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Baillargeon J, Linthicum LC, Murray OJ, Raji MA, Kuo YF, Pulvino JS, Milani SA, Williams B, Baillargeon GR, Blair PA, Kristen Peek M, Penn JV. The Prevalence of Cognitive Impairment and Dementia in Incarcerated Older Adults. J Gerontol B Psychol Sci Soc Sci 2023; 78:2141-2146. [PMID: 37793395 DOI: 10.1093/geronb/gbad136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVES In view of the growing number of older incarcerated persons in the United States, cognitive impairment represents one of the most challenging and costly health care issues facing the U.S. correctional system. This study examined the prevalence and correlates of this growing public health issue in the nation's largest prison system. METHODS In this study of a random sample of 143 older (≥55 years) adults incarcerated in the Texas prison system, we assessed-using the Montreal Cognitive Assessment (MoCA)-the percentage of inmates who met the MoCA thresholds for mild cognitive impairment (MCI; <23) and dementia (<18). Due to sample size limitations, our multivariable analysis assessed the binary outcome, MoCA <23. RESULTS Overall, 35.0% of our random sample of incarcerated older adults in Texas met the threshold for MCI and 9.1% met the threshold for dementia. After adjusting for covariates, study participants who were Black (odds ratio [OR] = 4.12, 95% confidence interval [CI] = 1.57-10.82), Hispanic (OR = 4.34, 95% CI = 1.46-12.93), and those with a diagnosis of major depressive disorder (8.56, 95% CI = 1.21-60.72) all had higher prevalence of a positive screen for MCI or dementia. Dementia was underdiagnosed in our study sample of incarcerated adults, with 15.4% of MoCA-diagnosed dementia patients having a dementia diagnosis documented in their medical records. DISCUSSION Future studies of cognitive impairment in prisons and jails can inform health care planning and resource allocation, such as expansion of access to palliative care, advance care planning, and targeted cognitive screening in older age groups.
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Affiliation(s)
- Jacques Baillargeon
- Department of Epidemiology, School of Public and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Lannette C Linthicum
- Department of Health Services, Texas Department of Criminal Justice, Huntsville, Texas, USA
| | - Owen J Murray
- Correctional Managed Care Division, University of Texas Medical Branch, Galveston, Texas, USA
| | - Mukaila A Raji
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Yong-Fang Kuo
- Department of Biostatistics and Data Science, School of Public and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - John S Pulvino
- Correctional Managed Care Division, University of Texas Medical Branch, Galveston, Texas, USA
| | - Sadaf A Milani
- Department of Epidemiology, School of Public and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Brie Williams
- Division of Geriatrics, University of California at San Francisco, San Francisco, California, USA
| | - Gwen R Baillargeon
- Correctional Managed Care Division, University of Texas Medical Branch, Galveston, Texas, USA
| | - Patricia A Blair
- School of Nursing, University of Texas Medical Branch, Galveston, Texas, USA
| | - M Kristen Peek
- Department of Population Health Sciences, School of Public and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Joseph V Penn
- Correctional Managed Care Division, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Psychiatry, University of Texas Medical Branch, Galveston, Texas, USA
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Mair CA, Peek MK, Slatcher RB, Cutchin MP. Examining Racial/Ethnic Disparities in Coping and Stress Within an Environmental Riskscape. J Immigr Minor Health 2023; 25:1033-1042. [PMID: 36800140 DOI: 10.1007/s10903-023-01458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 02/18/2023]
Abstract
Existing research on racial/ethnic differences in stress and coping is limited by small samples, single-item measures, and lack of inclusion of Mexican Americans. We address these gaps by analyzing data from the Texas City Stress and Health Study, a cross-sectional sample of Black (N = 257), White (N = 304), US-born (N = 689), and foreign-born (N = 749) Mexican Americans residing in proximity to a petrochemical complex. We compared active and avoidant coping by race/ethnicity and explored multivariable associations between coping and perceived stress. Black and foreign-born Mexican American respondents had the highest stressor exposure yet displayed different patterns of coping and perceived stress patterns. Active coping may be particularly effective for African Americans but may not offset extreme stress disparities. For Mexican Americans, the lack of association between coping and stress underscores the need for more work focused on the culturally diverse coping experiences.
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Affiliation(s)
- Christine A Mair
- Department of Sociology, Anthropology, and Public Health, Center for Health, Equity, and Aging, University of Maryland, Baltimore County, Baltimore, MD, USA.
| | - M Kristen Peek
- School of Public and Population Health, Department of Population Health and Health Disparities, University of Texas Medical Branch-Galveston, Galveston, TX, USA
| | | | - Malcolm P Cutchin
- School of Occupational Therapy, Pacific Northwest University of Health Sciences, Yakima, WA, USA
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Lopez DS, Malagaris I, Polychronopoulou E, Tsilidis KK, Milani SA, Peek MK, Villasante-Tezanos A, Alzweri L, Baillargeon J, Kuo YF, Canfield S. Metformin and testosterone replacement therapy inversely associated with hormone-associated cancers (prostate, colorectal and male breast cancers) among older White and Black men. Clin Endocrinol (Oxf) 2022; 97:792-803. [PMID: 35902376 PMCID: PMC9637746 DOI: 10.1111/cen.14803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The independent and joint association of metformin and testosterone replacement therapy (TTh) with the incidence of prostate, colorectal, and male breast cancers remain poorly understood, including the investigation of the risk of these cancers combined (HRCs, hormone-associated cancers) among men of different racial and ethnic background. METHODS In 143,035 men (≥ 65 yrs old) of SEER-Medicare 2007-2015, we identified White (N = 110,430), Black (N = 13,520) and Other Race (N = 19,085) men diagnosed with incident HRC. Pre-diagnostic prescription of metformin and TTh was ascertained for this analysis. Weighted multivariable-adjusted conditional logistic and Cox proportional hazards models were conducted. RESULTS We found independent and joint associations of metformin and TTh with incident prostate (odds ratio [OR]joint = 0.44, 95% confidence interval [CI]: 0.36-0.54) and colorectal cancers (ORjoint = 0.47, 95% CI: 0.34-0.64), but not with male breast cancer. There were also inversed joint associations of metformin and TTh with HRCs (ORjoint = 0.45, 95% CI: 0.38-0.54). Similar reduced associations with HRCs were identified among White, Black, and Other Race men. CONCLUSION Pre-diagnostic use of metformin and TTh were, independently and jointly, inversely associated with incident prostate and colorectal cancers. The risk of HRCs was also reduced among White, Black and Other Race men. Greatest reduced associations of prostate and colorectal cancers and HRCs were mainly observed in combination of metformin and TTh. Larger studies are needed to confirm the independent and joint association of metformin plus TTh with these cancers in understudied and underserved populations.
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Affiliation(s)
- David S. Lopez
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Ioannis Malagaris
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Efstathia Polychronopoulou
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Sadaf Arefi Milani
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - M. Kristen Peek
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Laith Alzweri
- Division of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Jacques Baillargeon
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Yong-Fang Kuo
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Steven Canfield
- Division of Urology, UTHealth McGovern Medical School, Houston, TX, USA
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Hussain M, Howell JL, Peek MK, Stowe RP, Zawadzki MJ. Psychosocial stressors predict lower cardiovascular disease risk among Mexican-American adults living in a high-risk community: Findings from the Texas City Stress and Health Study. PLoS One 2021; 16:e0257940. [PMID: 34618834 PMCID: PMC8496861 DOI: 10.1371/journal.pone.0257940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/14/2021] [Indexed: 12/02/2022] Open
Abstract
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.
