discharged home from a skilled nursing facility rehabilitation short stay.

Methods: Multilevel binary logistic regression was used to analyze 100% of U.

Healthcare utilization among pre-frail and frail Puerto Ricans.

Frailty is associated with adverse health outcomes and greater healthcare utilization. Less is known about the relationship between frailty and healthcare utilization in Puerto Rico, where high rates of chronic conditions and limited healthcare may put this group at a higher likelihood of using healthcare resources. This study examined the association between pre-frailty and frailty with healthcare utilization at baseline and 4-year follow-up among a cohort of community dwelling Puerto Ricans living on the island.

Nativity differences in the relationship between handgrip strength and cognitive impairment in older Mexican Americans over 20 years of follow-up.

Purpose: To examine nativity differences in the relationship between handgrip strength (HGS) and cognitive impairment among Mexican Americans aged ≥ 65 years with normal or high cognitive function at baseline over a 20-year period.

Methods: Prospective cohort study of 2,155 non-institutionalized Mexican Americans aged ≥ 65 years from the Hispanic Established Population for the Epidemiological Study of the Elderly) who scored ≥ 21 in the Mini Mental State Examination (MMSE) at baseline. Measures included socio-demographics, body mass index, medical conditions, depressive symptoms, physical function, disability, HGS quartiles (sex-adjusted), and MMSE.

Hospitalizations and Emergency Room Admissions by Mexican American Older Adults with and without Dementia and Caregiver Mental Health.

Background: Evidence from predominately non-Hispanic White populations indicates that emergency room (ER) admissions and hospitalizations by older adults with and without dementia are associated with caregiver stress and depressive symptoms. These results may not generalize to Hispanic populations because of cultural differences in caregiving roles, responsibilities, and perspectives about care burden.

Objective: Investigate the association between ER admissions and hospitalizations by Mexican American older adults with and without dementia and symptoms of depression and stress among family caregivers.

Association of Dementia Severity and Caregiver Support With Early Discharge From Home Health.

Introduction: The objective of this study was to examine the relationship between dementia severity and early discharge from home health.

Methods: This was a retrospective study of 100% national Medicare home health da ta files (2016-2017). Multilevel logistic regression was used to study the relationship of dementia severity, caregiver support, and medication assistance with early discharge from home health.

Body mass index and physical frailty among older Mexican Americans: Findings from an 18-year follow up.

Purposes: The relationship between body mass index (BMI) and frailty in older Mexican Americans has not been previously studied. The objective of this study was to examine the relationship between BMI and frailty among non-frail older Mexican Americans at baseline over 18 years of follow up.

Methods: Longitudinal population-based study of 1,648 non-institutionalized Mexican Americans aged ≥ 67 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13).

Relationship Between Diabetes-Related Complications and Sleep Complaints in Older Mexican Americans.

Introduction/objective: The prevalence of Type 2 Diabetes Mellitus is increasing in the older American population, especially Mexican Americans. Sleep disorders are common in older adults with T2DM. This study examined the relationship between T2DM-related complications and sleep complaints in older Mexican Americans over 9 years of follow-up.

The Association between Late-Life Alcohol Consumption and Incident Dementia among Mexican Americans Aged 75 and Older.

Evidence for late-life alcohol consumption being associated with reduced dementia risk is largely based on cohort studies of predominately non-Hispanic white older adults. Our objective was to investigate the relationship between late-life alcohol consumption and dementia risk among Mexican-America adults aged 75 and older. This study was a retrospective analysis of waves 5 (2004/05) to 8 (2012/13) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly.

Home health utilization association with discharge to community for people with dementia.

Introduction: The objective of this study was to identify home health utilization factors associated with successful discharge to community after home health care for patients with and without Alzheimer's disease and related dementias (ADRD).

Methods: This was a retrospective study of 100% national Medicare home health data files (2016 to 2017). Multilevel logistic regression was used to study the relationship of home health utilization with a modified definition of successful discharge to community (M-SDC) after home health (no readmission or discharge within 30 days).