The Hispanic Paradox and Predictors of Mortality in an Aging Biethnic Cohort of Mexican Americans and European Americans: The San Antonio Longitudinal Study of Aging
作者： Sara E. Espinoza , Inkyung Jung , Helen Hazuda
DOI: 10.1111/JGS.12421
关键词:
摘要: Objectives: To examine predictors of mortality in aging Mexican Americans (MAs) and European (EAs). Design: Longitudinal, observational cohort study. Setting: Socioeconomically diverse neighborhoods San Antonio, Texas. Participants: Community-dwelling adults aged 65 older (394 MA; 355 EA) who completed the baseline examination (1992�96) Antonio Longitudinal Study Aging (SALSA) for whom vital status was ascertained over an average 8.2 years follow-up. Measurements: Ethnic group classified using a validated algorithm. Hazard ratios (HRs) were estimated Cox proportional hazards models with age, sex, ethnic group, education, income, frailty, diabetes mellitus without complications, comorbidity, cognition, depressive symptoms, body mass index included as sequential models. Results: At baseline, MAs had higher prevalence frailty lower socioeconomic (SES) than EAs. The age- sex-adjusted HR (MA vs 1.54 (95% confidence interval (CI) = 1.17�2.03). After adjusting SES, no longer significant (HR 1.16, 95% CI 0.83�1.61). In final model, cognitive impairment independent risk factors mortality. Conclusion: Contrary to Hispanic paradox, at greater SES differences largely explained this disparity. Significant mortality, regardless impairment. Mortality reduction requires attention disparities disease factors.
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