Cross-Cultural Measurement Invariance of a Measure of Disability for White, Black, Hispanic and Asian Older Adults (original) (raw)
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Predictors of ADL Disability in Culturally Diverse Older Adults
Medicine & Science in Sports & Exercise, 2008
Almost 42% of adults over 65 years of age live with at least one disability. Further, people of lower socioeconomic status and Blacks have greater risks for disability than Whites and individuals at higher socioeconomic status. The consequences of disability include loss of independence, decreased quality of life, increased chances of depression, consumption of health care services, and institutionalization. The purpose of this study was to utilize the disablement process framework to examine the contribution of physical function, dyspnea, and pain to disability in activities-of-daily-living (ADL) in culturally diverse older adults (i.e., diverse according to race, income, and education). Participants were 51 older adults (M age = 60.0 years, SD = 9.7) from an urban community center and an independent living housing facility for seniors with fixed incomes who completed the Functional Status Index (FSI), which provides ratings of need for assistance (FSIA) and pain (FSIP) with ADLs, the Continuous Scale Physical Functional Performance 10-item Test (CS-PFP10), and an analog dyspnea scale. Hierarchical multiple regression revealed that CS-PFP10 scores alone account for approximately 21% and 30% of the variance in FSIA scores of the participants from the community center and the housing facility, respectively. Adding FSIP and dyspnea ratings to the prediction model results in explaining an even higher portion of the variance in FSIA scores (36% in the community center and 53% in the housing facility). Based on this model, functional capacity improvement and pain and dyspnea prevention and management should be targeted when designing culturally appropriate strategies for delaying disability and maintaining independent life. 2003). This rate of disability actually reflects a slightly lower prevalence of disability in older adults over the past two decades; however, the absolute number of adults living with disabilities is rising as a result of the growth of this segment of the population. Data from the U.S. Department of Health and Human Services (2004) indicate that the absolute number of disabled seniors has increased from 26.9 million in 1982 to 34.4 million in 2004. Disability has detrimental consequences for the individual including loss of independence in activities of daily living (ADL) eroding feelings of esteem, increased chances of depression (Yang & George, 2005), overall mortality (Wolinsky, Stump, Callahan, & Johnson, 1996), and decreased quality of life (Wilson & Cleary, 1995). In addition to the major impact to the individual, the financial consequences of an increase in number of disabled older adults include added health care utilization, institutionalization, and excess burden for the families. The direct and indirect annual costs associated with disability in the American population are more than $300 billion, or four percent of the gross domestic product (U.S. Department of Health and Human Services, 2004). Consequently, prevention, delay, and treatment of disability have become a top priority for public health and aging research. Disability in Understudied Populations According to the US Census Current Reports "Americans with Disabilities 2002" (Steinmetz, 2006), the prevalence of disability in Black persons is 19.8%. When compared with the other races, Blacks have the highest prevalence rate for severe disability (14%) and need for assistance (4.7%). Furthermore, the US Census Current Reports 65+ (He et al., 2005) reported that people of lower socioeconomic status and Blacks have greater risks for disability than Whites and individuals at higher socioeconomic status.
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 1997
Ethnic differences in response comparability and bias were evaluated for elderly African American, Puerto Rican, and non-Hispanic Caucasian elderly subjects with some degree of disability and their caregivers. Responses were compared for items assessing basic and instrumental activities of daily living, memory problems, confusion, and global health status. In general, for all ethnic groups, response comparability, based on kappa, was only poor to fair, with the lowest agreement found for items assessing memory problems and confusion. When disagreements occurred, caregivers tended to overestimate impairment relative to the elderly subjects, regardless of ethnicity. However, there were very few significant differences between the response patterns of the caregivers of these different ethnic groups. Thus, although there may be bias in the responses of caregivers relative to elderly persons, in general further bias is not introduced by ethnic differences in comparability ofcaregiver responses for elders with some degree of disability.