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Affiliation(s)
- Maryam Hussain
- Department of Psychological Sciences, University of California-Merced, Merced, California, United States of America
| | - Jennifer L. Howell
- Department of Psychological Sciences, University of California-Merced, Merced, California, United States of America
| | - M. Kristen Peek
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, Texas, United States of America
| | - Raymond P. Stowe
- Microgen Laboratories, La Marque, Texas, United States of America
| | - Matthew J. Zawadzki
- Department of Psychological Sciences, University of California-Merced, Merced, California, United States of America
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Jiang Y, Zilioli S, Stowe RP, Rubinstein R, Peek MK, Cutchin MP. Perceived Social Support and Latent Herpesvirus Reactivation: Testing Main and Stress-Buffering Effects in an Ethnically Diverse Sample of Adults. Psychosom Med 2021; 83:767-776. [PMID: 34267086 PMCID: PMC8419084 DOI: 10.1097/psy.0000000000000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Perceived social support is consistently associated with physical health outcomes, and one potential physiological mechanism underlying this association is immune function. In this study, we tested both the main and stress-buffering effects of perceived social support on cellular immunity measured via latent herpesvirus reactivation. METHODS Data were collected from a community-based sample of 1443 ethnically diverse adults between the ages of 25 and 90 years. Participants self-reported measures of perceived social support, stressful life events, daily hassles, and perceived stress, and provided a blood sample to assess antibody titers to the herpes simplex virus type 1 and Epstein-Barr virus (EBV). RESULTS In accordance with the main effect hypothesis, results indicated that perceived social support was directly associated with EBV viral capsid antigen antibody titers (β = -0.06, 95% confidence interval = -0.12 to -0.01, p = .029). Perceived social support, however, did not interact with stressful life events, daily hassles, or perceived stress to influence latent herpesvirus reactivation (p values > .05). Neither race/ethnicity nor age moderated any of the interactions between perceived social support and the stress measures on latent herpesvirus reactivation (p values > .10). CONCLUSIONS Overall, the current study supports the main effect hypothesis, according to which higher levels of perceived social support were associated with lower levels of herpesvirus antibody titers.
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Affiliation(s)
- Yanping Jiang
- Department of Psychology, Wayne State University, Detroit, MI, 48202
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit, MI, 48202
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, 48202
| | | | | | - M. Kristen Peek
- Department of Preventative Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, 77555
| | - Malcolm P. Cutchin
- Department of Biomedical Sciences, Pacific Northwest University of Health Sciences
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Lopez DS, Huang D, Tsilidis KK, Canfield S, Khera M, Baillargeon JG, Kuo YF, Peek MK, Platz EA, Markides K. The role of testosterone replacement therapy and statin use, and their combination, in prostate cancer. Cancer Causes Control 2021; 32:965-976. [PMID: 34041642 DOI: 10.1007/s10552-021-01450-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Previous studies have reported conflicting results in the associations of testosterone replacement therapy (TTh) and statins use with prostate cancer (PCa). However, the combination of these treatments with PCa stage and grade at diagnosis and prostate cancer-specific mortality (PCSM) and by race/ethnicity remains unclear. METHODS We identified non-Hispanic White (NHW, N = 58,576), non-Hispanic Black (NHB, n = 9,703) and Hispanic (n = 4,898) men diagnosed with PCa in SEER-Medicare data 2007-2011. Pre-diagnostic prescription of TTh and statins was ascertained for this analysis. Multivariable-adjusted logistic and Cox proportional hazards models were used to evaluate the association of TTh and statins use with PCa stage and grade and PCSM. RESULTS 22.5% used statins alone, 1.2% used TTh alone, and 0.8% used both. TTh and statins were independently, inversely associated with PCa advanced stage and high grade. TTh plus statins was associated with 44% lower odds of advanced stage PCa (OR 0.56, 95% CI 0.35-0.91). As expected, similar inverse associations were present in NHWs as the overall cohort is mostly comprised NHW men. In Hispanic men, statin use with or without TTh was inversely associated with aggressive PCa. CONCLUSIONS Pre-diagnostic use of TTh or statins, independent or in combination, was inversely associated with aggressive PCa, including in NHW and Hispanics men, but was not with PCSM. The findings for use of statins with aggressive PCa are consistent with cohort studies. Future prospective studies are needed to explore the independent inverse association of TTh and the combined inverse association of TTh plus statins on fatal PCa.
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Affiliation(s)
- David S Lopez
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA.
| | - Danmeng Huang
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Steven Canfield
- Division of Urology, UTHealth McGovern Medical School, Houston, TX, USA
| | - Mohit Khera
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Jacques G Baillargeon
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Yong-Fang Kuo
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - M Kristen Peek
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center At Johns Hopkins, Baltimore, MD, USA.,Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kyriakos Markides
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
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Lopez DS, Polychronopoulou E, Tsilidis KK, Khera M, Su LJ, Fowke JH, Peek MK, Kuo YF, Markides K, Canfield S. Independent and Joint Effects of Testosterone Replacement Therapy and Statins use on the Risk of Prostate Cancer Among White, Black, and Hispanic Men. Cancer Prev Res (Phila) 2021; 14:719-728. [PMID: 33879532 DOI: 10.1158/1940-6207.capr-21-0040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/31/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022]
Abstract
The associations of testosterone therapy (TTh) and statins use with prostate cancer remain conflicted. However, the joint effects of TTh and statins use on the incidence of prostate cancer, stage and grade at diagnosis, and prostate cancer-specific mortality (PCSM) have not been studied.We identified White (N = 74,181), Black (N = 9,157), and Hispanic (N = 3,313) men diagnosed with prostate cancer in SEER-Medicare 2007-2016. Prediagnostic prescription of TTh and statins was ascertained for this analysis. Weighted multivariable-adjusted conditional logistic and Cox proportional hazards models evaluated the association of TTh and statins with prostate cancer, including statistical interactions between TTh and statins.We found that TTh (OR = 0.74; 95% CI, 0.68-0.81) and statins (OR = 0.77; 95% CI, 0.0.75-0.88) were inversely associated with incident prostate cancer. Similar inverse associations were observed with high-grade and advanced prostate cancer in relation to TTh and statins use. TTh plus statins was inversely associated with incident prostate cancer (OR = 0.53; 95% CI, 0.48-0.60), high-grade (OR = 0.43; 95% CI, 0.37-0.49), and advanced prostate cancer (OR = 0.44; 95% CI, 0.35-0.55). Similar associations were present in White and Black men, but among Hispanics statins were associated with PCSM.Prediagnostic use of TTh or statins, independent or combined, was inversely associated with incident and aggressive prostate cancer overall and in NHW and NHB men. Findings for statins and aggressive prostate cancer are consistent with previous studies. Future studies need to confirm the independent inverse association of TTh and the joint inverse association of TTh plus statins on risk of prostate cancer in understudied populations. PREVENTION RELEVANCE: The study investigates a potential interaction between TTh and statin and its effect on incident and aggressive prostate cancer in men of different racial and ethnic backgrounds. These results suggest that among NHW and non-Hispanic Black men TTh plus statins reduced the odds of incident prostate cancer, high-grade and advance stage prostate cancer.
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Affiliation(s)
- David S Lopez
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas.
| | - Efstathia Polychronopoulou
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Mohit Khera
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas
| | - L Joseph Su
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Jay H Fowke
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - M K Peek
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas
| | - Yong-Fang Kuo
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas
| | - Kyriakos Markides
- Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas
| | - Steven Canfield
- Division of Urology, UTHealth McGovern Medical School, Houston, Texas
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Buschmann RN, Prochaska JD, Cutchin MP, Peek MK. Stress and health behaviors as potential mediators of the relationship between neighborhood quality and allostatic load. Ann Epidemiol 2018; 28:356-361. [DOI: 10.1016/j.annepidem.2018.03.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 04/24/2017] [Accepted: 03/24/2018] [Indexed: 01/24/2023]
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Lynch SM, Mitra N, Ravichandran K, Mitchell J, Spangler E, Zhou W, Paskett ED, Gehlert S, DeGraffinreid C, Stowe R, Dubowitz T, Riethman H, Branas CC, Peek MK, Rebbeck TR. Telomere Length and Neighborhood Circumstances: Evaluating Biological Response to Unfavorable Exposures. Cancer Epidemiol Biomarkers Prev 2018; 26:553-560. [PMID: 28373169 DOI: 10.1158/1055-9965.epi-16-0554] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/27/2016] [Accepted: 02/10/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Multilevel frameworks suggest neighborhood circumstances influence biology; however, this relationship is not well studied. Telomere length (TL) shortening has been associated with individual-level and neighborhood-level exposures and disease and may provide insights into underlying biologic mechanisms linking neighborhood with biology. To support neighborhood-biology investigations, we sought to determine the independent effect of neighborhood exposures on TL using standard multilevel linear regression models and quantile regression, a nonlinear, social science method applicable for testing the biologic hypothesis that extremes of the TL distribution are related to poor outcomes.Methods: In a multicenter, cross-sectional study, blood TL was measured in 1,488 individuals from 127 census tracts in three U.S. regions using terminal restriction fragment assays. Multilevel linear and quantile regression models were adjusted for individual-level race, education, perceived stress, and depression. Neighborhood exposures included population density, urban/residential crowding, residential stability/mobility, and socioeconomic status.Results: TL was not associated with any neighborhood variable using linear models, but quantile regression revealed inverse associations between population density and urban crowding at the lower tails of the TL distribution [5th (population density P = 0.03; urban crowding P = 0.002), 50th (both P < 0.001), 75th percentiles (both P < 0.001)]. TL was related to residential stability at the upper tail (95th percentile P = 0.006).Conclusions: Findings support the use of nonlinear statistical methods in TL research and suggest that neighborhood exposures can result in biological effects.Impact: TL may serve as an underlying example of a biologic mechanism that can link neighborhood with biology, thus supporting multilevel investigations in future studies. Cancer Epidemiol Biomarkers Prev; 26(4); 553-60. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."
