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A Binational Study of the Dementia Trajectory and Living Arrangements in the U.S. and Mexico

美国和墨西哥痴呆症轨迹和生活安排的双边研究

基本信息

批准号：
9896745
负责人：
JACQUELINE L. ANGEL
金额：
$ 7.24万
依托单位：
UNIVERSITY OF TEXAS AT AUSTIN
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2022-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9896745
关键词：
Address Adult Adult Children Affect Aging Alzheimer&apos s Disease Attention Caring Characteristics Child Chronic Disease Cognitive Cohort Studies Communities Country Cross-Sectional Studies Data Data Set Dementia Dependence Development Disease Elderly Epidemiology Face Family Family Sizes Family member Federal Government Growth Health Health Status Hispanics Home environment Household Immigration Impaired cognition Income Individual Intervention Latin America Latin American Latino Lead Left Living Arrangement Long-Term Care Long-Term Care for Elderly Longitudinal Studies Medical Methodology Mexican Mexican Americans Mexico Minority Groups Modeling Morbidity - disease rate Municipal Government Parents Pattern Pensions Persons Population Prevalence Process Prospective cohort study Quality of life Research Resources Risk Risk Factors Role Scheme Services Shapes Socioeconomic Factors Socioeconomic Status Source State Government Support System Surveys Theoretical model Time United States Vulnerable Populations Work aging population base care systems caregiving cognitive function cost dementia care disability epidemiology study ethnic minority population experience family caregiving family support frailty improved informal caregiver informal support innovation meetings migration protective factors prototype public health intervention racial and ethnic residence social socioeconomics sound trend

项目摘要

Abstract The majority of previous research on health and support among racial/ethnic minorities in the U.S. in general and among Latinos in particular, and among peoples of Latin American countries relies on the idea of familismo, the idea that family need is put before individual need. Although there is evidence supporting the benefits of strong family ties have for helping older adults in these settings delay or avoid institutional care, the proposed bi-national study is the first step toward assessing how Mexican and Mexican American families organize caregiving relationships for elderly family members who experience dementia. We propose to investigate trajectories of living arrangements and their relationship to dementia by employing the two largest epidemiologic surveys of older Mexican adults, the Hispanic Established Population of the Epidemiologic Study of the Elderly (H-EPESE) and the Mexican Health and Aging Study (MHAS). These studies contain a wide array of information regarding risk and protective factors for chronic diseases, dementia, dependency, socioeconomic characteristics, and living arrangements. One conceptual innovation of the proposed research is that the model for understanding the relationship between living arrangements and disability will serve as a prototype for future research on the dementia-related disablement processes for other racial/ethnic minority groups and bi-national comparisons with Mexico. By exploring the changing need for, and availability of, support, as dementia progresses, we can make better conclusions about the number of older Latinos at risk of being left without sound support and, consequently, highly dependent on public resources. We will estimate at which point in the disablement process interventions are most needed. The proposed project, by incorporating dementia, will also lead to the development of a more robust theoretical model for assessing disability and support need in older adults. Another innovative aspect of the proposed research is the use of quantitative, longitudinal data to examine the relationship between dementia and the need for assistance in two prospective cohort studies of older Mexicans in Mexico and Mexican-origin adults in the United States. We will examine patterns of stability and change in living arrangements among individuals with and without dementia; the extent to which migration to and from the U.S. affects morbidity; health and socioeconomic status; and other proximal factors to account for any differences. A key methodological innovation of this project is its move from static cross-sectional analyses and standard growth models to growth mixture modeling (GMM), which allows us to examine greater diversity in the lived experiences of older peoples with dementia in both nations. Altogether, this work will provide a deeper understanding of the role of dementia in the long-term family caregiving experience of the Mexican-origin population in both Mexico and the United States, and highlight the role of migration and socioeconomic factors in shaping social resources in a time of need.

摘要以前对美国少数种族/民族健康和支持的大多数研究总体上尤其是在拉丁美洲人中，在拉丁美洲国家的人民中，家庭主义，即家庭需要优先于个人需要的观念。虽然有证据表明，强有力的家庭关系对帮助这些环境中的老年人推迟或避免机构护理的好处，一项拟议中的两国研究是评估墨西哥和墨西哥裔美国人家庭为患有痴呆症的老年家庭成员组织互助关系。我们建议研究生活安排的轨迹及其与痴呆症的关系，采用两个最大的对墨西哥老年人的流行病学调查，流行病学研究的西班牙裔既定人群墨西哥老年人健康与老龄化研究（MHAS）。这些研究包含了广泛的一系列关于慢性病、痴呆症、依赖性、社会经济特征和生活安排。本研究的一个概念创新理解生活安排和残疾之间关系的模型将作为一个未来研究其他种族/少数民族与痴呆症有关的残疾过程的原型与墨西哥的双边比较。通过探讨不断变化的需求和可用性，支持，随着痴呆症的进展，我们可以对老年拉丁美洲人的数量做出更好的结论，没有健全的支持，因此高度依赖公共资源。我们估计，在失能过程中的哪一点最需要干预。建议的项目，包括痴呆症，也将导致发展一个更强大的理论模型，用于评估残疾，老年人需要的支持。拟议研究的另一个创新方面是使用定量，在两个前瞻性研究中，在墨西哥的老年墨西哥人和在美国的墨西哥裔成年人的队列研究。我们将研究痴呆患者和非痴呆患者生活安排的稳定性和变化模式; 移民到美国和从美国移民影响发病率;健康和社会经济地位;和其他近因素来解释任何差异。该项目的一个关键方法创新是它从静态横截面分析和标准增长模型增长混合模型（GMM），这使我们能够研究两国老年痴呆症患者生活经历的更大差异。总的来说，这项工作将使人们更深入地了解痴呆症在长期家庭生活中的作用。墨西哥裔人口在墨西哥和美国的经验，并强调了移民和社会经济因素在需要时对社会资源的形成起着重要作用。