Garcia Marc A, Reyes Adriana M, Downer Brian, Saenz Joseph L, Samper-Ternent Rafael A, Raji Mukaila
University of Texas Medical Branch, Sealy Center on Aging, Galveston.
Population Studies Center, University of Michigan.
Innov Aging. 2018 Feb 2;1(3):igx037. doi: 10.1093/geroni/igx037. eCollection 2017 Nov.
To explore nativity and age of migration differentials in the incidence of cognitive impairment among older Mexican-Americans.
We employ maximum-likelihood discrete time hazard models to estimate risk ratios of cognitive impairment in a sample of 2,708 Mexican-Americans 65 and older who were cognitively healthy at baseline over a follow-up period of up to 20 years.
Late-life immigrant women have a 46% higher risk of cognitive impairment compared to U.S.-born Mexican-American women. Conversely, midlife immigrant men have a 29% lower risk of cognitive impairment compared to U.S.-born Mexican-American men. The incidence of cognitive impairment did not differ for early-life and midlife immigrant women relative to U.S.-born women or for early- and late-life immigrant men compared to U.S.-born men.
Differences in cognitive impairment risk between U.S.-born and foreign-born Mexican-American subgroups may be partly due to health selectivity. Cognitive impairment is more prevalent among immigrant groups which may result in a higher burden on family members and/or high dependency on public resources. Programs are needed that can detect decline at earlier stages and reduce the risk for cognitive impairment among older immigrants entering their last decades of life.
探讨墨西哥裔美国老年人认知障碍发病率中出生地和移民年龄的差异。
我们采用最大似然离散时间风险模型，对2708名65岁及以上的墨西哥裔美国人进行抽样，这些人在基线时认知健康，随访期长达20年，以估计认知障碍的风险比。
与在美国出生的墨西哥裔美国女性相比，晚年移民女性患认知障碍的风险高46%。相反，与在美国出生的墨西哥裔美国男性相比，中年移民男性患认知障碍的风险低29%。与在美国出生的女性相比，早年和中年移民女性的认知障碍发病率没有差异；与在美国出生的男性相比，早年和晚年移民男性的认知障碍发病率也没有差异。
在美国出生和外国出生的墨西哥裔美国亚组之间，认知障碍风险的差异可能部分归因于健康选择。认知障碍在移民群体中更为普遍，这可能给家庭成员带来更大负担，和/或导致对公共资源的高度依赖。需要开展相关项目，以便在早期阶段检测出认知能力下降，并降低进入生命最后几十年的老年移民患认知障碍的风险。