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Affiliation(s)
- Shannon M Lynch
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania. .,Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nandita Mitra
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | | | - Jonathan Mitchell
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elaine Spangler
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Wenting Zhou
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | | | | | | | - Harold Riethman
- Wistar Institute, Philadelphia, Pennsylvania.,Old Dominion University, Norfolk, Virginia
| | - Charles C Branas
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - M K Peek
- University of Texas Medical Branch, Galveston, Texas
| | - Timothy R Rebbeck
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Dana Farber Cancer Institute, Boston, Massachusetts
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Abstract
Background Work-family conflict (WFC) and job insecurity are important determinants of workers' mental health. Aims To examine the relationship between WFC and psychological distress, and the co-occurring effects of WFC and job insecurity on distress in US working adults. Methods This study used cross-sectional data from the 2010 National Health Interview Survey (NHIS) for adults aged 18-64 years. The 2010 NHIS included occupational data from the National Institute for Occupational Safety and Health (NIOSH) sponsored Occupational Health Supplement. Logistic regression models were used to examine the independent and co-occurring effects of WFC and job insecurity on distress. Results The study group consisted of 12059 participants. In the model fully adjusted for relevant occupational, behavioural, sociodemographic and health covariates, WFC and job insecurity were independently significantly associated with increased odds of psychological distress. Relative to participants reporting WFC only, participants reporting no WFC and no job insecurity had lower odds of moderate and severe distress. Co-occurring WFC and job insecurity was associated with significantly higher odds of both moderate [odds ratio (OR) = 1.55; 95% confidence interval (CI) 1.25-1.9] and severe (OR = 3.57; 95% CI 2.66-4.79) distress. Conclusions Rates of WFC and job insecurity were influenced by differing factors in working adults; however, both significantly increased risk of adverse mental health outcomes, particularly when experienced jointly. Future studies should explore the temporal association between co-occurring WFC and job insecurity and psychological distress.
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Affiliation(s)
- M Mutambudzi
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - Z Javed
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - S Kaul
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - J Prochaska
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - M K Peek
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
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Stroope S, Martinez BC, Eschbach K, Peek MK, Markides KS. Neighborhood Ethnic Composition and Problem Drinking Among Older Mexican American Men: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly. J Immigr Minor Health 2016; 17:1055-60. [PMID: 25106726 DOI: 10.1007/s10903-014-0033-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Ethnic enclaves may be protective for health. This study investigates the effects of neighborhood co-ethnic density on problem drinking among older Mexican American men. Probability sample of 2,086 community-dwelling Mexican Americans aged 75 or older drawn in 2004-2005 residing in communities in Arizona, California, Colorado, New Mexico and Texas. Problem drinking was found among 15.3 % of men (n = 350). For each percent increase in neighborhood percent Mexican American, men had 2 % lower odds of problem drinking [odds ratio (OR) 0.98; P < 0.05]. U.S. born men had lower odds of problem drinking (OR 0.40; P < 0.05) compared with foreign born men, while English language use was associated with greater odds of problem drinking (OR 2.14; P < 0.05). Older Mexican American men in neighborhoods with low levels of co-ethnic density, the foreign born, and those with English language facility had an increased likelihood of problem drinking.
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Affiliation(s)
- Samuel Stroope
- Department of Sociology, Louisiana State University, 126 Stubbs Hall, Baton Rouge, LA, 70803, USA,
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Dierking L, Markides K, Al Snih S, Kristen Peek M. Fear of Falling in Older Mexican Americans: A Longitudinal Study of Incidence and Predictive Factors. J Am Geriatr Soc 2016; 64:2560-2565. [PMID: 27783403 DOI: 10.1111/jgs.14496] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine predictors of fear of falling in older Mexican Americans over time. DESIGN Longitudinal study. SETTING Community-dwelling residents throughout California, Colorado, New Mexico, Arizona, and Texas. PARTICIPANTS Community-dwelling Mexican Americans aged 72 and older participating in the Hispanic Established Populations for the Epidemiologic Study of the Elderly from 2000-01 to 2010-11 (N = 1,682). MEASUREMENTS Fear of falling was measured at baseline and at each subsequent wave. Baseline demographic and clinical variables included social support, fall history, depression symptoms, Mini-Mental State Examination (MMSE) score, activity of daily living (ADL) and instrumental ADL (IADL) limitations, and chronic health conditions. RESULTS Nine hundred fifty three (56.7%) subjects reported fear of falling at baseline, 262 of whom reported severe fear of falling. The predictors of reporting any fear of falling over time included female sex, frequent familial interaction, depression, chronic health conditions, IADL limitations, higher MMSE score, and three or more falls in the last 12 months. Predictors of severe fear of falling included older age, female sex, married, depressive symptoms, chronic health conditions, IADL limitations, higher MMSE score, and fall history. Protective factors included frequent friend interaction and higher levels of education. CONCLUSION Fear of falling is prevalent in older Mexican-American adults. The presence of friends nearby was shown to be protective against, whereas the presence of family nearby was shown to be predictive of fear of falling.
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Affiliation(s)
- Leah Dierking
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Kyriakos Markides
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Soham Al Snih
- Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas
| | - M Kristen Peek
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
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Murdock KW, Fagundes CP, Peek MK, Vohra V, Stowe RP. The effect of self-reported health on latent herpesvirus reactivation and inflammation in an ethnically diverse sample. Psychoneuroendocrinology 2016; 72:113-8. [PMID: 27398881 PMCID: PMC5116910 DOI: 10.1016/j.psyneuen.2016.06.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/17/2016] [Accepted: 06/20/2016] [Indexed: 02/05/2023]
Abstract
Self-rated health (SRH) is a reliable predictor of health outcomes including morbidity and mortality. Immune dysregulation is one hypothesized mechanism underlying the association between SRH and health outcomes. Indeed, poorer SRH is associated with greater inflammation. The association between SRH and reactivation of latent herpesviruses is unknown, representing an important gap in the literature given that reactivation of latent herpesviruses leads to enhanced inflammation. The present study addressed this important gap in the literature by examining associations between SRH, inflammation (i.e., peripheral cytokines in the blood), and reactivation of latent herpesviruses among a sample of 1208 individuals participating in the Texas City Stress and Health Study. Participants completed a self-report measure of SRH and a blood draw. Results indicated that higher SRH was associated with lower reactivation of latent herpesviruses and inflammation. Moreover, reactivation of latent herpesviruses partially mediated the association between SRH and inflammation. Accordingly, findings add to our growing understanding of the association between SRH and immune dysfunction.
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Affiliation(s)
- Kyle W. Murdock
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
| | - Christopher P. Fagundes
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
,Department of Symptoms Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, Texas 77030, USA
,Department of Psychiatry, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, Texas 77030 , USA
| | - M. Kristen Peek
- Department of Preventative Medicine and Community Health, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
| | - Vansh Vohra
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
| | - Raymond P. Stowe
- Microgen Laboratories, 903 Texas Avenue, La Marque, TX 77568, USA
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Abstract
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.
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Abstract
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.
