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“A Longitudinal Study of the Health of Mexican American Elderly: Archived and Ready for You”

“A Longitudinal Study of the Health of Mexican American Elderly: Archived and Ready for You”. Laura A. Ray, MA. University of Texas Medical Branch Galveston, Texas, USA. INTRODUCTION. The Hispanic EPESE began in 1993-94, with 5 follow-ups: (1995-96, 1998-99, 2000-01, 2004-05, and 2007).

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“A Longitudinal Study of the Health of Mexican American Elderly: Archived and Ready for You”

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  1. “A Longitudinal Study of the Health of Mexican American Elderly: Archived and Ready for You” Laura A. Ray, MA. University of Texas Medical Branch Galveston, Texas, USA

  2. INTRODUCTION The Hispanic EPESE began in 1993-94, with 5 follow-ups: (1995-96, 1998-99, 2000-01, 2004-05, and 2007). The first five waves of the study have been archived at the National Archive of Computerized Data on Aging (NACDA) and the Minority CAM Data Archive (M-CAMDA).

  3. A LONGITUDINAL STUDY OF THE HEALTH OF MEXICAN AMERICAN ELDERLY 1992-2013 FUNDED BY NIA(HISPANIC EPESE) UT Health Science Center, SAN ANTONIO, TX David V. Espino, PI. CO-INVESTIGATORS: • Donald Royall • Ray Palmer NIA STAFF: • Sidney Stahl FIELD STAFF: • Harris Interactive, Inc. OUTSIDE CONSULTANTS: • Carlos Mendes de Leon • Robert Wallace • Dan Blazer • Denis Evans • GerdaFillenbaum • Richard Schulz • Hector Gonzalez UTMB, GALVESTON, TX Kyriakos S. Markides, PI CO-INVESTIGATORS: • James S. Goodwin • Kenneth Ottenbacher • M. Kristen Peek • MukailaRaji • Soham Al Snih • Yong-Fang Kuo • Rebeca Wong • Laura A. Ray- Project Director UT AUSTIN, TX Ronald Angel, PI CO-INVESTIGATORS: • Jacqueline Angel

  4. Hispanic EPESE (H-EPESE) Area probability multi-stage sample of non-institutionalized Mexican Americans aged 65 and over residing in the five Southwestern states (Texas, New Mexico, Colorado, Arizona, and California) Study is patterned after original EPESE studies, in particular the Piedmont (Duke) EPESE. Baseline data collected during 1993-1994. There have been 5 follow-up waves of data collection. N = 3,050 with an additional 902 added at 4th follow-up.

  5. A LONGITUDINAL STUDY of MEXICAN AMERICAN ELDERLY HEALTH (Baseline 1993-94) SPECIFIC AIMS: • Estimate the prevalence of key physical and mental health conditions and functional impairments in older Mexican Americans and compare this prevalence with that in other populations for whom data exist • Investigate predictors of physical and mental health conditions and functional status at baseline. • Study changes in health and functioning among survivors • Examine changes in health behaviors and key social mediators of health status, including social networks and supports and various key transitions such as widowhood and changes in living arrangements, including institutionalization

  6. MEASURES: Every effort was made to assure comparability with other large studies of the elderly, in particular the original Established Populations for Epidemiologic Studies of the Elderly (EPESE). Comparability exists with the Duke (Piedmont) EPESE, which contains a large minority Afro American) population • SCREENER • ETHNIC ALGORITHM • LIVING ARRANGEMENTS • INSTRUMENTAL SOCIAL SUPPORT and FAMILY CONTACTS • U.S. Census EMPLOYMENT HISTORY • ACCULTURATION • GLOBAL HEALTH RATING

  7. MEASURES: (continued) • HEALTH CONDITIONS: • CHEST PAIN • SHORTNESS OF BREATH • CARDIOVASCULAR • STROKE • HYPERTENSION • CANCER • DIABETES • FRACTURES • GALLBLADDER • ARTHRITIS • INCONTINENCE

  8. MEASURES: (continued) • SLEEP PROBLEMS • HEARING • DENTAL • OTHER HEALTH PROBLEMS • VISION: Distant & Near • COGNITIVE STATE (Mini Mental) • FEELINGS (CES-D) • SMOKING • ALCOHOL CONSUMPTION • CURRENT MEDICATIONS (Rx, OTC, and Folk remedies) • ACTIVITIES of DAILY LIVING (IADL’s and ADL’s) • BLOOD PRESSURE (Standard) • STRESSORS/LIFE EVENTS • HEALTH LOCUS of CONTROL • RELIGION and SOCIAL INVOLVEMENT • SELF ESTEEM (Rosenberg, 5 positive items)

  9. MEASURES: (continued) • PERFORMANCE ORIENTED MOBILITY ASSESSMENT (POMA) • Stands (Semi-Tandem, Full Tandem, Single Leg) • Balance (Repeated Chair Stands) • Grip Strength • Gait Assessment • ANTHROPOMETRIC MEASURES (San Antonio Longitudinal Study of Aging) • Height • Weight • Umbilicus Circumference Measurement • HEALTH CARE SERVICE UTILIZATION • INCOME/FINANCIAL STRAIN ,INSURANCE

  10. INTERVIEWS • All interviewers were bilingual • Spanish and English versions of the questionnaire were available and used where appropriate (almost 2/3 of the interviews were completed in Spanish at baseline) • Fifteen percent of each interviewer’s work was validated by phone • Questions were answered by: • Respondent Only • Proxy with Respondent • Proxy Only

  11. Hispanic EPESE Summary: Baseline, Wave 2, Wave 3, Wave 4, Wave 5 and Wave 6 TotalProxy+DeceasedRefusedNot LocatedAge 1993-4 3050 177 65+ 1995-6 2438 143 241109261 67+ 1998-9 1981 145 432 122274 70+ 2000-1 1683 101 291133 272 72+ 2004-5 1167 93 504 139277 75+ Added Sample 2004-5 902 49 -- -- -- 75+ Both samples combined 2007 1542 159418 15736877+ Cumulative deceased=1823 at end of 6th wave + Includedin Total Updated02/21/2010

  12. Key Findings To date, the study has generated more than 190 manuscripts and 14 dissertations. Our findings are creating a profile of the health of Mexican American elderly who: • have very high rates of obesity and diabetes • have high rates of symptoms of depression, especially among women • have high rates of cognitive impairment and decline. • are more impaired in their physical function than Anglo elderly based on • reports of ability to perform important Activities of Daily Living • performance of physical tasks - walking speed, standing balance and chair stands (found to be early indicators of later disability and to be strong predictors of death) • have high rates of unawareness of hypertension based on comparing self-reported data and blood pressures taken in the home

  13. Final Comments • The Hispanic EPESE data base is extremely easy to use. There are no separate modules, each wave of data is a separate file. These files can be easily linked via a common identification number.

  14. NACDA • The National Archive of Computerized Data on Aging (NACDA) is the principal location for archiving aging related data. NACDA is a part of the Inter-university Consortium for Political and Social Research (ICPSR) located at the University of Michigan. Their holdings include data from all over the world. • http://www.icpsr.umich.edu/NACDA/

  15. Resource Book for the Hispanic EPESE (available through NACDA) Citation: • Black, S.A., Ray, L.A., Angel, R.J., Espino, D.V., Miranda, M., Markides, K.S. (eds.) Resource Book of the Hispanic Established Population for the Epidemiological Study of the Elderly. Ann Arbor: National Archive of Computerized on Aging, 2003. URL: http://www.icpsr.umich.edu(search: study no. 2851).

  16. Questions • Contact: Laura Ray, MA lray@utmb.edu

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