Long-term Health Outcomes in Mexican American Older Adults

摘要 墨西哥裔美国人是美国老年人口中增长最快的部分。 代表具有可能影响其使用卫生保健的独特健康和社会特征的群体 资源和健康成果。我们将研究墨西哥裔美国老年人的全国样本 参加西班牙裔老年人流行病学研究（EPESE）人群- a 20年来，NIA一直支持这项研究。 随着美国人口的老龄化和85岁以上人口的增加， 预计在未来十年将大幅增加。虚弱不仅影响老年人的功能 和生活质量，但这是家庭和美国医疗保健系统的负担。最近的研究 表明虚弱是一个动态的过程，个体可能会在虚弱的各个阶段中进进出出。这 研究表明，脆弱是可以预防的，而且有可能逆转。研究的目的是为了更好地 了解这一人群的长期健康结果、医疗保健利用率和预期寿命， 重点关注脆弱和残疾对墨西哥裔美国老年人的影响。我们将研究三个目标。 目标1。探索20多年来脆弱阶段（非脆弱，脆弱前和脆弱）的转变和轨迹， 墨西哥裔美国老年人 目标2.根据虚弱的阶段为墨西哥裔美国老年人制定预期寿命表。桌子将 包括无虚弱预期寿命、残疾预期寿命、虚弱预期寿命和残疾加虚弱预期寿命 期待将为男性和女性编制表格。 目标3。检查墨西哥裔美国老年人的长期健康结果和医疗保健利用率。 我们将分析健康结果（例如，残疾，认知功能和健康相关的生活质量）是 与虚弱状态有关西班牙裔EPESE数据将与医疗保险文件链接，以检查 利用保健和医疗服务，包括急诊室就诊、住院治疗、急性病后护理 服务（例如，专业护理）和随时间推移的医疗保健费用。 该样本包括来自西班牙裔的2，438名参与者。衡量身体虚弱的标准是 在沿着的20年里收集了8次，并测量了残疾和认知功能。我们将 将西班牙裔EPESE数据与Medicare索赔文件相关联，以获取有关卫生资源使用的信息， 存在慢性病、住院治疗以及使用熟练护理和其他急性后服务。我们 我将使用一个增长曲线模型与有序措施和广义线性混合模型，以研究 虚弱的纵向变化。脆弱阶段（非脆弱、脆弱前和脆弱）的过渡将是 比较男性和女性，重点是那些仍然不虚弱的人，或者已经从 恢复身体和/或功能独立的虚弱状态。

ABSTRACT Mexican Americans comprise the fastest growing segment of the older adult population in the U.S. They represent a group with distinct health and social characteristics that may influence their use of health care resources and health outcomes. We will study a national sample of Mexican American older adults participating in the Hispanic Established Populations for the Epidemiologic Study of the Elderly (EPESE) - a study supported by the NIA for 20 years. With the aging of the U.S. population and increase in persons over the age of 85, the number of frail individuals is projected to increase substantially in the coming decade. Frailty not only affects the older person’s function and quality of life, but is a burden for caregiving families and the U.S. healthcare system. Recent research indicates that frailty is a dynamic process and individuals may transition in-and-out of the stages of frailty. This research suggests that frailty is preventable and potentially reversible. The goal of the research is to better understand the long-term health outcomes, healthcare utilization, and life expectancy of this population with a focus on the impact of frailty and disability on Mexican American older adults. We will examine three aims. Aim 1. Explore transitions and trajectories in frailty stages (non-frail, pre-frail, and frail) over 20 years in Mexican American older adults. Aim 2. Develop life expectancy tables for older Mexican Americans based on stages of frailty. The tables will include frail-free life expectancy, disability life expectancy, frail life expectancy, and disability plus frail life expectancy. Tables will be developed for males and females. Aim 3. Examine the long-term health outcomes and healthcare utilization of Mexican American older adults. We will analyze how health outcomes (e.g., disability, cognitive function, and health related quality-of-life) are related to frailty status over time. The Hispanic EPESE data will be linked to Medicare files to examine the utilization of health and medical services including, emergency room visits, hospitalizations, post-acute care services (e.g., skilled nursing), and health care costs over time. The sample includes 2,438 participants from the Hispanic. A standard measure of physical frailty has been collected eight times over a period of 20 years along with measures of disability and cognitive function. We will link the Hispanic EPESE data with Medicare claims files to obtain information on the use of health resources, presence of chronic diseases, hospitalization, and the use of skilled nursing and other post-acute services. We will use a growth curve model with ordinal measures and generalized linear mixed models to examine longitudinal changes in frailty. The transitions across frailty stages (non-frail, pre-frail and frail) will be compared for men and women with a focus on persons who have remained non-frail, or have transitioned from a state of frailty back to physical and/or functional independence.