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Howrey BT, Peek MK, McKee JM, Raji MA, Ottenbacher KJ, Markides KS. Chamomile Consumption and Mortality: A Prospective Study of Mexican Origin Older Adults. Gerontologist 2015; 56:1146-1152. [PMID: 26035879 DOI: 10.1093/geront/gnv051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/27/2015] [Indexed: 01/13/2023] Open
Abstract
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. METHODS AND DESIGN 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 (Texas, California, New Mexico, Colorado, and Arizona). We included all men and women from 2000 to 2007 (n = 1,677). RESULTS Chamomile was used by 14% of the sample. Cox proportional hazards regression analyses showed that chamomile was associated with a decreased risk of mortality in the total sample (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.55-0.92) and for women (HR 0.67, 95% CI 0.49-0.92) but not for men. In models adjusted for sociodemographic variables, health behaviors, and chronic conditions, chamomile remained significantly associated with reduced mortality in women (HR 0.72, 95% CI 0.53-0.98). IMPLICATIONS The use of chamomile shows protective effects against mortality in this sample of older adults of Mexican origin for women. Further research is warranted in other populations to determine if these effects are consistent.
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Affiliation(s)
- Bret T Howrey
- Department of Family Medicine, University of Texas Medical Branch, Galveston.
| | - M Kristen Peek
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston
| | - Juliet M McKee
- Department of Family Medicine, University of Texas Medical Branch, Galveston
| | - Mukaila A Raji
- Division of Geriatrics, University of Texas Medical Branch, Galveston
| | - Kenneth J Ottenbacher
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston
| | - Kyriakos S Markides
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston
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Howrey BT, Raji MA, Masel MM, Peek MK. Stability in Cognitive Function Over 18 Years: Prevalence and Predictors among Older Mexican Americans. Curr Alzheimer Res 2015; 12:614-21. [PMID: 26239038 PMCID: PMC5501462 DOI: 10.2174/1567205012666150701102947] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/28/2015] [Indexed: 11/22/2022]
Abstract
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. METHODS Using a sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of non-institutionalized Mexican Americans aged 65 and older from five Southwestern states (N = 2767), latent class mixture models were developed to identify subgroups of cognitive change over time. RESULTS Three distinct trajectories of cognitive change were identified and characterized as stable, slow decline and rapid decline. Compared to the rapid decline group, a higher proportion of the stable cognition group were women, had high school education, were married and attended church one or more times per week. Regular church attendance had a significant positive impact in the stable group (β = 0.64, p <0.01), the slow decline group (β = 0.84, p <0.001) and the rapid decline group (β = 2.50, p <0.001). Activity limitations had a consistently negative association with cognition in the stable, slow decline and rapid decline groups (β = -0.37, p <0.001; β = -0.85, p <0.001; and β = -1.58, p <0.001 respectively). CONCLUSION Substantial heterogeneity exists in rates of cognitive decline among older Mexican Americans. Interventions targeting cognitive maintenance may benefit from increased focus on factors associated with continued social engagement.
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Affiliation(s)
| | | | | | - M Kristen Peek
- University of Texas Medical Branch, 301 University Blvd, University of Texas Medical Branch, Galveston, TX 77555-1153, USA.
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Do TN, Peek MK. Abstract A78: Factors associated with screening mammography in Asian Americans: Test of the Andersen's Behavioral Model of Health Services Use. Cancer Epidemiol Biomarkers Prev 2014. [DOI: 10.1158/1538-7755.disp13-a78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Despite its effectiveness as a preventive measure, minority women are less likely to obtain screening mammograms. Although numerous studies have examined factors associated with mammography utilization and women's adherence to mammography screening guidelines, less attention has been directed to mammography adherence among Asian Americans and how nativity influences adherence. Asian Americans may be one of the fastest growing racial/ethnic groups in the United States, but remains one of the most poorly understood minorities in terms of screening mammography adherence. Using an adapted Andersen's Behavioral Model of Health Services Use and data from the California Health Interview Survey (2001-2009), this study sought to determine the relationship between predisposing, enabling, and need factors on mammography adherence among Asian Americans and to determine if it varied by nativity. The sample included 8,353 Asian Americans with 80.2% foreign-born. A multivariate logistic regression models were used to explore the association between enabling, predisposing, and need factors to screening mammography. The factors associated with screening mammography varied by nativity. Among U.S.-born Asian females, mammography adherence was associated with current smokers, prior cancer prevention health service use, Asians over the age of 65 years old, household size, speaking English very good or well and being uninsured. Among foreign-born Asian females, mammography adherence is associated with being overweight, sedentary, prior cancer prevention health service use, age (50-64 years old), household size, marital status, health insurance, and having one or more chronic conditions. Understanding the factors that impact mammography adherence may inform intervention strategies.
Citation Format: ThuyQuynh Ngoc Do, M. Kristen Peek. Factors associated with screening mammography in Asian Americans: Test of the Andersen's Behavioral Model of Health Services Use. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A78. doi:10.1158/1538-7755.DISP13-A78
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Abstract
OBJECTIVES This study extends previous work on longitudinal patterns of spousal associations between functional impairments and psychological well-being in older couples in 3 important ways: By examining Mexican Americans, by considering a broader range of functional limitations, and by assessing the role of health status, social integration, and socioeconomic resources in these associations. METHOD Drawing on data from 6 waves of the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993-2007), we employed growth curve models to investigate the implications of the spouse's functional limitations for the respondent's age trajectories of depressive symptoms in older Mexican American couples. Models were run separately for husbands and wives. RESULTS The spouse's functional limitations were associated with higher levels of depressive symptoms in the respondent. Personal resources can both ameliorate and intensify the adverse implications of the spouse's functional limitations for the respondent's depressive symptomatology. The interplay among these factors can vary by gender and the type of the spouse's functional impairment. DISCUSSION Future studies would benefit by examining caregiving patterns in older couples, by distinguishing between different dimensions of social support available to them, and by considering changes in couples' marital quality and social ties over time.
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Affiliation(s)
| | - M Kristen Peek
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston
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Shell AM, Peek MK, Eschbach K. Neighborhood Hispanic composition and depressive symptoms among Mexican-descent residents of Texas City, Texas. Soc Sci Med 2013; 99:56-63. [PMID: 24355471 DOI: 10.1016/j.socscimed.2013.10.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 03/05/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
Abstract
Substantial research shows that increased Hispanic neighborhood concentration is associated with several beneficial health outcomes including lower adult mortality, better self-rated health, and fewer respiratory problems. Literature on the relationship of Hispanic composition and depressive symptoms is more equivocal. In addition, few studies have directly investigated hypothesized mechanisms of this relationship. This study uses data from a probability sample of 1238 Mexican-descent adults living in 48 neighborhoods in Texas City, Texas. Multilevel regression models investigate whether Hispanic neighborhood composition is associated with fewer depressive symptoms. This study also investigates whether social support, perceived discrimination, and perceived stress mediate or moderate the relationship, and whether results differ by primary language used at home. We find that individuals living in high Hispanic composition neighborhoods experience fewer depressive symptoms than individuals in low Hispanic composition neighborhoods. In addition, we find that these beneficial effects only apply to respondents who speak English. Social support, perceived discrimination, and perceived stress mediate the Hispanic composition-depressive symptoms relationship. In addition, discrimination and stress moderate the relationship between Hispanic composition and depressive symptoms. Our findings support theories linking higher neighborhood Hispanic composition and better mental health, and suggest that Spanish language use, social support, discrimination and stress may play important roles in the Hispanic composition-depressive symptoms relationship.
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Affiliation(s)
- Alyssa Marie Shell
- University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, USA.
| | - M Kristen Peek
- University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, USA
| | - Karl Eschbach
- University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, USA
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Stowe RP, Peek MK, Cutchin MP, Goodwin JS. Reactivation of herpes simplex virus type 1 is associated with cytomegalovirus and age. J Med Virol 2013; 84:1797-802. [PMID: 22997083 DOI: 10.1002/jmv.23397] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Recent studies have shown that cytomegalovirus (CMV) may be an emerging marker of immunosenescence. CMV can affect the immune system by directly infecting leukocytes and hematopoietic cells or by eliciting an expansion of oligoclonal CD8+ T cells/contraction of the naïve T cell compartment that may reduce the host's ability to fight other pathogens. To investigate further CMV-associated changes in immunity, a study was conducted with 1,454 adults (ages 25-91) to determine the association between CMV and reactivation of another latent herpesvirus, Herpes simplex virus type 1 (HSV-1), as indexed by antibody titers. Elevated antibody titers to latent HSV-1 were significantly associated with both CMV seropositivity and high CMV antibody levels. Evaluation by specific age groups (<45, 45-64, and 65+ years old) revealed that this association was detectable early in life (<45 years of age). Increases in HSV-1 antibodies by age occurred in CMV seropositive individuals but not CMV seronegative subjects. Within CMV seropositive subjects, increases in HSV-1 antibodies by age were only found in individuals with low CMV antibody levels as those with high CMV antibodies already exhibited elevated HSV-1 antibodies. These associations remained significant after accounting for body mass index, gender, and socioeconomic status. These results suggest that CMV can influence the immune response to another pathogen and support the concept that CMV may accelerate immunosenescence.
