Acculturation and disability in Mexican American older adults
Mary Ellen E. Kuhlmann
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Abstract: The purpose of this study is to examine acculturation and disability in Mexican American older adults living independently in the southwestern United States. Design: A prospective cohort study (1993-2005). Setting: Texas, New Mexico, Colorado, Arizona, and California. Participants: Participants in the Hispanic Established Population for Epidemiologic Studies of the Elderly (H-EPESE), a population-based sample of 3050 non-institutionalized Mexican-American men and women aged 65 and over. Measures: Variables included three measures of acculturation (English proficiency, English usage, and Mainstream contact), risk factors (age, gender, education, marital status, and BMI), disablement process factors (chronic pathology, cognitive status, and physical performance), and activities of daily living disability (ADLs), and instrumental activities of daily living disability (IADLs). Chi-Square, Chi-Square test for trends, ordinary least squares regression and discrete hazard analyses were used to identify associations of measures of acculturation with incidence of ADL and IADL disability. Results: There was a significant association between one measure of acculturation (English proficiency) and incidence of IADL disability, which remained after adding risk factors and Disablement process variables to the model. Conclusion: The findings support the importance of acculturation when examining ADL and IADL disability. Interventions that consider acculturation may be useful in reducing ADL and IADL disability in Mexican American older adults.