Seraina Silberschmidt1,2, Amit Kumar3, Mukaila M Raji4, Kyriakos Markides2,5, Kenneth J Ottenbacher1,6, Soham Al Snih1,4,6. 1. Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas. 2. University of Geneva, Geneva, Switzerland. 3. Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island. 4. Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas. 5. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas. 6. Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas.
Abstract
OBJECTIVES: To examine the association between life-space mobility and cognitive decline over a five-year period among older Mexican Americans. DESIGN: Longitudinal study. SETTING: Hispanic Established Population for the Epidemiologic Study of the Elderly survey conducted in the southwestern of United States (Texas, Colorado, Arizona, New Mexico, and California). PARTICIPANTS: Four hundred thirty-two Mexican Americans aged 75 and older with normal or high cognitive function at baseline. MEASUREMENTS: Socio-demographic factors, living arrangement, type of household, social support, financial strain, self-reported medical conditions, Mini-Mental State Examination (MMSE), depressive symptoms, activities of daily living (ADLs), and Short Physical Performance Battery. Life-space assessment (LSA) during the past 4 weeks was assessed during in-home interview. Scores ranged from 0 (daily restriction to the bedroom) to 120 (daily trips outside of their own town without assistance) and categorized as 0 to 20, 21 to 40, 41 to 60, 61 to 80, and 81 to 120. Because of the small sample size in the category of 81 to 120, the two highest categories were combined into a single group. RESULTS: The mean LSA score and MMSE score of participants at baseline was 44.6 (Standard Deviation [SD], 20.7) and 25.7 (SD, 3.2), respectively. Mixed Model analyses showed that participants in the highest life-space category (≥61) experienced slower rates of cognitive decline over time compared to participants in the lowest category (0 to 20) (β = 1.03, Standard Error [SE] = 0.29, P = 0.0004), after adjusting for all covariates. CONCLUSION: Greater life-space mobility at baseline was predictor of slower rates of cognitive decline over 5 years in older Mexican Americans.
OBJECTIVES: To examine the association between life-space mobility and cognitive decline over a five-year period among older Mexican Americans. DESIGN: Longitudinal study. SETTING: Hispanic Established Population for the Epidemiologic Study of the Elderly survey conducted in the southwestern of United States (Texas, Colorado, Arizona, New Mexico, and California). PARTICIPANTS: Four hundred thirty-two Mexican Americans aged 75 and older with normal or high cognitive function at baseline. MEASUREMENTS: Socio-demographic factors, living arrangement, type of household, social support, financial strain, self-reported medical conditions, Mini-Mental State Examination (MMSE), depressive symptoms, activities of daily living (ADLs), and Short Physical Performance Battery. Life-space assessment (LSA) during the past 4 weeks was assessed during in-home interview. Scores ranged from 0 (daily restriction to the bedroom) to 120 (daily trips outside of their own town without assistance) and categorized as 0 to 20, 21 to 40, 41 to 60, 61 to 80, and 81 to 120. Because of the small sample size in the category of 81 to 120, the two highest categories were combined into a single group. RESULTS: The mean LSA score and MMSE score of participants at baseline was 44.6 (Standard Deviation [SD], 20.7) and 25.7 (SD, 3.2), respectively. Mixed Model analyses showed that participants in the highest life-space category (≥61) experienced slower rates of cognitive decline over time compared to participants in the lowest category (0 to 20) (β = 1.03, Standard Error [SE] = 0.29, P = 0.0004), after adjusting for all covariates. CONCLUSION: Greater life-space mobility at baseline was predictor of slower rates of cognitive decline over 5 years in older Mexican Americans.
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