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Peek MK, Howrey BT, Ternent RS, Ray LA, Ottenbacher KJ. Social support, stressors, and frailty among older Mexican American adults. J Gerontol B Psychol Sci Soc Sci 2012; 67:755-64. [PMID: 23009957 DOI: 10.1093/geronb/gbs081] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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. METHOD To address the influence of social support and stressors on frailty among older Mexican Americans, we utilized five waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (Hispanic EPESE) to examine the impact of stressors and social support on frailty over a 12-year period. Using a modified version of the Fried and Walston Frailty Index, we estimated the effects of social support and stressors on frailty over time using trajectory modeling (SAS 9.2, PROC TRAJ). RESULTS We first grouped respondents according to one of three trajectories: low, progressive moderate, and progressive high frailty. Second, we found that the effects of stressors and social support on frailty varied by trajectory and by type of stressor. Health-related stressors and financial strain were related to increases in frailty over time, whereas social support was related to less-steep increases in frailty. CONCLUSION Frailty has been hypothesized to reflect age-related physiological vulnerability to stressors, and the analyses presented indicate partial support for this hypothesis in an older sample of Mexican Americans. Future research needs to incorporate measures of stressors and social support in examining those who become frail, especially in minority populations.
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Affiliation(s)
- M Kristen Peek
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1150, USA.
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Howrey BT, Peek MK, Raji MA, Ray LA, Ottenbacher KJ. 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. J Am Geriatr Soc 2012; 60:1906-11. [PMID: 23006250 DOI: 10.1111/j.1532-5415.2012.04144.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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. PARTICIPANTS Two thousand two hundred fifty-six Mexican-American men and women aged 65 and older. MEASUREMENTS The association between self-reported sleep problems and mortality over a 15-year period in a population based sample of older Mexican Americans was examined. Using five waves of data (1993-2008) from the H-EPESE, Cox proportional hazard models stratified according to sex were used to model the risk of death as a function of chronic sleep problems. RESULTS Having any sleeping problems during the last month was associated with greater risk of mortality (hazard ratio = 1.14, 95% confidence interval = 1.00-1.29) in unadjusted models, although the association was attenuated after accounting for covariates. CONCLUSIONS Similar factors explained the association between sleep and mortality in men and women: health behaviors, depressive symptoms, and health conditions. These factors are related to stress, and both may lead to poor sleep quality. Research is needed to better understand the factors moderating the relationship between sleep, mortality, and sex.
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Affiliation(s)
- Bret T Howrey
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX 77555, USA.
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Stimpson JP, Wilson FA, Watanabe-Galloway S, Peek MK. The effect of marriage on utilization of colorectal endoscopy exam in the United States. Cancer Epidemiol 2012; 36:e325-32. [PMID: 22633538 DOI: 10.1016/j.canep.2012.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 05/01/2012] [Accepted: 05/07/2012] [Indexed: 12/31/2022]
Abstract
PURPOSE This study examines the association between marriage and colorectal endoscopy exam, and whether this association varies by gender and financial benefits of marriage including improved access to health insurance and pooled family income. METHODS Representative survey data of the non-institutionalized United States population were used from the 2000, 2005, and 2008 National Health Interview Survey. Analyses targeted persons 50-85 years of age without a personal history of cancer and with complete information on all study variables (n=21,760). Multivariate logistic regression was used to model marital status differences in the probability of undergoing a colorectal endoscopy exam with interaction effects used to model variation over time by gender, health insurance, and poverty level. RESULTS Married persons were more likely than unmarried persons to report ever having undergone a colorectal endoscopy exam (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.29), and the difference between married and unmarried persons in the probability of undergoing a colorectal endoscopy exam remained stable over time. Married persons were more likely than unmarried persons to report having undergone a colorectal endoscopy exam within the past 10 years (OR, 1.49; 95% CI, 1.15-1.95). For each survey year, married men were significantly more likely than women and unmarried men to report having undergone a colorectal endoscopy exam. For example, in 2008, 56% of married men reported having undergone a colorectal endoscopy exam, compared to 49% of unmarried men, 52% of married women, and 50% of unmarried women. Among persons with health insurance, married persons were significantly more likely than unmarried persons to have undergone a colorectal endoscopy exam. Among persons who were poor, there was no difference by marital status in the likelihood of having undergone a colorectal endoscopy exam. However, among persons who were not poor, married persons were more likely than unmarried persons to have undergone a colorectal endoscopy exam. CONCLUSION Given that colorectal endoscopy exams are a potentially life-saving procedure, persistently higher uptake of colorectal endoscopy for married persons over time may be an important health promoting benefit of marriage. Therefore, clinicians and policy makers should focus on improving the use of cancer prevention services among unmarried persons.
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Affiliation(s)
- Jim P Stimpson
- University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE 68198-4350, USA.
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Sheffield KM, Peek MK. Changes in the prevalence of cognitive impairment among older Americans, 1993-2004: overall trends and differences by race/ethnicity. Am J Epidemiol 2011; 174:274-83. [PMID: 21622948 DOI: 10.1093/aje/kwr074] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The authors used data from 6 waves of the Health and Retirement Study to evaluate changes in the prevalence of cognitive impairment among adults 70 years of age or older from 1993 to 2004. Having sampling weights for each wave enabled the authors to create merged waves that represented cross-sections of the community-dwelling older population for that year. Logistic regression analyses with year as the predictor were used to estimate trends and determine the contribution of sociodemographic and health status variables to decreasing trends in the prevalence of cognitive impairment over time (score ≤8 on a modified Telephone Interview Cognitive Screen). Results showed an annual decline in the prevalence of cognitive impairment of 3.4% after adjustment for age, gender, and prior test exposure (odds ratio (OR) = 0.966, 95% confidence interval (CI): 0.941, 0.992). The addition of socioeconomic variables to the model attenuated the trend by 72.1%. The annual percentage of decline in impairment was larger for blacks (OR = 0.943, 95% CI: 0.914, 0.973) and Hispanics (OR = 0.954, 95% CI: 0.912, 0.997) than for whites (OR = 0.971, 95% CI: 0.936, 1.006), although the differences were not statistically significant. Linear probability models used in secondary analyses showed larger percentage-point declines for blacks and Hispanics. Improvements in educational level contributed to declines in cognitive impairment among older adults-particularly blacks and Hispanics-in the United States.
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Affiliation(s)
- Kristin M Sheffield
- Department of Surgery, University of Texas Medical Branch, Galveston, 77555-054, USA.
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Gerst K, Miranda PY, Eschbach K, Sheffield KM, Peek MK, Markides KS. Protective neighborhoods: neighborhood proportion of Mexican Americans and depressive symptoms in very old Mexican Americans. J Am Geriatr Soc 2011; 59:353-8. [PMID: 21314653 DOI: 10.1111/j.1532-5415.2010.03244.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research indicates that neighborhood context can have a significant effect on the health of older adults. The evidence suggests that there may be physical health benefits afforded to Mexican Americans living in ethnically homogenous neighborhoods, despite the relatively high economic risk in such neighborhoods, but few studies have considered the effect of neighborhood ethnic density on mental health outcomes in older adults. This study evaluated the association between neighborhoods with a high proportion of Mexican Americans and depressive symptoms in very old Mexican Americans. Hierarchical linear modeling was used to examine data from Wave 5 (2004/05) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Subjects included 1,875 community-dwelling Mexican Americans aged 75 and older living in 386 neighborhoods in five states in the southwestern United States (Arizona, California, Colorado, New Mexico, Texas). Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (α=0.88). Results showed that, in very old men, there was a significant negative association between percentage of Mexican Americans in the neighborhood and depressive symptoms (P=.01). In women, the direction of the association was the same, but the effect was not significant. These findings suggest that the proportion of Mexican Americans in the neighborhood matter more for very old Mexican American men than women. Further research may inform screening and treatment for depressive symptoms based on differences in neighborhood composition. Recommendations include culturally customized programs that offer older Mexican Americans greater mobility and access to programs and opportunities in culturally identifiable neighborhoods.
