Cognitive status and incident disability in older Mexican Americans: Findings from the Hispanic established population for the epidemiological study of the elderly

Mukaila Raji, Soham Al Snih al snih, Laura A. Ray, Kushang V. Patel, Kyriakos Markides

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Abstract

Objective: To determine the effects of baseline cognitive function on incidence of disability in activities of daily living (ADL) in initially non-disabled Mexican-American elderly over a 7-year period. Design: A prospective cohort study. Setting: Southwestern United States: Texas, California, Arizona, New Mexico, and Colorado. Participants: A population-based sample of Mexican Americans aged 65 and over who completed the Mini-Mental State Examination (MMSE) and other relevant variables at baseline. The sample at baseline consisted of 2731 subjects, of which 2431 were non-ADL disabled. Measurements: In-home interviews in 1993-94, 1995-96, 1998-99, and 2000-2001 assessed sociodemographic variables, selected medical conditions (stroke, cancer, diabetes, arthritis, and hip fracture), cognitive function, depressive symptomatology, and ADLs. Results: In a Cox proportional regression analysis, a significant relationship was evident between MMSE score at baseline and risk of incident ADL disability over a 7-year period. Among non-disabled subjects at baseline, the hazard ratio of any new ADL limitation was 1.58 (95% Cl, 1.18-2.12) for those with ilm paired cognition (MMSE score 0-21), 1.38 (95% Cl, 1.04-1.82) for low normal cognition (MMSE score 22-24), and 1.30 (95% Cl, 1.02-1.66) for normal cognition (MMSE score 25-28) when compared to subjects with high-normal cognition (MMSE score 29-30), adjusting for sociodemographic variables, presence of selected medical conditions and depressive symptoms at baseline. Similar results were also found when MMSE score was used as a continuous variable. Among non-disabled subjects at baseline, each unit increase in MMSE score decreased the risk of onset of any ADL limitation over a 7-year follow-up period, controlling for relevant variables at baseline (HR=0.97; 95% Cl, 0.95-0.99). Conclusion: Low MMSE score was associated with increased risk for incident ADL disability over a 7-year period in older Mexican Americans. Given the social, economic, and health impact of cognitive impairment, these findings suggest a need to develop effective intervention programs that delay or prevent the onset of cognitive and ADL disability in the elderly.

Original languageEnglish (US)
Pages (from-to)26-31
Number of pages6
JournalEthnicity and Disease
Volume14
Issue number1
StatePublished - Dec 2004

Fingerprint

Activities of Daily Living
Hispanic Americans
Epidemiologic Studies
Cognition
Population
Southwestern United States
Hip Fractures
Arthritis
Cohort Studies
Stroke
Regression Analysis
Economics
Prospective Studies
Interviews
Depression
Incidence
Health
Neoplasms

Keywords

  • Activities of daily living
  • Aging
  • Mexican Americans
  • MMSE

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

@article{9e8315dbe49b4e3ebe91c4dc347ec213,
title = "Cognitive status and incident disability in older Mexican Americans: Findings from the Hispanic established population for the epidemiological study of the elderly",
abstract = "Objective: To determine the effects of baseline cognitive function on incidence of disability in activities of daily living (ADL) in initially non-disabled Mexican-American elderly over a 7-year period. Design: A prospective cohort study. Setting: Southwestern United States: Texas, California, Arizona, New Mexico, and Colorado. Participants: A population-based sample of Mexican Americans aged 65 and over who completed the Mini-Mental State Examination (MMSE) and other relevant variables at baseline. The sample at baseline consisted of 2731 subjects, of which 2431 were non-ADL disabled. Measurements: In-home interviews in 1993-94, 1995-96, 1998-99, and 2000-2001 assessed sociodemographic variables, selected medical conditions (stroke, cancer, diabetes, arthritis, and hip fracture), cognitive function, depressive symptomatology, and ADLs. Results: In a Cox proportional regression analysis, a significant relationship was evident between MMSE score at baseline and risk of incident ADL disability over a 7-year period. Among non-disabled subjects at baseline, the hazard ratio of any new ADL limitation was 1.58 (95{\%} Cl, 1.18-2.12) for those with ilm paired cognition (MMSE score 0-21), 1.38 (95{\%} Cl, 1.04-1.82) for low normal cognition (MMSE score 22-24), and 1.30 (95{\%} Cl, 1.02-1.66) for normal cognition (MMSE score 25-28) when compared to subjects with high-normal cognition (MMSE score 29-30), adjusting for sociodemographic variables, presence of selected medical conditions and depressive symptoms at baseline. Similar results were also found when MMSE score was used as a continuous variable. Among non-disabled subjects at baseline, each unit increase in MMSE score decreased the risk of onset of any ADL limitation over a 7-year follow-up period, controlling for relevant variables at baseline (HR=0.97; 95{\%} Cl, 0.95-0.99). Conclusion: Low MMSE score was associated with increased risk for incident ADL disability over a 7-year period in older Mexican Americans. Given the social, economic, and health impact of cognitive impairment, these findings suggest a need to develop effective intervention programs that delay or prevent the onset of cognitive and ADL disability in the elderly.",
keywords = "Activities of daily living, Aging, Mexican Americans, MMSE",
author = "Mukaila Raji and {Al Snih al snih}, Soham and Ray, {Laura A.} and Patel, {Kushang V.} and Kyriakos Markides",
year = "2004",
month = "12",
language = "English (US)",
volume = "14",
pages = "26--31",
journal = "Ethnicity and Disease",
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TY - JOUR

