Longitudinal Study of Mexican American Elderly Health

描述（由申请人提供）：本申请寻求资金，用于在2009-2010年和2011-2012年期间对西班牙裔EPESE（老年人流行病学研究的既定人群）进行两次面对面随访。这项研究的基线是在1993-1994年间进行的，当时有3050名65岁及以上的墨西哥裔美国人的代表性样本，他们居住在西南五个州——德克萨斯州、新墨西哥州、科罗拉多州、亚利桑那州和加利福尼亚州——接受了四次采访和随访。到2004-2005年（第五波），1167名年龄在75岁及以上的原始受试者再次接受了采访。另外902名年龄在75岁及以上的墨西哥裔美国人加入了第5波的代表性样本，总共有2069名年龄在75岁及以上的受试者。其中，1542人在大约两年半后的2007年重新接受了采访（数据仍在处理中）。到目前为止，这项研究已经出版了170多份出版物，并提供了与老年墨西哥裔美国人的健康和保健需求有关的宝贵信息。第七波计划在2009-2010年进行，我们估计会采访1000多名80岁及以上的幸存受试者。我们还建议采访一名“焦点亲属”，最有可能是一名儿童，他将提供有关受试者健康、家庭和经济状况的信息。这两项研究都将在两年后的2011-2012年进行。我们预计将重新采访700名82岁及以上的受试者和800名焦点亲属。已故受试者的家庭成员将提供有关受试者死亡情况的信息，这是我们多年来通过使用代理死亡问卷所做的。我们的第一个和新的目标将主要通过访谈焦点亲属来实现，他们将对老年受试者的经济、家庭和健康状况进行评估。我们将评估任何照顾年迈的墨西哥裔美国人的安排的性质和程度，以及大家庭中老年人的身体、心理和经济负担。考虑到样本的高龄，我们希望有足够数量的受试者进入养老院和辅助生活设施，以了解导致机构化的因素。尽管墨西哥裔美国人的收容率低于一般人群，但我们迄今为止的数据表明，这一比例可能正在上升。我们将有机会评估导致收容的社会心理和医疗因素的影响。我们继续评估身体功能、抑郁症状和认知功能的变化轨迹。我们还建议对认知功能进行更广泛的评估，包括由焦点亲属进行的评估。正如我们过去所做的那样，我们计划迅速将数据存档，并鼓励其他人使用它们。墨西哥裔美国人正经历着快速的老龄化，而人们对老年人的健康、医疗保健需求和经济状况知之甚少。到目前为止，我们的研究结果表明，这是一个以预期寿命延长为特征的人口，伴随着疾病负担的增加和残疾率的增加。公共卫生相关性：将从对墨西哥裔美国老年人（80岁以上）及其一位近亲的访谈中获得有关其健康和保健需求的数据。这些信息将对旨在改善高龄墨西哥裔美国人的健康和生活质量的保健和社会政策产生重大影响。

DESCRIPTION (provided by applicant): This application seeks funds to conduct two in-person follow-ups of the Hispanic EPESE (Established Population for the Epidemiological Study of Elderly) during 2009-2010 and 2011-2012. The study's baseline was conducted during 1993-1994 when a representative sample of 3,050 Mexican Americans age 65 and over residing in the five Southwestern states - Texas, New Mexico, Colorado, Arizona, and California - were interviewed and followed up four times. By 2004-2005 (Wave 5) 1,167 of the original subjects now aged 75 and over were re-interviewed. An additional representative sample of 902 Mexican Americans also aged 75 and over was added at Wave 5 giving us a combined sample of 2069 subjects aged 75 and over. Of these, 1542 were re-interviewed in 2007 (data still being processed), approximately 2 1/2 years later. The study thus far has generated over 170 publications and has provided valuable information related to the health and health care needs of older Mexican Americans. Wave 7 is proposed to take place in 2009-2010 and we estimate interviewing slightly over 1,000 surviving subjects aged 80 and over. We also propose to interview a "focal relative", most likely a child, who will supply information on the subjects' health, family, and financial situation. Both will be followed up two years later in 2011-2012. We expect that we will re-interview 700 subjects aged 82 and over and 800 of the focal relatives. Family members of deceased subjects will provide information on circumstances surrounding the subjects' death, which we have done over the years by using a proxy death questionnaire. Our first and new aim will be accomplished primarily by interviewing the focal relatives who will provide assessments of the older subjects' financial, family, and health situation. We will assess the nature and extent of any caregiving arrangements in very old Mexican Americans and the physical, psychological, and financial burdens of advanced age on the extended family. Given the advanced age of the sample, we expect to have sufficient numbers of subjects entering nursing homes and assisted living facilities to learn about factors leading to institutionalization. Although the rate of institutionalization among Mexican Americans is lower than that in the general population, our data thus far have suggested that it may be rising. We will have the opportunity to assess the influence of psychosocial and medical factors leading to institutionalization. We continue to assess trajectories of change in physical function, depressive symptomology, and cognitive function. We also propose to do a more extensive assessment of cognitive function including assessments made by the focal relatives. As we have done in the past, we plan to rapidly archive the data and to encourage others to use them. The Mexican American population is experiencing rapid rates of aging, and very little is known about the health, health care needs, and financial situation of the very old. Our findings thus far suggest that this is a population characterized by rising life expectancy which is accompanied by increased disease burden and increasing disability rates. PUBLIC HEALTH RELEVANCE: Data on the health and health care needs of older Mexican Americans (aged 80+) will be obtained from interviews with them as well as one of their close relatives. Such information will have significant implications for health and social policy aimed at improving the health and quality of life of very old Mexican Americans.