Prevalence of Health Conditions and Predictors of Mortality in Oldest Old Mexican Americans and Non-Hispanic Whites

Background

The oldest old represent a unique group of older adults. This group is rapidly growing worldwide and yet there are gaps
in the knowledge related to their health condition. Ethnic differences in disease prevalence and mortality must be
understood to better care for the oldest old.

Objective

To compare prevalence of common health conditions and predictors of mortality in oldest old Mexican Americans
and non-Hispanic Whites.

Methods

This study included 568 community dwelling Mexican Americans (MA) aged 85 years and older from the Hispanic
Established Population for the Epidemiological Study of the Elderly (H-EPESE) 2004-2005 and 933 non-Hispanic
Whites (NHW) of the same age from the Health and Retirement Study (HRS) 2004. Measures included socio-demographic
variables, self-reported medical conditions, activities of daily living (ADL), and instrumental activities of daily living (IADL).
Logistic regression analysis was used to examine two-year mortality in both populations.

Results

Heart attack was significantly more prevalent in oldest old NHW compared to MA, regardless of gender.
Conversely, diabetes was significantly more prevalent among MA men and women compared to their NHW counterparts.
Compared to NHW men MA men had significantly higher prevalence of cognitive impairment and hypertension. Additionally,
prevalence of hip fracture was significantly higher for MA women compared to NHW women. Significant differences in ADL
disability were observed only between both groups of women while significant differences in IADL disability were only observed
between men. MA men and women had higher prevalence of obesity compared to NHW. Predictors of two-year mortality for
both ethnic groups included older age, male gender, and ADL disability. Cognitive impairment was only a mortality predictor
for NHW. Similarly, lung disease was only a predictor for MA.

Conclusion

Health related conditions that affect the oldest old vary by gender and ethnicity and entail careful evaluation and monitoring in the
clinical setting. Better care requires inclusion of such differences as part of the comprehensive evaluation of oldest old adults.