Mexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in instrumental activities of daily living (IADL) disability and tertiary outcomes of the IADL disablement for the oldest old (after 80 years old). Methods We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010–2011, 2012–2013, and 2016, N = 1,078) to investigate the longitudinal patterns of IADL decline using latent transition analysis. Results Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. Discussion These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.
AkaikeH. (1987). Factor analysis and AIC. In: Selected papers of hirotugu akaike (pp. 371-386). Springer
2.
AngelR. J.AngelJ. L. (2021). Healthy life expectancy (2nd ed.). John Wiley & Sons.
3.
AngelR. J.AngelJ. L.HillT. D. (2014). Longer lives, sicker lives? Increased longevity and extended disability among mexican-origin elders. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70, 639-649. https://dx.doi.org/10.1093/geronb/gbu158.
4.
BerlauD. J.CorradaM. M.KawasC. (2009). The prevalence of disability in the oldest-old is high and continues to increase with age: Findings from the 90+ study. International Journal of Geriatric Psychiatry, 24(11), 1217-1225. https://dx.doi.org/10.1002/gps.2248.
5.
BleijenbergN.ZuithoffN. P. A.SmithA. K.De WitN. J.SchuurmansM. J. (2017). Disability in the individual ADL, IADL, and mobility among older adults: A prospective cohort study. The Journal of Nutrition, Health & Aging, 21(8), 897-903.
6.
Carmona-TorresJ. M.Rodríguez-BorregoM. A.Laredo-AguileraJ. A.López-SotoP. J.Santacruz-SalasE.Cobo-CuencaA. I. (2019). Disability for basic and instrumental activities of daily living in older individuals. Plos one, 14(7), e0220157. https://dx.doi.org/10.1371/journal.pone.0220157.
7.
CollinsL. M.LanzaS. T. (2009). Latent class and latent transition analysis: With applications in the social, behavioral, and health sciences (Vol. 718). John Wiley & Sons.
8.
DodgeH. H.KadowakiT.HayakawaT.YamakawaM.SekikawaA.UeshimaH. (2005). Cognitive impairment as a strong predictor of incident disability in specific ADL-IADL tasks among community-dwelling elders: The Azuchi study. The Gerontologist, 45(2), 222-230.
9.
FauthE. B.GerstorfD.RamN.MalmbergB. (2012). Changes in depressive symptoms in the context of disablement processes: Role of demographic characteristics, cognitive function, health, and social support. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 67B(2), 167-177.
10.
Gallagher-ThompsonD.Choryan BilbreyA.Apesoa-VaranoE. C.GhatakR.KimK. K.CothranF. (2020). Conceptual framework to guide intervention research across the trajectory of dementia caregiving. The Gerontologist, 60(Supplement_1), S29-S40.
11.
GarciaM. A.AngelJ. L.AngelR. J.ChiuC.-T.MelvinJ. (2015). Acculturation, gender, and active life expectancy in the Mexican-origin population. Journal of aging and health, 27(7), 1247-1265.
12.
GarciaM. A.ReyesA. M. (2018). Prevalence and trends in morbidity and disability among older Mexican Americans in the Southwestern United States, 1993-2013. Research on Aging, 40(4), 311-339.
13.
GoldD. A. (2012). An examination of instrumental activities of daily living assessment in older adults and mild cognitive impairment. Journal of Clinical and Experimental Neuropsychology, 34(1), 11-34.
14.
HanL.AlloreH.MurphyT.GillT.PeduzziP.LinH. (2013). Dynamics of functional aging based on latent-class trajectories of activities of daily living. Annals of Epidemiology, 23(2), 87-92.
15.
HughesM. E.WaiteL. J.HawkleyL. C.CacioppoJ. T. (2004). A short scale for measuring loneliness in large surveys. Research on Aging, 26(6), 655-672.
16.
JekelK.DamianM.WattmoC.HausnerL.BullockR.ConnellyP. J.DuboisB.EriksdotterM.EwersM.GraesselE.KrambergerM. G.LawE.MecocciP.MolinuevoJ. L.NygårdL.Olde-RikkertM. G.OrgogozoJ.-M.PasquierF.PeresK.SalmonE.FrölichL. (2015). Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review. Alzheimer's Research & Therapy, 7(1), 17.
17.
Kelley-MooreJ. A.FerraroK. F. (2004). The black/white disability gap: Persistent inequality in later life?. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 59(1), S34-S43. https://dx.doi.org/10.1093/geronb/59.1.s34.
18.
KiossesD. N.AlexopoulosG. S. (2005). IADL functions, cognitive deficits, and severity of depression: A preliminary study. The American Journal of Geriatric Psychiatry, 13(3), 244-249.
