Transcript A LONGITUDINAL STUDY of MEXICAN AMERICAN ELDERLY …

Laura A. Ray, MA.
University of Texas Medical Branch
Galveston, Texas, USA
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The first five waves of the study have been
archived at the National Archive of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).
UTMB, GALVESTON, TX
Kyriakos S. Markides, PI
CO-INVESTIGATORS:
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James S. Goodwin
Kenneth Ottenbacher
M. Kristen Peek
Mukaila Raji
Soham Al Snih
Yong-Fang Kuo
Rebeca Wong
Laura A. Ray- Project
Director
UT AUSTIN, TX
Ronald Angel, PI
CO-INVESTIGATORS:
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Jacqueline Angel
UT Health Science Center,
SAN ANTONIO, TX
David V. Espino, PI.
CO-INVESTIGATORS:
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Donald Royall
Ray Palmer
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Sidney Stahl
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Harris Interactive, Inc.
NIA STAFF:
FIELD STAFF:
OUTSIDE CONSULTANTS:
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Carlos Mendes de Leon
Robert Wallace
Dan Blazer
Denis Evans
Gerda Fillenbaum
Richard Schulz
Hector Gonzalez
Area probability multi-stage sample of noninstitutionalized 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.
SPECIFIC AIMS:
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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
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
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SCREENER
ETHNIC ALGORITHM
LIVING ARRANGEMENTS
INSTRUMENTAL SOCIAL SUPPORT and FAMILY
CONTACTS
U.S. Census EMPLOYMENT HISTORY
ACCULTURATION
GLOBAL HEALTH RATING
MEASURES:
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HEALTH CONDITIONS:
◦ CHEST PAIN
◦ SHORTNESS OF BREATH
◦ CARDIOVASCULAR
◦ STROKE
◦ HYPERTENSION
◦ CANCER
◦ DIABETES
◦ FRACTURES
◦ GALLBLADDER
◦ ARTHRITIS
◦ INCONTINENCE
(continued)
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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)
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PERFORMANCE ORIENTED MOBILITY ASSESSMENT
(POMA)
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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
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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
Hispanic EPESE Summary: Baseline, Wave
2, Wave 3, Wave 4, Wave 5 and Wave 6
Total
Proxy+ Deceased
Refused
Not Located
Age
1993-4
3050
177
1995-6
2438
143
241
109
261
67+
1998-9
1981
145
432
122
274
70+
2000-1
1683
101
291
133
272
72+
504
139
277
75+
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75+
368
77+
2004-5 1167
93
Added Sample
2004-5
902
49
Both samples combined
2007
1542
159
65+
418
157
Cumulative deceased=1823 at end of 6th wave
+ Included in Total
Updated 02/21/2010
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)
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have high rates of unawareness of hypertension based
on comparing self-reported data and blood pressures
taken in the home
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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.
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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/
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).
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Contact:
Laura Ray, MA
[email protected]