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Mexican-American Men (mexican-american + man)
Selected AbstractsRelationship Between Frailty and Cognitive Decline in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2008Rafael Samper-Ternent MD OBJECTIVES: To examine the association between frailty status and change in cognitive function over time in older Mexican Americans. DESIGN: Data used were from the Hispanic Established Population for the Epidemiological Study of the Elderly. SETTING: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: One thousand three hundred seventy noninstitutionalized Mexican-American men and women aged 65 and older with a Mini-Mental State Examination (MMSE) score of 21 or higher at baseline (1995/96). MEASUREMENTS: Frailty, defined as three or more of the following components: unintentional weight loss of more than 10 pounds, weakness (lowest 20% in grip strength), self-reported exhaustion, slow walking speed (lowest 20% in 16-foot walk time in seconds), and low physical activity level (lowest 20% on Physical Activity Scale for the Elderly score). Information about sociodemographic factors, MMSE score, medical conditions (stroke, heart attack, diabetes mellitus, arthritis, cancer, and hypertension), depressive symptoms, and visual impairment was obtained. RESULTS: Of the 1,370 subjects, 684 (49.9%) were not frail, 626 (45.7%) were prefrail (1,2 components), and 60 (4.4%) were frail (,3 components) in 1995/96. Using general linear mixed models, it was found that frail subjects had greater cognitive decline over 10 years than not frail subjects (estimate=,0.67, standard error=0.13; P<.001). This association remained statistically significant after controlling for potential confounding factors. CONCLUSION: Frail status in older Mexican Americans with MMSE scores of 21 or higher at baseline is an independent predictor of MMSE score decline over a 10-year period. Future research is needed to establish pathophysiological components that can clarify the relationship between frailty and cognitive decline. [source] Weight Change and Lower Body Disability in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Soham Al Snih MD Objectives: To examine the association between 2-year weight change and onset of lower body disability over time in older Mexican Americans. Design: Data were from the Hispanic Established Population for the Epidemiological Study of the Elderly (1993,2001). Weight change was examined by comparing baseline weight to weight at 2-year follow-up. Incidence of lower body disability was studied from the end of this period through an additional 5 years. Setting: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. Participants: One thousand seven hundred thirty-seven noninstitutionalized Mexican-American men and women aged 65 and older who reported no limitation in activities of daily living (ADLs) and were able to perform the walk test at 2-year follow-up. Measurements: In-home interviews assessed sociodemographic factors, self-reported physician diagnoses of medical conditions (arthritis, diabetes mellitus, heart attack, stroke, hip fracture, and cancer), self-reported ADLs, depressive symptoms, and number of hospitalizations. Cognitive function, handgrip muscle strength, and body mass index (BMI) were obtained. The outcomes were any limitation of lower body ADL (walking across a small room, bathing, transferring from a bed to a chair, and using the toilet) and limitation on the walk test over subsequent 5-year follow-up period. General Estimation Equation (GEE) was used to estimate lower body disability over time. Results: Weight change of 5% or more occurred in 42.3% of the participants; 21.7% lost weight, 20.6% gained weight, and 57.7% had stable weight. Using GEE analysis, with stable weight as the reference, weight loss of 5% or more was associated with greater risk of any lower body ADL limitation (odds ratio (OR)=1.43, 95% confidence interval (CI)=1.06,1.95) and walking limitation (OR=1.35, 95% CI=1.03,1.76) after controlling for sociodemographic variables and BMI at baseline. Weight gain of 5% or more was associated with greater risk of any lower body ADL limitation (OR=1.39, 95% CI=1.02,1.89), after controlling for sociodemographic variables and BMI at baseline. When medical conditions, handgrip muscle strength, high depressive symptomatology, cognitive function, and hospitalization were added to the equation, the relationship between 2-year weight change (>5% loss or >5% gain) and lower body disability decreased. Conclusion: Health conditions and muscle strength partially mediate the association between weight loss or gain and future loss of ability to walk and