Background Falls are a major cause of disability, morbidity, institutionalization, and mortality in older adults. Objectives To examine the risk factors for falls among Mexican older adults aged 60 years and older. Methods This study included 6,247 participants and their spouse or partner aged 60 years and older from the Mexican Health and Aging Study, an ongoing longitudinal study (2001-2012) conducted in Mexico. Measures included socio-demographics, falls, physical activity, comorbid conditions, pain, vertigo, vision and hearing impairments, urinary incontinence, lower extremity functional limitation, Activities of Daily Living (ADLs), cognitive function, and depressive symptoms. Results Mean age was 69.6 years (Standard Error=0.18) and 51.8% were female. Forty percent reported one or more falls at baseline. Older age, being female, obesity, arthritis, fractures, stroke, suffering pain, vertigo, lower extremity functional limitations, physical activity, depressive symptoms, urinary incontinence, and ADL disability were significant factors associated with one or more falls over time. Discussion Early detection and treatment of the risk factors for falls in this population will help improve the quality of life and reduce medical complications and health care costs.
The U.S. Mexican American population enjoys longer life expectancies relative to other racial/ethnic groups but is disproportionately affected by chronic conditions and functional limitations. Studying the impact of heterogeneity in age, time and other characteristics of migration among older Mexican Americans can inform our understanding of health disparities and health care needs in later-life. This research employed 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess the proportion of life spent with functional limitations and one or more morbidity (by age of migration and gender) in the United States Mexican American population. Our results indicate early-life and late-life migrant women spend a larger number of years with performance-oriented mobility assessment (POMA) limitations than U.S.-born women. Conversely, mid-life migrant women were not statistically different from U.S.-born women in years spent disabled. Among men, mid-life migrants had longer life expectancies and spent more years disability-free than U.S.-born men. For morbidity, late-life migrant women spent a significantly smaller proportion of their elderly years with morbidity than U.S.-born women. However, late-life migrant men spent more years with morbidity than U.S.-born men. These findings illustrate that older Mexican Americans in the United States are heterogeneous in nativity and health outcomes. More years spent disabled/unhealthy may result in greater burden on family members and higher dependency on public resources. These findings have implications for the development of social and health policies to appropriately target the medical conditions and disabilities of older Mexican Americans entering late-life.
Objective Arthritis and vitamin D insufficiency are prevalent in older adults and are risk factors for disability. The objective of this study was to examine the effect of co-ocurring arthritis and vitamin D defficiency on upper-lower extremity functional limitations and disability in older adults. Methods We examined 1,533 participants aged ≥50 years from a subsample of the Mexican Health and Aging Study. Measures included sociodemographics, body mass index, comorbid conditions, falls, physical activity, physical function tests, functional limitations, activities of daily living (ADL), and vitamin D. Participants were categorized into four groups according to arthritis and vitamin D status: no vitamin D insufficiency and no arthritis (58.80%), vitamin D insufficiency only (27.49%), arthritis only (8.47%), and arthritis and vitamin D insufficiency (5.24%). Results Fourteen percent reported arthritis and 31.2% had vitamin D insufficiency. The arthritis and vitamin D insufficiency group was associated with upper-lower extremity functional limitations (odds ratio [OR] =1.82, 95% Confidence Interval[CI]=1.06-3.15, and OR=1.90, 95%CI=1.00-3.62, respectively) and ADL disability (OR=3.00, 95%CI=1.63-5.51) when compared with the no vitamin D insufficiency and no arthritis group (reference group). The arthritis only group was three times more likely to report upper-lower extremity functional limitations and ADL disability. The vitamin D insufficiency only group was not significantly associated with functional limitations nor ADL disability. Conclusion Arthritis and vitamin D insufficiency increased the risk of ADL disability in this population. However, the effect of arthritis and vitamin D insufficiency on upper- lower extremity functional limitations was not higher than the effect of arthritis only, but higher than the effect on vitamin D insufficiency alone.
Aim: Rheumatic manifestations are common in patients with Hashimoto's thyroiditis (HT).Since previous reports on the prevalence of arthritis in this disease may have a rheumatology referral bias, we sought to establish the prevalence of undifferentiated inflammatory arthropathy (UIA) in unselected HT patients as seen in an endocrinology clinic.Methods: Cross-sectional study of 92 consecutive HT patients and no definite rheumatic disease from the Endocrinology Division, Hospital Universitario de Caracas diagnosed by the presence of anti-thyroid peroxidase antibodies (n = 68) or typical ultrasonographic findings (n = 24). Undifferentiated inflammatory arthropathy was defined as combination of morning stiffness and joint pain with ≥2 characteristics of inflammatory joint pain. The study was revised and approved by the Ethics Committee of our hospital and all patients signed an informed consent form. Results:Twenty-three patients (25%; 95% CI 16-34) met the criteria for UIA. Joints most commonly affected were the knees, hands and ankles and the most common pattern was oligoarticular (82.6%). In the multivariate analysis, variables associated to the presence of UIA were the presence of myalgia (odds ratio [OR] = 19.41; 95% CI = 2.38-158.38) andRaynaud's phenomenon (OR = 4.32; 95% CI = 1.01-18.60). No association was found with demographics, duration of disease, comorbidities or thyroid function status.
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