Mejia-Arango Silvia, Aguila Emma, López-Ortega Mariana, Gutiérrez-Robledo Luis Miguel, Vega William A, Andrade Flavia C Drumond, Rote Sunshine M, Grasso Stephanie M, Markides Kyriakos S, Angel Jacqueline L
Department of Population Studies El Colegio de la Frontera Norte Tijuana Baja California México.
Health Policy and Management Department, Sol Price School of Public Policy University of Southern California Los Angeles California USA.
Alzheimers Dement (N Y). 2020 Dec 16;6(1):e12105. doi: 10.1002/trc2.12105. eCollection 2020.
Substantial gaps in research remain across oldest-old ethnic populations while the burden of dementia increases exponentially with age among Mexican and Mexican American older adults.
Prevalence and correlates of dementia among individuals ≥82 years of age were examined using two population-based cohort studies: The Mexican Health and Aging Study (MHAS, n = 1078, 2012) and the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE, n = 735, 2012-2013). The analytic MHAS and HEPESE samples had an average age of 86.4 and 88.0 years, 1.2 and 1.8 women to men, and 2.7 and 5.1 average years of education, respectively.
We identified 316 (29.2%) and 267 (36.3%) cases of likely dementia in the MHAS and HEPESE cohorts, respectively. For Mexicans but not Mexican Americans, age-adjusted prevalence rates of likely dementia were higher in women than men. For both populations prevalence rates increased with age and decreased with education for Mexican Americans but not for Mexicans. In both populations, odds of likely dementia increased with age. Health insurance for the low-income was significantly associated with higher odds of likely dementia for Mexican American men and women and Mexican women but not men. Living in extended households increased the odds of likely dementia in women, but not in men for both studies. Multiple cardiovascular conditions increased the odds of likely dementia for Mexicans but not for Mexican Americans.
Our study provides evidence of the high burden of dementia among oldest-old Mexicans and Mexican Americans and its association with health and social vulnerabilities.
在最年长的老年人群体中,研究仍存在重大差距,而在墨西哥及墨西哥裔美国老年人中,痴呆症负担随年龄呈指数增长。
利用两项基于人群的队列研究,对82岁及以上个体痴呆症的患病率及相关因素进行了研究:墨西哥健康与老龄化研究(MHAS,n = 1078,2012年)和西班牙裔老年人流行病学研究既定人群(HEPESE,n = 735,2012 - 2013年)。分析的MHAS和HEPESE样本平均年龄分别为86.4岁和88.0岁,女性与男性的比例分别为1.2和1.8,平均受教育年限分别为2.7年和5.1年。
我们在MHAS和HEPESE队列中分别确定了316例(29.2%)和267例(36.3%)可能患有痴呆症的病例。对于墨西哥人而非墨西哥裔美国人,经年龄调整后的可能痴呆症患病率女性高于男性。对于这两个人群,墨西哥裔美国人的患病率随年龄增加而上升,随教育程度下降,但墨西哥人并非如此。在两个人群中,可能患痴呆症的几率均随年龄增加。低收入人群的医疗保险与墨西哥裔美国男性和女性以及墨西哥女性(而非男性)患可能痴呆症的几率显著较高有关。在两项研究中,生活在大家庭中会增加女性患可能痴呆症的几率,但男性不会。多种心血管疾病会增加墨西哥人患可能痴呆症的几率,但墨西哥裔美国人不会。
我们的研究提供了证据,证明最年长的墨西哥人和墨西哥裔美国人中痴呆症负担沉重,且与健康和社会脆弱性相关。