Liver disease, heart failure, and 13-year mortality among Mexican American older adults: Nativity differences

Purpose: To examine nativity differences of co-occurring liver disease (LD) and heart failure (HF) on 13-year mortality among Mexican American older adults. Methods: Prospective cohort study of 1601 Mexican Americans aged ≥ 75 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/05–2016). Participants were grouped into four groups: no LD and no HF (n = 1138), LD only (n = 53), HF only (n = 382), and both LD and HF (n = 28). We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of death over time. Results: The HR of death, as a function of HF only, was 1.32 (95% CI=1.07–1.62) among US-born and 1.36 (95% CI=1.04–1.78) among foreign-born participants, vs. those with no LD and no HF. Among foreign-born participants, the HR of death as a function of LD and HF was 3.39 (95% CI=1.65–6.93) vs. those without either. LD alone was not associated with mortality in either group. Among US-born, co-occurring LD and HF was not associated with mortality. Conclusions: Foreign-born participants with both LD and HF were at higher risk of mortality over 13 years of follow up.