Jacqueline M Torres1, Kara E Rudolph2, Oleg Sofrygin3, Rebeca Wong4, Louise C Walter5,6, M Maria Glymour1. 1. From the Department of Epidemiology and Biostatistics, School of Medicine. UC San Francisco, San Francisco, CA. 2. Department of Emergency Medicine, UC Davis, Sacramento, CA. 3. Division of Research, Kaiser Permanente, Oakland, CA. 4. Sealy Center on Aging, University of Texas-Medical Branch, Galveston, TX. 5. Division of Geriatrics, School of Medicine, UC San Francisco, San Francisco, CA. 6. Division of Geriatrics, Veterans Affairs Medical Center, San Francisco, CA.
Abstract
BACKGROUND: Migration of adult children may impact the health of aging parents who remain in low- and middle-income countries. Prior studies have uncovered mixed associations between adult child migration status and physical functioning of older parents; none to our knowledge has examined the impact on unmet caregiving needs. METHODS: Data come from a population-based study of Mexican adults ≥50 years. We used longitudinal targeted maximum likelihood estimation to estimate associations between having an adult child US migrant and lower-body functional limitations, and both needs and unmet needs for assistance with basic or instrumental activities of daily living (ADLs/IADLs) for 11,806 respondents surveyed over an 11-year period. RESULTS: For women, having an adult child US migrant at baseline and 2-year follow-up was associated with fewer lower-body functional limitations [marginal risk difference (RD) = -0.14, 95% confidence interval (CI) = -0.26, -0.01] and ADLs/IADLs (RD = -0.08, 95% CI = -0.16, -0.001) at 2-year follow-up. Having an adult child US migrant at all waves was associated with a higher prevalence of functional limitations at 11-year follow-up (RD = 0.04, 95% CI = 0.01, 0.06). Having an adult child US migrant was associated with a higher prevalence of unmet needs for assistance at 2 (RD = 0.13, 95% CI = 0.04, 0.21) and 11-year follow-up for women (RD = 0.07, 95% CI = -0.02, 0.15) and 11-year follow-up for men (RD = 0.08, 95% CI = 0.00, 0.16). CONCLUSION: Having an adult child US migrant had mixed associations with physical functioning, but substantial adverse associations with unmet caregiving needs for a cohort of older adults in Mexico.
BACKGROUND: Migration of adult children may impact the health of aging parents who remain in low- and middle-income countries. Prior studies have uncovered mixed associations between adult child migration status and physical functioning of older parents; none to our knowledge has examined the impact on unmet caregiving needs. METHODS: Data come from a population-based study of Mexican adults ≥50 years. We used longitudinal targeted maximum likelihood estimation to estimate associations between having an adult child US migrant and lower-body functional limitations, and both needs and unmet needs for assistance with basic or instrumental activities of daily living (ADLs/IADLs) for 11,806 respondents surveyed over an 11-year period. RESULTS: For women, having an adult child US migrant at baseline and 2-year follow-up was associated with fewer lower-body functional limitations [marginal risk difference (RD) = -0.14, 95% confidence interval (CI) = -0.26, -0.01] and ADLs/IADLs (RD = -0.08, 95% CI = -0.16, -0.001) at 2-year follow-up. Having an adult child US migrant at all waves was associated with a higher prevalence of functional limitations at 11-year follow-up (RD = 0.04, 95% CI = 0.01, 0.06). Having an adult child US migrant was associated with a higher prevalence of unmet needs for assistance at 2 (RD = 0.13, 95% CI = 0.04, 0.21) and 11-year follow-up for women (RD = 0.07, 95% CI = -0.02, 0.15) and 11-year follow-up for men (RD = 0.08, 95% CI = 0.00, 0.16). CONCLUSION: Having an adult child US migrant had mixed associations with physical functioning, but substantial adverse associations with unmet caregiving needs for a cohort of older adults in Mexico.
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