19.
KiyoshigeE.KabayamaM.SugimotoK.AraiY.IshizakiT.GondoY.RakugiH.KamideK. (2018). Difference in association of depression with IADL decline between 70s and 80s age groups. Innovation in Aging, 2(suppl_1), 943.
20.
LanzaS. T.TanX.BrayB. C. (2013). Latent class analysis with distal outcomes: A flexible model-based approach. Structural Equation Modeling: A Multidisciplinary Journal, 20(1), 1-26.
21.
LawtonMPBrodyEM (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3_Part_1), 179-186.
22.
LiangJ.XuX.BennettJ. M.YeW.QuiñonesA. R. (2010). Ethnicity and changing functional health in middle and late life: A person-centered approach. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65B(4), 470-481.
23.
LoY.MendellN. R.RubinD. B. (2001). Testing the number of components in a normal mixture. Biometrika, 88(3), 767-778.
24.
MansbachWEMaceRA (2019). Predicting functional dependence in mild cognitive impairment: Differential contributions of memory and executive functions. The Gerontologist, 59(5), 925-935.
25.
NagiS. Z. (1976). An epidemiology of disability among adults in the United States. In: The milbank memorial fund quarterly (Vol. 54, pp. 439-467). The Milbank Memorial Fund Quarterly. Health and Society.
26.
NgT.-P.NitiM.ChiamP.-C.KuaE.-H. (2006). Physical and cognitive domains of the instrumental activities of daily living: Validation in a multiethnic population of Asian older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61(7), 726-735.
27.
ParkJ.LeeY. J. (2017). Patterns of instrumental activities of daily living and association with predictors among community-dwelling older women: A latent class analysis. BMC Geriatrics, 17(1), 158.
28.
PasslerJ. S.KennedyR. E.ClayO. J.CroweM.HowardV. J.CushmanM.UnverzagtF. W.WadleyV. G. (2020). The relationship of longitudinal cognitive change to self-reported IADL in a general population. Aging, Neuropsychology, and Cognition, 27(1), 125-139.
29.
PeekM. K.HowreyB. T.TernentR. S.RayL. A.OttenbacherK. J. (2012). Social support, stressors, and frailty among older Mexican American adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 67(6), 755-764.
30.
PeekM. K.PatelK. V.OttenbacherK. J. (2005). Expanding the disablement process model among older Mexican Americans. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60(3), 334-339. https://dx.doi.org/10.1093/gerona/60.3.334.
31.
PeelD.McLachlanG. J. (2000). Robust mixture modelling using the t distribution. Statistics and Computing, 10(4), 339-348.
32.
RajanK. B.HebertL. E.ScherrP. A.Mendes de LeonC. F.EvansD. A. (2013). Disability in basic and instrumental activities of daily living is associated with faster rate of decline in cognitive function of older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 68(5), 624-630.
33.
RoteS. M.AngelJ. L.KimJ.MarkidesK. S. (2020). Dual trajectories of dementia and social support in the Mexican-origin population. The Gerontologist, 61(3), 374-382.
34.
RussellD.PeplauL. A.CutronaC. E. (1980). The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39(3), 472-480.
35.
SchwarzG. (1978). Estimating the dimension of a model. The Annals of Statistics, 6(2), 461-464.
36.
ScloveS. L. (1987). Application of model-selection criteria to some problems in multivariate analysis. Psychometrika, 52(3), 333-343.
37.
ShankarA.McMunnA.DemakakosP.HamerM.SteptoeA. (2017). Social isolation and loneliness: Prospective associations with functional status in older adults. Health psychology, 36(2), 179-187.
38.
SheehanC. M.Tucker-DrobE. M. (2019). Gendered expectations distort male-female differences in instrumental activities of daily living in later adulthood. The Journals of Gerontology: Series B, 74(4), 715-723.
39.
VerbruggeL. M.JetteA. M. (1994). The disablement process. Social Science & Medicine, 38(1):1-14.
40.
WolfD. A.FreedmanV. A.OndrichJ. I.SeplakiC. L.SpillmanB. C. (2015). Disability trajectories at the end of life: A “countdown” model. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(5), 745-752.
41.
World Health Organization (2007). International classification of functioning, disability, and health: Children & youth version ICF-CY. World Health Organization.
42.
ZsembikB. A.PeekM. K.PeekC. W. (2000). Race and ethnic variation in the disablement process. Journal of Aging and Health, 12(2), 229-249. https://dx.doi.org/10.1177/089826430001200205.