Gerontology and Geriatric Medicine
Background: Significant racial/ethnic disparities exist in the prevalence of functional disability among older Americans. Objective: The study analyzed the odds of older people in the United States experiencing single and multiple disabilities, by race and region of birth. Method: Data came from the American Community Survey (2011–2015). Multinomial logistic regression analysis was used. Results: Region of birth, race/ethnicity, age, citizenship status, duration of stay, sex, marital status, veteran status, educational attainment, poverty status, and class of workers were all significantly associated with reports of either single or multiple disabilities. However, the introduction of the interaction terms for citizenship status by race modified some of the significant results. For instance, being born in Latin America no longer reduced the odds in reports of both single and multiple disabilities. However, compared with Whites and native-born of all races, both Hispanics who were eit...
Demographic Research, 2014
BACKGROUND Rapid population aging and increasing racial/ethnic and immigrant/native diversity make a broad documentation of U.S. health patterns during both mid-and late life particularly important. OBJECTIVE We aim to better understand age-and gender-specific racial/ethnic and nativity differences in physical functioning and disability among adults aged 50 and above. METHODS We aggregate 14 years of data from the National Health Interview Survey and calculate age-and gender-specific proportions of physical functioning and two types of disability for each population subgroup. RESULTS Middle-aged foreign-born individuals in nearly every subgroup exhibit lower proportions of functional limitations and disability than U.S.-born whites. This pattern of immigrant advantage is generally reversed in later life. Moreover, most U.S.-born minority groups have significantly higher levels of functional limitations and disability than U.S.-born whites in both mid-and late life.
Relevance of Race and Ethnicity for Self-Reported Functional Limitation
Journal of the American Geriatrics Society, 2000
It is unclear whether older adults of different race or ethnicity vary in the ways they perceive functional limitations. Variation in such self-reports may be relevant clinically, because many diagnoses (and subsequent care) depend on self-reported disability. To examine this question, selfreported hand function was compared with performance-based assessment of strength (hand dynamometer) and dexterity (Moberg Pick-Up Test) in white (n = 102), African-American (n = 67), and Hispanic (n = 196) elderly people. Participants were Medicare beneficiaries from northern Manhattan, New York City, aged 70 and older. In adjusted analyses, self-reported hand function was associated with weaker grip strength in African-American and Hispanic participants but not in white participants. Self-reported difficulty with hand function was associated with poorer dexterity in all three groups. Similar results were observed in the subsample of participants with arthritis. These results suggest that culture or socioenvironmental differences associated with culture may influence reports of functional limitation.
Hospital topics, 2009
The authors compared disability and functional limitation among elder Hispanic subgroups by using data from the 2001-2003 National Health Interview Survey (National Center for Health Statistics 2008a). The authors applied chi-square analysis for bivariate comparisons and used multiple logistic regression analyses for making comparisons, estimating odds ratios, and predicting disabilities. Results revealed a 21.4% rate of disability of any type in Hispanics. Puerto Ricans reported the highest rates of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) disabilities compared with other Hispanic subgroups (Mexicans, Cubans, Central and South Americans) and reported a higher rate than did Blacks. Cubans showed the lowest rate of IADL and any disability among Hispanics and a lower rate than did Whites. These findings highlight the high rates of intragroup variability among the U. S. Hispanic population. Among seniors, ADLs and IADLs were significant predictors...
Journal of Hospital Marketing & Public Relations, 2009
A drastically increasing elderly population and disparity among disability poses a concern for the US health care industry. This retrospective cross-sectional study analyzed whether ADL and IADL disabilities were different among non-Hispanic white (NHW) and non-Hispanic black (NHB) populations age 65 and over. Data was retrieved from the 2001-2003 National Health Interview Survey (NHIS) for comparing NHBs and NHWs using chi-square analysis for bivariate comparisons. For both elderly NHBs and elderly NHWs, increased rates of disability were reported for being over 75, female, single, and having lower education. NHBs reported statistically higher disability rates for ADL, IADL, and for any disability, with 10.0%, 18.0%, and 19.3%, respectively, compared to NHWs. There is a need to increase the access for NHBs to nursing home, hospice, and assisted-living facilities. Of further concern is the finding of lower institutionalization rates in the NHB population despite the significant presence of increased disability. The growing NHB elderly population needs an urgent societal intervention to address the persistent disparity, which has been neglected for so many years.