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Affiliation(s)
- Kerstin Gerst
- Institute of Gerontology, College of Public Health, University of Georgia, Athens, Georgia, USA.
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Mair CA, Cutchin MP, Kristen Peek M. Allostatic load in an environmental riskscape: the role of stressors and gender. Health Place 2011; 17:978-87. [PMID: 21543249 DOI: 10.1016/j.healthplace.2011.03.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 03/23/2011] [Accepted: 03/24/2011] [Indexed: 11/17/2022]
Abstract
Stressors are theorized to be associated with higher allostatic load (AL), a concept of physiological wear measured as a composite of physical biomarkers. Risk of high AL may vary by gender and may be intensified in places with significant environmental risks, otherwise known as 'environmental riskscapes'. Yet, no study has examined the relationship between stressors, gender, and allostatic load in an environmental riskscape. Using primary data collected in a sample (N=1072) exposed to various environmental and social stressors, we find that long-term residence in Texas City (30 or more years), residential proximity to petrochemical plants, perceived poor neighborhood conditions, and daily hassles are associated with higher allostatic load components. Variation in AL differs by gender and the types of biomarkers examined. Gender moderates the effect of length of residence in Texas City on cardiovascular health risk. We discuss our findings in light of current research on stressors, gender, allostatic load, and double jeopardy within environmental riskscapes.
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Affiliation(s)
- Christine A Mair
- Department of Sociology and Anthropology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250-0002, USA.
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Abstract
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. RESULTS Greater English language proficiency was associated with a 10% reduced likelihood of becoming prefrail (p < .05) and marginally associated with a reduced likelihood of becoming frail (relative risk = 0.88; p = .07). Frequent contact with Anglos was significantly associated with a reduced likelihood of becoming frail (relative risk = 0.87; p < .05). DISCUSSION Among older Mexican Americans, acculturation at baseline was protective of transitioning from a nonfrail or prefrail to a frail state. These findings suggest that increased acculturation may provide Mexican Americans with protection from health issues in old age.
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Affiliation(s)
- Meredith C Masel
- University of Texas Medical Branch, Galveston, TX 77555-0434, USA.
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Masel MC, Raji M, Peek MK. Education and physical activity mediate the relationship between ethnicity and cognitive function in late middle-aged adults. Ethn Health 2010; 15:283-302. [PMID: 20401816 PMCID: PMC3967857 DOI: 10.1080/13557851003681273] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Minority status has been implicated as a risk factor for disparate scores on cognitive function tests in older adults. Research on ethnicity and cognitive function has yielded socioeconomic status, particularly education, as a primary reason for the discrepancy. Other factors, such as physical activity may provide insight into the relationship. Despite this knowledge, few studies have thoroughly examined the mediating characteristics of education or physical activity in the relationship between ethnicity and cognitive function in younger aged groups. Most research conducted focuses only on older adults during a time when degeneration of brain tissue may complicate the exploration of the relationships among ethnicity and cognitive function. The current research will expand existing knowledge about education, physical activity, and cognitive function in minority groups. DESIGN The study presents data from the Health and Retirement Study, a nationally representative sample of late middle-aged White, Black, and Hispanic adults (n=9204, mean age+/-SD = 55.8+/-3.1). Regression and mediation testing determined the mediating effects of education and physical activity in the relationship between ethnicity and cognitive function. RESULTS Significant association between White ethnicity and higher scores on cognitive tests was evident as early as late middle age. The magnitude of the association significantly diminished on adjusting for education and leisure time physical activity. CONCLUSION Our data suggest a potential mediating role of education and physical activity on the ethnic differences in cognitive tests in late middle-aged White, Black, and Hispanic adults. Our findings suggest a need for studies to understand if adult education and culturally appropriate physical activity interventions in middle age influence ethnic disparities in prevalence of cognitive impairment in old age.
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Affiliation(s)
- Meredith C Masel
- Center to Eliminate Health Disparities, University of Texas Medical Branch, Galveston, TX, USA.
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Berges IM, Kuo YF, Peek MK, Markides KS. Religious Involvement and Physical Functioning among Older Mexican Americans. Hallym Int J Aging HIJA 2010; 12:1-10. [PMID: 21318083 PMCID: PMC3035948 DOI: 10.2190/ha.12.1.a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND AND PURPOSE: Examine the association between attendance at religious services and incidence of ADL disability over a period of seven years among older Mexican Americans 65 years and older. METHODS: Using data from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE), logistic generalized estimation equation (GEE) models were used to analyze the contribution of attendance at religious services to the differences in incidence of ADL disability over seven years, controlling for demographics, medical conditions, and physical mobility. RESULTS: Frequent attendees at religious services had 30% lower odds of developing ADL disability over seven years compared to the non-regular attendance group. The odds were reduced to 23%, but remained significant when physical and mental health were controlled. CONCLUSIONS: In this older Mexican American population, regular attendees at religious services were less likely to develop ADL disability over a period of seven years compared to those who attended services less often.
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Affiliation(s)
- Ivonne-Marie Berges
- Sealy Center on Aging, University of Texas Medical Branch
- School of Health Professions, University of Texas Medical Branch
| | - Yong-Fang Kuo
- Sealy Center on Aging, University of Texas Medical Branch
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch
- Department of Internal Medicine, University of Texas Medical Branch
| | - M. Kristen Peek
- Sealy Center on Aging, University of Texas Medical Branch
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch
| | - Kyriakos S. Markides
- Sealy Center on Aging, University of Texas Medical Branch
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch
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Stowe RP, Peek MK, Cutchin MP, Goodwin JS. Plasma cytokine levels in a population-based study: relation to age and ethnicity. J Gerontol A Biol Sci Med Sci 2009; 65:429-33. [PMID: 20018825 DOI: 10.1093/gerona/glp198] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
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; aged 25-91 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 non-Hispanic blacks.
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Affiliation(s)
- Raymond P Stowe
- Microgen Laboratories, 903 Texas Avenue, La Marque, TX 77568, USA.
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Peek MK, Cutchin MP, Salinas JJ, Sheffield KM, Eschbach K, Stowe RP, Goodwin JS. Allostatic load among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin: effects of ethnicity, nativity, and acculturation. Am J Public Health 2009; 100:940-6. [PMID: 19834005 DOI: 10.2105/ajph.2007.129312] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
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.
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Affiliation(s)
- M Kristen Peek
- Department of Preventive Medicine and Community Health, 301 University Blvd, Galveston, TX 77555-1153, USA.
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Stowe RP, Peek MK, Perez NA, Yetman DL, Cutchin MP, Goodwin JS. Herpesvirus reactivation and socioeconomic position: a community-based study. J Epidemiol Community Health 2009; 64:666-71. [PMID: 19825788 DOI: 10.1136/jech.2008.078808] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Elevated antibodies to latent herpesviruses have been demonstrated to be a reliable marker of diminished cellular immunity and recently have been associated with low socioeconomic position (SEP) in older adults. Extending these observations in a community-based study over a wide age range would provide an important new direction for investigating mechanisms underlying poor health outcomes in individuals with low SEP. METHODS Anti-herpes simplex virus (HSV)-1 and anti-Epstein-Barr virus (EBV) antibodies were measured in blood samples from 1457 adults aged 25-90. Regression models were then used to determine the relationships between viral reactivation, age, gender, ethnicity and SEP. RESULTS Individuals were significantly more likely to have higher antiviral antibodies (ie, reactivation) to both EBV and HSV-1 than one virus alone. Individuals in the lowest age group had less reactivation, whereas greater reactivation was observed in women and those with the least education. Compared to white non-Hispanics, Hispanics and black non-Hispanics experienced more viral reactivation. These relationships remained strong after controlling for sociodemographic factors as well as smoking status, body mass index and physical activity. CONCLUSIONS These results demonstrate that herpesvirus reactivation is associated with variables such as age, gender, ethnicity and education, and may play a role in poorer health outcomes in both younger and older adults.
