Racial Disparities in Disability: Recent Evidence From Self-Reported and Performance-Based Disability Measures in a Population-Based Study of Older Adults

Leon, Carlos F. Mendes de; Barnes, Lisa L.; Bienias, Julia L.; Skarupski, Kimberly A.; Evans, Denis A.

doi:10.1093/geronb/60.5.s263

Cited by 130 publications

(156 citation statements)

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“…11,12,35,36 Importantly, the study adds insight into the Hispanic disability experience. Previous cross-sectional national studies report Hispanic versus White differences in prevalent disability.…”

Section: Discussionmentioning

confidence: 97%

“…These findings show that African American versus White differences in prevalent disability and the development of disability persist into the new century, consonant with earlier national data. 11,12,35,36 Importantly, the study adds insight into the Hispanic disability experience. Previous cross-sectional national studies report Hispanic versus White differences in prevalent disability.…”

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confidence: 97%

“…9 While disability trends have declined among older Americans, racial/ethnic disparities persist. 1,[10][11][12][13] Literature on racial/ ethnic disparities in disability largely evaluate African American experiences; national studies investigating disability among Hispanics are limited 1,12,14,15 Despite the common practice of conducting interviews in languages other than English to allows respondent to participate in their primary language, few national studies consider the influence of language differences on health outcomes. 16 There are known differences in health and mortality related to immigration and acculturation.…”

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confidence: 99%

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Racial/Ethnic Differences in the Development of Disability Among Older Adults

et al. 2007

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Objective-This study investigates differences in developing activities of daily living (ADL) disability among non-Hispanic Whites, African Americans, Hispanics interviewed in Spanish (Hispanic/Spanish), and Hispanics interviewed in English (Hispanic/English) Methods-Six-year risk for disability development is estimated from 8161 participants age 65 or older free of baseline disability in a population-based sample. Mediating factors amenable to clinical and public health intervention on racial/ethnic difference are evaluated.Results-The risk for developing disability among Hispanic/English was similar to Whites (hazard ratio [HR] = 0.99, 95% confidence interval [CI]: 0.6, 1.4), but substantially elevated for African Americans (HR=1.6, 95%CI: 1.3, 1.9) and Hispanic/Spanish (HR=1.8, 95%CI: 1.4, 2.1). Adjustment for demographics, health, and socioeconomic status reduced a large portion of those disparities (African American adjusted HR=1.1, Hispanic/Spanish adjusted HR=1.2).Conclusion-Excess risks for developing disability among older African Americans and Hispanic/ Spanish compared to Whites are largely attenuated by health and socioeconomic differences. Language and culture specific programs to increase physical activity and promote weight maintenance may prove to be efficient strategies to both reduce national ADL disability rates in the future and reduce racial/ethnic disparities in disability. INSTITUTIONAL REVIEW BOARD APPROVAL. This study received exemption from Human Subjects Review by the Northwestern University Institutional Review Board for these analyses of public data. Disability among older adults is a major health issue that is tied to high personal and economic costs. The number of Americans age 65 or older with chronic disability exceeds 7 million people. 1 Maintaining the quality of life for older adults by delaying disability may be as important as prolonging life. 2, 3 Medical spending among older adults is related more strongly to the presence of disability than remaining life expectancy. 4,5 Long-term care expenditures for older persons are projected to reach $161 billion by 2010, of which two-thirds is paid by government programs. 6 The composition of the U.S. population is changing. In 2000, 18% of people in the U.S. spoke a language at home other than English, up from 11% in 1980. 7 The fastest growing part of the U.S. population over 65 is among minority groups, particularly African American and Hispanic. 8 As numbers of older minorities increase, well documented public health concerns grow regarding racial/ethnic disparities in health outcomes. 9 While disability trends have declined among older Americans, racial/ethnic disparities persist. 1, 10-13 Literature on racial/ ethnic disparities in disability largely evaluate African American experiences; national studies investigating disability among Hispanics are limited 1,12,14,15 Despite the common practice of conducting interviews in languages other than English to allows respondent to participate in their primary language, few nat...