T1 - Cognitive status and incident disability in older Mexican Americans

T2 - Findings from the Hispanic established population for the epidemiological study of the elderly

AU - Raji, Mukaila

AU - Al Snih al snih, Soham

AU - Ray, Laura A.

AU - Patel, Kushang V.

AU - Markides, Kyriakos

PY - 2004/12

Y1 - 2004/12

N2 - Objective: To determine the effects of baseline cognitive function on incidence of disability in activities of daily living (ADL) in initially non-disabled Mexican-American elderly over a 7-year period. Design: A prospective cohort study. Setting: Southwestern United States: Texas, California, Arizona, New Mexico, and Colorado. Participants: A population-based sample of Mexican Americans aged 65 and over who completed the Mini-Mental State Examination (MMSE) and other relevant variables at baseline. The sample at baseline consisted of 2731 subjects, of which 2431 were non-ADL disabled. Measurements: In-home interviews in 1993-94, 1995-96, 1998-99, and 2000-2001 assessed sociodemographic variables, selected medical conditions (stroke, cancer, diabetes, arthritis, and hip fracture), cognitive function, depressive symptomatology, and ADLs. Results: In a Cox proportional regression analysis, a significant relationship was evident between MMSE score at baseline and risk of incident ADL disability over a 7-year period. Among non-disabled subjects at baseline, the hazard ratio of any new ADL limitation was 1.58 (95% Cl, 1.18-2.12) for those with ilm paired cognition (MMSE score 0-21), 1.38 (95% Cl, 1.04-1.82) for low normal cognition (MMSE score 22-24), and 1.30 (95% Cl, 1.02-1.66) for normal cognition (MMSE score 25-28) when compared to subjects with high-normal cognition (MMSE score 29-30), adjusting for sociodemographic variables, presence of selected medical conditions and depressive symptoms at baseline. Similar results were also found when MMSE score was used as a continuous variable. Among non-disabled subjects at baseline, each unit increase in MMSE score decreased the risk of onset of any ADL limitation over a 7-year follow-up period, controlling for relevant variables at baseline (HR=0.97; 95% Cl, 0.95-0.99). Conclusion: Low MMSE score was associated with increased risk for incident ADL disability over a 7-year period in older Mexican Americans. Given the social, economic, and health impact of cognitive impairment, these findings suggest a need to develop effective intervention programs that delay or prevent the onset of cognitive and ADL disability in the elderly.

AB - Objective: To determine the effects of baseline cognitive function on incidence of disability in activities of daily living (ADL) in initially non-disabled Mexican-American elderly over a 7-year period. Design: A prospective cohort study. Setting: Southwestern United States: Texas, California, Arizona, New Mexico, and Colorado. Participants: A population-based sample of Mexican Americans aged 65 and over who completed the Mini-Mental State Examination (MMSE) and other relevant variables at baseline. The sample at baseline consisted of 2731 subjects, of which 2431 were non-ADL disabled. Measurements: In-home interviews in 1993-94, 1995-96, 1998-99, and 2000-2001 assessed sociodemographic variables, selected medical conditions (stroke, cancer, diabetes, arthritis, and hip fracture), cognitive function, depressive symptomatology, and ADLs. Results: In a Cox proportional regression analysis, a significant relationship was evident between MMSE score at baseline and risk of incident ADL disability over a 7-year period. Among non-disabled subjects at baseline, the hazard ratio of any new ADL limitation was 1.58 (95% Cl, 1.18-2.12) for those with ilm paired cognition (MMSE score 0-21), 1.38 (95% Cl, 1.04-1.82) for low normal cognition (MMSE score 22-24), and 1.30 (95% Cl, 1.02-1.66) for normal cognition (MMSE score 25-28) when compared to subjects with high-normal cognition (MMSE score 29-30), adjusting for sociodemographic variables, presence of selected medical conditions and depressive symptoms at baseline. Similar results were also found when MMSE score was used as a continuous variable. Among non-disabled subjects at baseline, each unit increase in MMSE score decreased the risk of onset of any ADL limitation over a 7-year follow-up period, controlling for relevant variables at baseline (HR=0.97; 95% Cl, 0.95-0.99). Conclusion: Low MMSE score was associated with increased risk for incident ADL disability over a 7-year period in older Mexican Americans. Given the social, economic, and health impact of cognitive impairment, these findings suggest a need to develop effective intervention programs that delay or prevent the onset of cognitive and ADL disability in the elderly.

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KW - Aging

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