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Sheffield KM, Peek MK. Neighborhood context and cognitive decline in older Mexican Americans: results from the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Am J Epidemiol 2009; 169:1092-101. [PMID: 19270047 DOI: 10.1093/aje/kwp005] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In previous research on cognitive decline among older adults, investigators have not considered the potential impact of contextual variables, such as neighborhood-level conditions. In the present investigation, the authors examined the association between 2 neighborhood-context variables-socioeconomic status and percentage of Mexican-American residents-and individual-level cognitive function over a 5-year follow-up period (1993-1998). Data were obtained from the Hispanic Established Populations for Epidemiologic Studies of the Elderly, a longitudinal study of community-dwelling older Mexican Americans (n = 3,050) residing in the southwestern United States. Individual records were linked with 1990 US Census tract data, which provided information on neighborhood characteristics. Hierarchical linear growth-curve models and hierarchical logistic models were used to examine relations between individual- and neighborhood-level variables and the rate and incidence of cognitive decline. Results showed that baseline cognitive function and rates of cognitive decline varied significantly across US Census tracts. Respondents living in economically disadvantaged neighborhoods experienced significantly faster rates of cognitive decline than those in more advantaged neighborhoods. Odds of incident cognitive decline decreased as a function of neighborhood percentage of Mexican-American residents and increased with neighborhood economic disadvantage. The authors conclude that neighborhood context is associated with late-life cognitive function and that the effects are independent of individual-level risk factors.
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Affiliation(s)
- Kristin M Sheffield
- Division of Sociomedical Sciences, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77550-1153, USA.
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Peek MK, Cutchin MP, Freeman D, Stowe RP, Goodwin JS. Environmental hazards and stress: evidence from the Texas City Stress and Health Study. J Epidemiol Community Health 2009; 63:792-8. [PMID: 19282316 DOI: 10.1136/jech.2008.079806] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Substantial research has suggested that exposure to environmental health hazards, such as polluting industrial activity, has deleterious effects on psychological and physiological well-being. However, one gap in the existing literature is comparative analysis of objective and subjective exposure's relative association with various measurable outcomes of exposure. METHODS These relationships were explored within a community sample of 2604 respondents living near a large petrochemical complex in Texas City, Texas, USA. Objective exposure was investigated using distance of residence from a cluster of petrochemical plants and subjective exposure using residents' concern about potential health effects from those plants. Regression models were then used to examine how each type of exposure predicts perceived stress, physiological markers of stress and perceived health. RESULTS Results suggest that objective exposure was associated primarily with markers of physiological stress (interleukin-6 and viral reactivation), and subjective exposure (concern about petrochemical health risk) was associated with variables assessing perceived health. CONCLUSIONS From the analysis, it can be inferred that, in the context of an environmental hazard of this type, subjective exposure may be at least as important a predictor of poor health outcomes as objective exposure.
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Affiliation(s)
- M K Peek
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1153, USA.
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Salinas JJ, Peek MK. Work experience and gender differences in chronic disease risk in older Mexicans. Ann Epidemiol 2008; 18:628-30. [PMID: 18652980 PMCID: PMC2527781 DOI: 10.1016/j.annepidem.2008.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 04/01/2008] [Accepted: 04/06/2008] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study is to examine the relationship between labor force participation and gender differences in the prevalence of arthritis, diabetes, and hypertension. METHODS The Mexican Health and Aging Survey (MHAS) data is nationally representative sample of older Mexicans 50 years and older. Binomial logistic regression models were performed to examine differences between older Mexican men and women in the prevalence of arthritis, diabetes, and hypertension. Interaction effects were also estimated between gender and occupation, length of time in the labor force, and pension eligibility. RESULTS Older Mexican women have a significantly greater risk of having arthritis, diabetes, and hypertension. Findings from this study suggest that within the same occupational classification, women suffer from the damaging effects on health to a greater extent than men. Interaction effects show that women who work in services or in client's home are particularly susceptible to arthritis. Moreover, women who work in sales were at a significantly greater risk of hypertension than men. CONCLUSIONS Older Mexican women are at greater risk of chronic disease and part of their vulnerability is a result of the type of work that they do.
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Affiliation(s)
- Jennifer J Salinas
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX 77555-0460, USA.
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Peek MK, Cutchin MP, Freeman DH, Perez NA, Goodwin JS. Perceived health change in the aftermath of a petrochemical accident: an examination of pre-accident, within-accident, and post-accident variables. J Epidemiol Community Health 2008; 62:106-12. [PMID: 18192597 DOI: 10.1136/jech.2006.049858] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Little research has been conducted on changes in perceived health after an industrial accident. Using data from an ongoing survey on stress and health in a petrochemical complex in Texas City, Texas, the associations of a petrochemical accident with perceived health changes were examined. METHODS The mean changes in perceived mental and physical health across pre-accident, within-accident, and post-accident categories were compared. The association of these categorical variables with the change in perceived mental and physical health using multiple regression was also examined. RESULTS Significant declines in both perceived mental and physical health were observed for the sample. Regression analyses showed that middle age, lower education level and reported damage in the neighbourhood were associated with decreases in perceived mental health. Lower education level, explosion impact, and distance from the explosion site were associated with decreases in perceived physical health. CONCLUSIONS These results indicate that both pre-accident and within-accident variables, such as education level and explosion impact, are associated with decreases in perceived physical and mental health. Even a modest event within the range of accidents and disasters was shown to be associated with negative health outcomes for a population-based sample.
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Affiliation(s)
- M K Peek
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1153, USA.
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Graham JE, Stoebner-May DG, Ostir GV, Al Snih S, Peek MK, Markides K, Ottenbacher KJ. Health related quality of life in older Mexican Americans with diabetes: a cross-sectional study. Health Qual Life Outcomes 2007; 5:39. [PMID: 17626634 PMCID: PMC1947953 DOI: 10.1186/1477-7525-5-39] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Accepted: 07/12/2007] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The older Hispanic population of the U.S. is growing at a tremendous rate. While ethnic-related risk and complications of diabetes are widely-acknowledged for older Hispanics, less is known about how health related quality of life is affected in this population. METHODS Cross-sectional study assessing differences in health related quality of life between older Mexican Americans with and without diabetes. Participants (n = 619) from the Hispanic Established Population for the Epidemiological Study of the Elderly were interviewed in their homes. The primary measure was the Medical Outcomes Study Short Form (SF-36). RESULTS The sample was 59.6% female with a mean age of 78.3 (SD = 5.2) years. 31.2% (n = 193) of the participants were identified with diabetes. Individuals with diabetes had significantly (F = 19.35, p < .001) lower scores on the Physical Composite scale (mean = 37.50, SD = 12.69) of the SF-36 compared to persons without diabetes (mean = 43.04, SD = 12.22). There was no significant difference between persons with and without diabetes on the Mental Composite scale of the SF-36. CONCLUSION Diabetes was associated with lower health related quality of life in older Mexican Americans. The physical components of health related quality of life uniformly differentiated those with diabetes from those without, whereas mental component scores were equivocal.
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Affiliation(s)
- James E Graham
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, USA
| | | | - Glenn V Ostir
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
- Department of Internal Medicine, Division of Geriatrics, University of Texas Medical Branch, Galveston, USA
| | - Soham Al Snih
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
| | - M Kristen Peek
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, USA
| | - Kyriakos Markides
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, USA
| | - Kenneth J Ottenbacher
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
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Abstract
Research has consistently linked marriage and positive health outcomes. In addition, many researchers have found that couples often have similar or concordant health statuses. However, concordance research has been conducted in many fields for decades without a concise review of the literature, nor has one theory of health concordance been established. A systematic review was performed implementing rigorous identification strategies, and 103 health concordance research articles were identified and reviewed to understand what research has been conducted in mental health, physical health, and health behavior concordance among couples. The research overwhelmingly suggests evidence for concordant mental and physical health, as well as health behaviors among couples. Each area of health concordance research offers room for greater research and deeper understanding for the causes of health concordance.