independently perform ADLs. [source] Cognitive Status, Muscle Strength, and Subsequent Disability in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2005Mukaila A. Raji MD Objectives: To examine the association between Mini-Mental State Examination (MMSE) score and subsequent muscle strength (measured using handgrip strength) and to test the hypothesis that muscle strength will mediate any association between impaired cognition and incident activity of daily living (ADL) disability over a 7-year period in elderly Mexican Americans who were initially not disabled. Design: A 7-year prospective cohort study (1993,2001). Setting: Five southwestern states (Texas, New Mexico, Colorado, Arizona, and California). Participants: Two thousand three hundred eighty-one noninstitutionalized Mexican-American men and women aged 65 and older with no ADL disability at baseline. Measurements: In-home interviews in 1993/1994, 1995/1996, 1998/1999, and 2000/2001 assessed social and demographic factors, medical conditions (diabetes mellitus, stroke, heart attack, and arthritis), body mass index (BMI), depressive symptomatology, handgrip muscle strength, and ADLs. MMSE score was dichotomized as less than 21 for poor cognition and 21 or greater for good cognition. Main outcomes measures were mean and slope of handgrip muscle strength over the 7-year period and incident disability, defined as new onset of any ADL limitation at the 2-, 5-, or 7-year follow-up interview periods. Results: In mixed model analyses, there was a significant cross-sectional association between having poor cognition (MMSE<21) and lower handgrip strength, independent of age, sex, and time of interview (estimate=,1.41, standard error (SE)=0.18; P<.001). With the introduction of a cognition-by-time interaction term into the model, there was also a longitudinal association between poor cognition and change in handgrip strength over time (estimate=,0.25, SE=0.06; P<.001), indicating that subjects with poor cognition had a significantly greater decline in handgrip strength over 7 years than those with good cognition, independent of age, sex, and time. This longitudinal association between poor cognition and greater muscle decline remained significant (P<.001) after controlling for age, sex, education, and time-dependent variables of depression, BMI, and medical conditions. In general estimation equation models, having poor cognition was associated with greater risk of 7-year incident ADL disability (odds ratio=2.01, 95% confidence interval (CI)=1.60,2.52); the magnitude of the association decreased to 1.66 (95% CI=1.31,2.10) when adjustment was made for handgrip strength. Conclusion: Older Mexican Americans with poor cognition had steeper decline in handgrip muscle strength over 7 years than those with good cognition, independent of other demographic and health factors. A possible mediating effect of muscle strength on the association between poor cognition and subsequent ADL disability was also indicated. [source] Frailty in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2005Kenneth J. Ottenbacher PhD 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 (R2)=0.37). Predictors for women included lower extremity strength, disability (activities of daily living), and body mass index (Nagelkerke R2=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. [source] Exploring Chronically Ill Seniors' Attitudes About Discussing Death and Postmortem Medical ProceduresJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2005Henry S. Perkins MD Proxy decisions about postmortem medical procedures must consider the dead patient's likely preferences. Ethnic-and sex-based attitudes surely underlie such preferences but lack sufficient characterization to guide decisions. Therefore, this exploratory study interviewed Mexican-American, Euroamerican, and African-American seniors in San Antonio, Texas, for their attitudes about discussing death before it occurs and about organ donation, autopsy, and practice on cadavers. A rigorous content analysis identified themes. Majority attitudes of an ethnic group or sex subgroup here may characterize the group generally. Attitudes about discussing death differed only by ethnic group. Mexican Americans and Euroamericans favored such discussions, but African Americans did not. Attitudes about the postmortem procedures differed by ethnic group and sex. Overall, Mexican Americans viewed the procedures most favorably; Euroamericans, less so; and African Americans, least so. Men and women differed further within ethnic groups. Mexican-American men and women split evenly over organ donation, the men expressed no majority preference about autopsies and the