Social Support, Stressors, and Frailty Among Older Mexican American Adults

Peek, M. Kristen; Howrey, Bret; Samper‐Ternent, Rafael; Ray, L.; Ottenbacher, Kenneth J.

doi:10.1093/geronb/gbs081

Cited by 81 publications

(83 citation statements)

References 53 publications

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“…Group‐based trajectory modeling has been used to identify outcome patterns for disability at the end of life36; frailty,39 depression,40 and hypertension41 in general populations; and short‐term depression in young survivors of breast cancer 42, 43. To the best of our knowledge, the current study is the first application of this statistical method to long‐term outcomes in older breast cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Mandelblatt

Clapp

Luta

et al. 2016

Cancer

138

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BACKGROUNDThe number of survivors of breast cancer aged ≥65 years (“older”) is growing, but to the authors' knowledge, little is known regarding the cognitive outcomes of these individuals.METHODSA cohort of cognitively intact older survivors with nonmetastatic, invasive breast cancer was recruited from 78 sites from 2004 through 2011; approximately 83.7% of the survivors (1280 survivors) completed baseline assessments. Follow‐up data were collected at 6 months and annually for up to 7 years (median, 4.1 years). Cognitive function was self‐reported using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ‐C30); scores ranged from 0 to 100, with a higher score indicating better function. Group‐based trajectory modeling determined trajectories; women were assigned to a trajectory group based on the highest predicted probability of membership. Multinomial logistic regression evaluated the association between receipt of chemotherapy (with or without hormonal treatment) and trajectory group.RESULTSSurvivors were aged 65 to 91 years; approximately 41% received chemotherapy. There were 3 cognitive trajectories: “maintained high” (42.3% of survivors); “phase shift” (50.1% of survivors), with scores slightly below but parallel to maintained high; and “accelerated decline” (7.6% of survivors), with the lowest baseline scores and greatest decline (from 71.7 [standard deviation, 19.8] to 58.3 [standard deviation, 21.9]). The adjusted odds of being in the accelerated decline group (vs the maintained high group) were 2.1 times higher (95% confidence interval, 1.3‐3.5) for survivors who received chemotherapy (with or without hormonal therapy) versus those treated with hormonal therapy alone. Greater comorbidity and frailty also were found to be associated with accelerated decline.CONCLUSIONSTrajectory group analysis demonstrated that the majority of older survivors maintained good long‐term self‐reported cognitive function, and that only a small subset who were exposed to chemotherapy manifested accelerated cognitive decline. Future research is needed to determine factors that place some older survivors at risk of experiencing cognitive decline. Cancer 2016;122:3555–3563. © 2016 American Cancer Society

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Section: Discussionmentioning

confidence: 99%

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Mandelblatt

Clapp

Luta

et al. 2016

Cancer

138

View full text Add to dashboard Cite

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“…In the Women's Health and Aging Studies (which also used Fried's criteria), the odds of frailty were increased for those of low education or income regardless of race . The Hispanic Established Populations for the Epidemiologic Study of the Elderly (which used Fried's criteria) found that financial strain was related to increases in frailty over time . The Hertfordshire Cohort Study highlighted socioeconomic inequalities in frailty using Fried's criteria .…”

Section: Discussionmentioning

confidence: 99%

Frailty Index in Europeans: Association with determinants of health

Romero-Ortuño

2013

Geriatrics Gerontology Int

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Aim The Frailty Index (FI) summarizes differences in health status within individuals, and the determinants of health drive that variability. The aim of the present study was to investigate the influence of education, income, smoking, alcohol intake, and parental longevity on the FI variability in subjects of the same chronological age group. Methods Analyses were based on a 40-item FI based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http://www.share-project.org/), including 29,905 participants aged ≥ 50 from 12 countries. For each sex, the sample was divided into age categories (50s, 60s, 70s, 80s and ≥ 90) and FI quartiles within age categories were calculated. Multivariate ordinal regressions were computed to assess the relative contribution of the health determinants on the FI quartiles in each age group. Results In women, the most significant multivariate predictors were years of education (Odds Ratios [ORs] around 0.9), and difficulties making ends meet (ORs between 1.8 and 2.1). In men, the most significant multivariate predictors were years of education (ORs around 0.9), difficulties making ends meet (ORs between 1.6 and 2.1), mother’s age of death (OR under 1), and father’s age of death (ORs under 1). Conclusions Consistently with the literature, education and income explained, in both sexes, cross-sectional variability in FI in subjects of the same chronological age group. The influence of parental longevity seemed to be greater in men, which mirrors previous studies showing that genetic factors may have a higher impact on longevity in men.

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“…With this approach, the population under study is viewed as a mixture within which a finite number of subgroups (latent classes) can be identified possessing distinct trajectory shapes. Each trajectory is then modeled with its own functional form (e.g., linear, quadratic) and direction simultaneously [54–57]. These models were developed using the user-written Stata procedure for trajectory modeling [53] based on semi-parametric, finite mixture modeling using maximum likelihood.…”

Section: Methodsmentioning

confidence: 99%

Stability in Cognitive Function Over 18 Years: Prevalence and Predictors among Older Mexican Americans

Howrey¹,

Raji²,

Masel³

et al. 2015

CAR

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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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Social Support, Stressors, and Frailty Among Older Mexican American Adults

Cited by 81 publications

References 53 publications

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Frailty Index in Europeans: Association with determinants of health

Stability in Cognitive Function Over 18 Years: Prevalence and Predictors among Older Mexican Americans

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