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AJPH First Look, published online ahead of print Feb 5, 2009
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April 2009, Vol 99, No. 4 | American Journal of Public Health 673-679
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.143958


RESEARCH AND PRACTICE

Mexican Americans and Frailty: Findings From the Hispanic Established Populations Epidemiologic Studies of the Elderly

Kenneth J. Ottenbacher, PhD, James E. Graham, PhD, Soham Al Snih, MD, PhD, Mukaila Raji, MD, Rafael Samper-Ternent, MD, Glenn V. Ostir, PhD and Kyriakos S. Markides, PhD

Kenneth J. Ottenbacher, James E. Graham, and Soham Al Snih are with the Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston. Mukaila Raji and Glenn V. Ostir are with the Division of Geriatrics, University of Texas Medical Branch, Galveston. Rafael Samper-Ternent is with the WHO/PAHO Collaborating Center on Aging, University of Texas Medical Branch, Galveston. Kyriakos S. Markides is with the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston.

Correspondence: Requests for reprints should be sent to Kenneth Ottenbacher, PhD, University of Texas Medical Branch, 301 University Blvd, Rt 1137, Galveston, TX 77555 (e-mail: kottenba{at}utmb.edu).

Objectives. We examined the prevalence of frailty among Mexican American older adults and explored the correlates associated with becoming frail to determine their affect on disability and morbidity in this population.

Methods. We studied the trajectory of frailty over 10 years in 2049 Mexican Americans participating in the Hispanic Established Populations Epidemiologic Studies of the Elderly. We constructed a frailty index based on weight loss, exhaustion, grip strength, walking speed, and physical activity and collected data on sociodemographic and health status, comorbidities, and functional measures of performance.

Results. The sample was 58% female, with a mean age of 74.43 years (SD = 6.04) at baseline. Fifty-five percent of participants at baseline and 75% of the surviving sample at follow-up (n = 777) were classified as prefrail or frail. Of persons identified as frail at baseline, 84% died by the end of follow-up. Baseline age, diabetes, arthritis, smoking status, body mass index, cognition, negative affect, and number of comorbid conditions were predictors of frailty at follow-up (R2 = 0.29; P < .05).

Conclusions. Further research into ways to reduce the number of Mexican American older adults who become frail and disabled and therefore lose their independence is needed. Future studies should continue to examine the trajectory of frailty as a dynamic process that includes psychosocial and cognitive components.







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