Trajectories of limitations in activities of daily living among older adults in Mexico, 2001–2012

Abstract

Background Trajectories of disability are an essential component to understand the burden of disability at the societal level. Longitudinal studies, compared to cross-national studies, enable a better analysis of the progression of physical limitations among the elderly. However, information on disability dynamics in developing countries is limited. Objectives This paper examines the changes in activities of daily living (ADLs) in an 11-yr. period in the Mexican elderly population aged 60 or older and identifies how sociodemographic variables alter these trajectories. Methods The data come from the Mexican Health and Aging Study (MHAS), a national sample of adults born in 1951 or earlier, including a baseline survey in 2001 and follow-ups in 2003 and 2012. Results The ADL score increased on average by 0.03 for every year respondents aged after 60. In contrast, the ADL score was reduced by 0.06 for every additional year of education. Conclusions Age, gender, and years of education were confirmed to influence the trajectories of ADL limitations. Understanding the patterns of deterioration of functional limitations will help inform public health policies to better serve the population.

Age Trajectories of Physical Health Among Older Adults of Mexican Descent: Implications of Immigrant Status, Age at Immigration, and Gender

“…In contrast, I hypothesize that midlife immigrant (between ages 20 and 49) men and women will experience steeper increases in ADL limitations and chronic conditions than U.S.-born men because midlife immigrants tend to have lower likelihood of accumulating socioeconomic resources throughout the life course and, as a result, might have a higher risk of negative acculturation. Moreover, following prior research on gender differences in age-related changes in physical health, I predict that increases in ADL limitations may be steeper among women, whereas increases in chronic conditions may be faster among men (Díaz-Venegas & Wong, 2016; Gorman & Read, 2006; Kahng et al, 2004).…”

“…Individuals who immigrate in midlife tend to be healthier because they decide to move in search of employment, whereas early-life and later-life immigrants are less likely to be self-selected on health because they immigrate with their parents or under family reunification program, respectively (Markides, Eschbach, Ray, & Peek, 2007). In addition, prior research shows that women, regardless of immigrant status and race/ethnicity, have a higher prevalence of functional disabilities (Díaz-Venegas & Wong, 2016; Rohlfsen & Kronenfeld, 2014) and chronic conditions (Denton, Prus, & Walters, 2004; Zunzunegui, Alvarado, Béland, & Vissandjee, 2009). Potential gender disparities in physical health might be attributed to gender differences in social activities, habits, and roles that affect individuals’ exposure to health risks and their access to resources (Rieker, Bird, & Lang, 2010).…”

“…Moreover, findings on age-related changes in gender disparities in physical health are mixed, but they also demonstrate that the implications of gender for age trajectories might vary by the physical health outcome examined. For instance, some studies show that women may have a steeper increase in functional limitations with age (Díaz-Venegas & Wong, 2016; Gorman & Read, 2006), whereas other research did not find gender differences in the rate of increase in these disabilities (Kahng, Dunkle, & Jackson, 2004; Rohlfsen & Kronenfeld, 2014). At the same time, prior research suggests that age-related increases in chronic conditions may be faster for men, although they might have fewer of these issues at younger ages (Gorman & Read, 2006; Kahng et al, 2004).…”

Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults

“… 10 , 11 A Mexican study has shown that every additional year of formal education leads to an improvement in ADL scores (0.06 points), as measured by the Katz index (score 0-5). 12 The direct comparison of advanced and instrumental ADL performance in community-dwelling older adults with different levels of formal education has revealed that little or no formal education (≤4 years) were associated with significantly lower activity participation (e.g. engaging in social visits, going to church, housework, cooking and watching television) than those with higher levels of formal education in Brazil.…”

Sensory and cognitive functions, gait ability and functionality of older adults

“…Regarding the decrease in the cognitive function, like functional alterations, it has been observed that this is generally manifested by the same aging process (9) , or due to the presence of diseases, it has been shown that, at an older age, cognitive problems increase, and these increase if the adult suffers from two or more chronic diseases (10)(11) ; regarding functionality, the literature shows a relationship between cognitive functionality and physical functionality, including gait.…”