Jimenez Daniel E, Martinez Garza David, Cárdenas Verónica, Marquine María
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Florida.
Moores Cancer Center, University of California, San Diego.
Innov Aging. 2020 Aug 18;4(5):igaa033. doi: 10.1093/geroni/igaa033. eCollection 2020.
The aggregation of Latino subgroups in national studies creates an overly simplistic narrative that Latinos are at lower risk of mental illness and that foreign nativity seems protective against mental illness (i.e., immigrant paradox). This broad generalization does not hold up as the Latino population ages. Given that social inequalities for risk appear to widen with age, the social disadvantages of being Latino in the United States increase the risk for mental illness across the life span. This review focuses on the mental health of older Latinos, specifically the 3 subgroups with the longest residential history in the United States-Mexicans, Puerto Ricans, and Cubans. We examine relevant epidemiological and clinical psychopathology studies on aging in these Latino populations and present evidence of the heterogeneity of the older Latino population living in the United States, thus illustrating a limitation in this field-combining Latino subgroups despite their diversity because of small sample sizes. We address the migration experience-how intraethnic differences and age of migration affect mental health-and discuss social support and discrimination as key risk and protective factors. We conclude with a discussion on meeting the mental health needs of older Latinos with a focus on prevention, a promising approach to addressing mental illness in older Latinos, and future directions for mental health research in this population. Success in this endeavor would yield a substantial reduction in the burden of late-life depression and anxiety and a positive public health impact.
在全国性研究中,拉丁裔亚群体的聚集形成了一种过于简单化的说法,即拉丁裔患精神疾病的风险较低,而且外国出生似乎对精神疾病有保护作用(即移民悖论)。随着拉丁裔人口老龄化,这种一概而论的观点并不成立。鉴于风险方面的社会不平等似乎会随着年龄增长而加剧,在美国身为拉丁裔的社会劣势会增加其一生患精神疾病的风险。本综述聚焦于老年拉丁裔的心理健康,特别是在美国居住历史最长的三个亚群体——墨西哥裔、波多黎各裔和古巴裔。我们审视了有关这些拉丁裔人群老龄化的相关流行病学和临床精神病理学研究,并展示了居住在美国的老年拉丁裔人口的异质性证据,从而说明了该领域存在的一个局限性——尽管拉丁裔亚群体存在多样性,但由于样本量小,仍将他们合并在一起研究。我们探讨了移民经历——族内差异和移民年龄如何影响心理健康——并讨论了社会支持和歧视作为关键风险因素和保护因素的情况。我们最后讨论了满足老年拉丁裔心理健康需求的问题,重点是预防,这是应对老年拉丁裔精神疾病的一种有前景的方法,以及该人群心理健康研究的未来方向。在这一努力中取得成功将大幅减轻晚年抑郁和焦虑的负担,并对公共卫生产生积极影响。