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Stimpson JP, Kuo YF, Ray LA, Raji MA, Peek MK. Risk of mortality related to widowhood in older Mexican Americans. Ann Epidemiol 2007; 17:313-9. [PMID: 17306987 PMCID: PMC2700854 DOI: 10.1016/j.annepidem.2006.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Revised: 09/08/2006] [Accepted: 10/16/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine the risk and correlates of mortality after death of a spouse and whether mortality risk varies by sex. METHODS Prospective cohort study (1993 to 2000) of 1693 Mexican Americans ages 65 years and older who were married at baseline. Mortality was confirmed by matching records with the National Death Index or through proxy report. Risk of death related to incidence of widowhood was estimated by using proportional hazard regression and adjusted for age, education, US nativity, financial strain, social support, health behaviors, medical conditions, disability, and depressive symptoms. RESULTS In the unadjusted Cox hazard analysis, widowed men are significantly more likely to die (HR=2.32, CI=1.48 to 3.61), but loss of spouse has no significant effect on the subsequent risk of death for widowed women (HR=1.50, CI=0.90 to 2.49). After adjustment for covariates known to influence survival, the association between widowhood and mortality in men remained significant, but the magnitude of the association decreased by 26%, which suggests a partial mediation effect of these factors on survival. The trajectory of the survival curve shows that the risk of death associated with widowhood is highest within the first 2 years. CONCLUSIONS Widowhood in older Mexican American men is a risk factor for mortality.
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Affiliation(s)
- Jim P Stimpson
- Department of Social and Behavioral Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107-2699, USA.
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Abstract
OBJECTIVES To determine if acculturation is associated with smoking, alcohol use, and physical activity among older Mexican Americans. METHODS Multivariate analyses of data from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE) were used. RESULTS Those who were more proficient in English were more likely to be former or current smokers than nonsmokers and former or current drinkers than abstainers. In addition, those who had greater contact with Anglo-Americans were more likely to be former or current smokers than nonsmokers and former or current drinkers than abstainers. CONCLUSIONS These results can assist health promotion programs in identifying those most at risk of engaging in negative health behaviors.
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Affiliation(s)
- Meredith C Masel
- University of Texas Medical Branch-Galveston, 301 University Boulevard, Galveston, TX 77550, USA.
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Abstract
The aim of this prospective cohort study was to assess whether the prevalence of chronic disease of one spouse would be associated with a change in depressive symptoms of the other spouse and whether this relationship varies by immigrant status. Negative binomial regression was used to calculate risk ratios from a matched sample of 553 husbands and 553 wives aged 65 years or older of Mexican Americans. Overall, prevalence of chronic disease of one spouse was associated with change in high depressive symptoms for the other spouse. When the results were stratified by immigrant status, respondents born in the US exhibited higher risk of depressive symptoms associated with the chronic conditions of their spouse, while foreign born respondents did not exhibit higher risk for depressive symptoms. These findings highlight how immigrant status and the marital relationship may be related to chronic disease and depression.
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Affiliation(s)
- Jim P Stimpson
- Department of Social and Behavioral Sciences, University of North Texas Health Science Center, Educational and Administration Building, 3500 Camp Bowie Boulevard, Fort Worth, 76107-2699 TX, USA.
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Abstract
OBJECTIVE To assess the association of health behaviors among husbands and wives. METHODS Cohort study of 553 Mexican American couples aged 65 years or older from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE). Multivariate regression analyses test the association of body mass index, smoking, and alcohol consumption among husbands and wives. RESULTS Body mass index is positively associated among couples. Risk of smoking or drinking was higher if the partner had ever smoked or drank alcohol. CONCLUSION Health behaviors are associated among older Mexican American couples. Intervention efforts should be directed at both spouses.
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Affiliation(s)
- Jim P Stimpson
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, 77555, USA.
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Abstract
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.
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Affiliation(s)
- M Kristen Peek
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd., Route 1153, Galveston TX 77555-1153, USA.
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Abstract
Although the association between marriage and well-being is well established, few studies have focused on learning more about the context of marriage and mental health. Recent research studying the mechanisms of marriage and health has focused on contagion of well-being among spouses. This study examined the association of depression with self-esteem, social support, life satisfaction, concern for independence, and cognitive function using baseline data for 553 older, Mexican American couples. Overall, we found evidence to suggest an interdependent relationship between husbands' and wives' emotional states, but the association was not equal for couples. Husbands' depression was significantly associated with the well-being of their wife, but the wife's depression was rarely associated with the husband's well-being. The findings from this study add to the increasing literature on spousal contagion by focusing on an under studied minority group, examining how depression affects well-being, and highlighting unequal effects of marriage on spousal well-being.
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Affiliation(s)
- J P Stimpson
- Sealy Center on Aging, University of Texas MEdical Branch, 300 University Blvd, Galveston, 77555-0460, USA.
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Patel KV, Peek MK, Wong R, Markides KS. Comorbidity and disability in elderly Mexican and Mexican American adults: findings from Mexico and the southwestern United States. J Aging Health 2006; 18:315-29. [PMID: 16614346 DOI: 10.1177/0898264305285653] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This article aims to compare the effects of morbid and comorbid medical conditions on disability in elderly Mexican and Mexican American adults. Data from the 2001 Mexican Health and Aging Study (N = 4,872) and 1993 to 1994 Hispanic Established Population for Epidemiologic Studies of the Elderly (N = 3,050) were analyzed. Prevalence of medical conditions and disability in activities of daily living were calculated and logistic models were used to test associations. Prevalence of disability in older Mexicans was 16.3% while it was slightly lower in Mexican Americans (13.1%). Prevalence of arthritis, cancer, diabetes, heart attack, and stroke were substantially higher in Mexican Americans than in older adults living in Mexico. Diabetes, stroke, and heart attack were comorbid conditions that raised the likelihood of disability in both populations among subjects with other medical conditions. Despite differences in prevalence, the associations of morbidity and comorbidity with disability had similar magnitudes in both populations.
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Affiliation(s)
- Kushang V Patel
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, 7201 Wisconsin Avenue, Suite 3C309, Bethesda, MD 20892-9205, USA.
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Abstract
Several researchers have examined how acculturation shapes the self-esteem of adolescents, but few studies have looked at the influence of acculturation for older Mexican Americans. The aim of this study was to examine how language acculturation shaped the self-esteem of older Mexican Americans. The data come from the baseline wave (N=3050) of the ongoing Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE), a multistage area probability sample conducted in 1993 and 1994. Research revealed that language acculturation is positively associated with self-esteem. However, depressive symptoms mediate and moderate the association of acculturation on self-esteem. Language acculturation among older Mexican Americans is positively associated with self-esteem, even when individuals experience depressive symptoms. Findings suggest that acculturation influences multiple dimensions of mental health.
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Affiliation(s)
- D Meyler
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
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50
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Abstract
OBJECTIVES To identify sociodemographic characteristics and health performance variables associated with frailty in older Mexican Americans. DESIGN A prospective population-based survey. SETTING Homes of older adults living in the southwest. PARTICIPANTS Six hundred twenty-one noninstitutionalized Mexican-American men and women aged 70 and older included in the Hispanic Established Populations for Epidemiologic Study of the Elderly participated in a home-based interview. MEASUREMENTS Interviews included information on sociodemographics, self-reports of medical conditions (arthritis, diabetes mellitus, heart attack, hip fracture, cancer, and stroke) and functional status. Weight and measures of lower and upper extremity muscle strength were obtained along with information on activities of daily living and instrumental activities of daily living. A summary measure of frailty was created based on weight loss, exhaustion, grip strength, and walking speed. Multivariable linear regression identified variables associated with frailty at baseline. Logistic regression examined variables predicting frailty at 1-year follow-up. RESULTS Sex was associated with frailty at baseline (F=4.28, P=.03). Predictors of frailty in men included upper extremity strength, disability (activities of daily living), comorbidities, and mental status scores (Nagelkerke coefficient of determination (R(2))=0.37). Predictors for women included lower extremity strength, disability (activities of daily living), and body mass index (Nagelkerke R(2)=0.29). At 1-year follow-up, 83% of men and 79% of women were correctly classified as frail. CONCLUSION Different variables were identified as statistically significant predictors of frailty in Mexican-American men and women aged 70 and older. The prevention, development, and treatment of frailty in older Mexican Americans may require consideration of the unique characteristics of this population.
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Affiliation(s)
- Kenneth J Ottenbacher
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas 77555, USA.
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