women agreed to them, and the men refused and the women agreed to practice on their cadavers. Euroamerican men expressed no majority preferences, but Euroamerican women agreed to organ donation, had no majority preference about autopsies, and refused practice on their cadavers. African-American men expressed no majority preferences, and African-American women expressed none about organ donation or autopsies but refused practice on their cadavers. If confirmed, these ethnic- and sex-based attitudes can help health professionals tailor postmortem care to individual patients' preferences. [source] Handgrip Strength and Mortality in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2002Soham Al Snih MD OBJECTIVES: To examine the association between handgrip strength and mortality in older Mexican American men and women. DESIGN: A 5-year prospective cohort study. SETTING: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: A population-based sample of 2,488 noninstitutionalized Mexican-American men and women aged 65 and older. MEASUREMENTS: Maximal handgrip strength, timed walk, and body mass index were assessed at baseline during 1993/94. Self-reports of functional disability, various medical conditions, and status at follow-up were obtained. RESULTS: Of the baseline sample with complete data, 507 persons were confirmed deceased 5 years later. Average handgrip strength ± standard deviation was significantly higher in men (28.4 kg ± 9.5) than in women (18.2 kg ± 6.5). Of men who had a handgrip strength less than 22.01 kg and women who had a handgrip strength less than 14 kg, 38.2% and 41.5%, respectively, were dead 5 years later. In men in the lowest handgrip strength quartile, the hazard ratio of death was 2.10 (95% confidence interval (CI) = 1.31,3.38) compared with those in the highest handgrip strength quartile, after controlling for sociodemographic variables, functional disability, timed walk, medical conditions, body mass index, and smoking status at baseline. In women in the lowest handgrip strength quartile, the hazard ratio of death was 1.76 (95% CI = 1.05,2.93) compared with those in the highest handgrip strength quartile. Poorer performance in the timed walk and the presence of diabetes mellitus, hypertension, and cancer were also significant predictors of mortality 5 years later. CONCLUSION: Handgrip strength is a strong predictor of mortality in older Mexican Americans, after controlling for relevant risk factors. [source] Quantitative Trait Loci on Chromosomes 2p, 4p, and 13q Influence Bone Mineral Density of the Forearm and Hip in Mexican Americans,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 12 2003Candace M Kammerer Abstract We performed a genome scan using BMD data of the forearm and hip on 664 individuals in 29 Mexican-American families. We obtained evidence for QTL on chromosome 4p, affecting forearm BMD overall, and on chromosomes 2p and 13q, affecting hip BMD in men. Introduction: The San Antonio Family Osteoporosis Study (SAFOS) was designed to identify genes and environmental factors that influence bone mineral density (BMD) using data from large Mexican-American families. Materials and Methods: We performed a genome-wide linkage analysis using 416 highly polymorphic microsatellite markers spaced approximately 9.5 cM apart to locate and identify quantitative trait loci (QTL) that affect BMD of the forearm and hip. Multipoint variance components linkage analyses were done using data on all 664 subjects, as well as two subgroups of 259 men and 261 premenopausal women, from 29 families for which genotypic and phenotypic data were available. Results: We obtained significant evidence for a QTL affecting forearm (radius midpoint) BMD in men and women combined on chromosome 4p near D4S2639 (maximum LOD = 4.33, genomic p = 0.006) and suggestive evidence for a QTL on chromosome 12q near locus D12S2070 (maximum conditional LOD = 2.35). We found suggestive evidence for a QTL influencing trochanter BMD on chromosome 6 (maximum LOD = 2.27), but no evidence for QTL affecting the femoral neck in men and women combined. In men, we obtained evidence for QTL affecting neck and trochanter BMD on chromosomes 2p near D2S1780 (maximum LOD = 3.98, genomic p = 0.013) and 13q near D13S788 (maximum LOD = 3.46, genomic p = 0.039), respectively. We found no evidence for QTL affecting forearm or hip BMD in premenopausal women. Conclusion: These results provide strong evidence that a QTL on chromosome 4p affects radius BMD in Mexican-American men and women, as well as evidence that QTL on chromosomes 2p and 13q affect hip BMD in men. Our results are consistent with some reports in humans and mice. [source] | ||||||||||