Longitudinal Study of Mexican American Elderly Health

描述（由申请人提供）：本申请寻求资金，以进行两个在2009-2010年和2011-2012年期间的西班牙裔EPESE（老年人流行病学研究的既定人群）的人的后续行动。这项研究的基线是在1993年至1994年期间进行的，当时对居住在西南部五个州--得克萨斯州、新墨西哥州、科罗拉多州、亚利桑那州和加州州--的3,050名65岁及以上的墨西哥裔美国人进行了四次访谈和随访。到2004-2005年（第5波），重新采访了1，167名75岁及以上的原始受试者。在第5波增加了902名75岁及以上墨西哥裔美国人的额外代表性样本，使我们获得了2069名75岁及以上受试者的合并样本。其中，1，542人在2007年（数据仍在处理中），即大约两年半之后再次接受采访。这项研究迄今已产生了170多份出版物，并提供了有关墨西哥裔美国老年人健康和保健需求的宝贵信息。第7波拟于2009-2010年进行，我们估计采访了略超过1 000名80岁及以上的幸存者。我们还建议采访一位“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。两年后，即2011-2012年，将对这两个项目进行后续跟踪。我们预计，我们将重新采访700名82岁及以上的受试者和800名焦点亲属。已故受试者的家属将提供受试者死亡情况的信息，我们多年来一直使用代理死亡问卷进行这项工作。我们的第一个也是新的目标将主要通过采访焦点亲属来实现，他们将提供老年受试者的财务，家庭和健康状况的评估。我们将评估在非常老的墨西哥裔美国人和身体，心理和经济负担上的大家庭的先进年龄的任何养老安排的性质和程度。鉴于样本的高龄，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。虽然墨西哥裔美国人的机构化率低于一般人群，但我们迄今为止的数据表明，它可能正在上升。我们将有机会评估导致机构化的心理社会和医疗因素的影响。我们继续评估身体功能、抑郁症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。墨西哥裔美国人口正在经历快速老龄化，对老年人的健康，医疗保健需求和财务状况知之甚少。迄今为止，我们的研究结果表明，这是一个以预期寿命增加为特征的人口，伴随着疾病负担的增加和残疾率的增加。公共卫生相关性：关于老年墨西哥裔美国人（80岁以上）的健康和医疗保健需求的数据将从与他们及其近亲的访谈中获得。这些信息将对旨在改善老年墨西哥裔美国人健康和生活质量的健康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.