Physical function transitions and the role of social determinants of health on functional recovery after an acute hospitalization among older Mexican Americans



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The purpose of this project is to 1) examine patterns of physical function transitions and predictors of physical function recovery among older Mexican Americans over a 12-year period; 2) identify social determinants of health that predict physical function recovery after acute hospitalization over a 12-year period; and 3) evaluate the effect of social determinants of health on disability recovery and 30-day readmission after acute hospitalization over a 12-year period. This is a prospective cohort study of community-dwelling Mexican Americans aged >75 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004-2016) linked with the United States Census Bureau and Medicare Claims files from the Center for Medicaid and Medicare Services (2004-2013). We examined participant demographic characteristics, socioeconomic factors, health and health care factors, physical/built factors, and socio-cultural environmental factors. Generalized estimating equations (GEE) were used to estimate the odds of physical function recovery, physical function recovery after hospitalization, disability recovery after hospitalization, and 30-day hospital readmission over a 12-year period. Our study found that experiencing a hospitalization decreased the odds of physical function recovery over time compared to those who did not experience a hospitalization. Hypothesized social determinants of health did not predict physical function over time or physical function and disability recovery after hospitalization or 30-day hospital readmission among Mexican American Medicare Beneficiaries. Additional findings show that older age, being female, having a higher body mass index, having cognitive impairment, and having an Charlson Comorbidity index >3 was associated with physical function recovery over time. Our study found that social determinants of health like nativity status, self-reported loneliness, neighborhood concentration level, sex, and interview language did not predict functional recovery or 30-day hospital readmission among Mexican American Medicare Beneficiaries over a 12-year period. Additional participant and healthcare characteristics may need to be explored to understand mechanisms that affect functional transitions later in life to promote functional maintenance or recovery. This study provides an opportunity for clinicians, researchers, and families aiming to promote functional recovery among older adults.