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confidence: 97%

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Racial/Ethnic Differences in the Development of Disability Among Older Adults

et al. 2007

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“…In general, White men had lower levels of lean body mass but higher levels of physical function [4]. Similarly, data from the Chicago Health and Aging Project indicated that Black men and women have lower physical function compared with White men and women [38]. Finally, a recent systematic literature review on the epidemiology of sarcopenia concluded Non-White populations experience a more rapid decline in muscle strength and function compared to White populations [39].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Sarcopenia and Sarcopenic Obesity Vary with Race/Ethnicity and Advancing Age

Du¹,

Goates²,

Arensberg³

et al. 2018

Divers Equal Health Care

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Sarcopenia is the natural age-associated loss of muscle mass/function, often occurring simultaneously with obesity, especially in older adults. Sarcopenia and obesity contribute to poor health outcomes and when occurring together as sarcopenic obesity (SO) can cause further health complications. Few studies have specifically considered these conditions across different racial/ethnic populations. This study examined the prevalence of sarcopenia and SO among U.S. adults by different age, sex, and racial/ethnic groups, using 1999-2004 data from the National Health and Nutrition Examination Survey (NHANES) and its racial/ethnic subpopulation groupings. Sarcopenia was defined as low appendicular lean mass (adjusted for Body Mass Index (BMI) of <0.789 kg/ m 2 for males, <0.512 kg/m 2 for females) and self-reported functional limitation. Obesity was defined as BMI ≥30 kg/m 2 with SO defined as those meeting criteria for both sarcopenia and obesity. The analysis included 4367 adult subjects; for each race/ethnic subpopulation, sarcopenia prevalence increased with age. Sarcopenia prevalence varied by sex and race/ ethnic subpopulation: Hispanic (26.8% male, 27.2% female); Non-Hispanic (NH) White (15.5% male, 15.1% female); NH Black (8.6% male, 1.6% female); and Other (16.5% male, 23.2% female). Sarcopenic obesity also increased with age and varied by sex and race/ethnic subpopulation: Hispanic (8.57% male, 8.87% female); NH White (6.48% male, 8.06% female); NH Black (3.95% male, 1.12% female); and Other (4.46% male, 0.0% female). Increased awareness of variability in sarcopenia/SO may help develop effective screenings/ care management and interventions/public health policies to maintain functionality and reduce health disparities among an increasingly diverse U.S. older adult population.

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“…It is also a measure that can be tapped effectively through selfreport (Freedman et al 2011;Maenty et al 2007). Mendes de Leon et al (2005) find it a useful means to capture net changes in mobility from baseline to follow-up. Moreover, Guralnik et al (2000) maintain that lower extremity function demonstrates consistency across studies of diverse populations.…”

Section: Introductionmentioning

confidence: 99%

Social network and mobility improvement among older Europeans: the ambiguous role of family ties

Litwin

Stoeckel

2013

Eur J Ageing

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This study examined the social network correlates of improvement in lower extremity mobility among respondents aged 65 and older from the longitudinal sample of the Survey of Health, Ageing and Retirement in Europe. The study focused on those who self-reported having difficulties with four lower extremity functions: (1) walking 100 m; (2) rising from a seated position; (3) climbing flights of steps; and (4) stooping, kneeling, or crouching. Multivariate logistic regression analyses revealed that social networks were variously associated with improvement in lower extremity function at the two-year follow-up. The findings suggest that under certain circumstances, a lack of social support in late life may actually promote mobility improvement. The research also shows that family networks are not always facilitative of mobility improvement. This is in contrast to previously published social network research positing that supportive relationships help foster health and buffer stressors in late life. Family caregivers and social services should keep this in mind when devising treatment plans upon discharge from the hospital and implementing care management plans for frail older persons in the community.

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Racial Disparities in Disability: Recent Evidence From Self-Reported and Performance-Based Disability Measures in a Population-Based Study of Older Adults

Abstract: Racial disparities in disability have not been eliminated, are greater among women, and have their origins earlier in adulthood.

Cited by 130 publications

References 54 publications

Racial/Ethnic Differences in the Development of Disability Among Older Adults

Racial/Ethnic Differences in the Development of Disability Among Older Adults

Prevalence of Sarcopenia and Sarcopenic Obesity Vary with Race/Ethnicity and Advancing Age

Social network and mobility improvement among older Europeans: the ambiguous role of family ties

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