Impact of Multiple Chronic Conditions on Activity Limitations Among Older Mexican-American Care Recipients

• Type of Material: Article
• Authors: Diane M. Collins, University of Texas Medical Branch; Brian Downer, University of Texas Medical Branch; Amit Kumar, Brown University; Shilpa Krishnan, Emory University; Chih-ying Li, University of Texas Medical Branch; Kyriakos S. Markides, University of Texas Medical Branch; Amol M. Karmarkar, University of Texas Medical Branch
• Language: English
• Date: 2018-05-01
• Publisher: Centers for Disease Control and Prevention
• Publication Version: Final Published Version
• Copyright Statement: © 2018 Centers for Disease Control and Prevention (CDC).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.5888/pcd15.170358
• Title of Journal or Parent Work: Preventing Chronic Disease
• ISSN: 1545-1151
• Volume: 15
• Issue: 5
• Start Page: E51
• End Page: E51
• Grant/Funding Information: This work was supported by the National Institute on Aging (NIA) grant no. R01 AG010939. Research reported in this publication was supported by the UTMB Claude D. Pepper Older Americans Independence Center grant P30 AG024832 from the NIA of the National Institutes of Health (NIH).; Dr Karmarkar is supported by a National Institutes of Health career development award no. K01-HD086290; Dr Krishnan is supported by a grant from the Agency for Healthcare Research and Quality (no. R24 HS022134) and National Institute of Disability, Independent Living and Rehabilitation Research (no. 90SFGE0002).
• Keywords: COMBINATIONS; PREVALENCE; UNITED-STATES; HISPANICS; Science & Technology; WHITES; Life Sciences & Biomedicine; DISABILITY; ADULTS; ELDERS; HEALTH; MULTIMORBIDITY PATTERNS; Public, Environmental & Occupational Health
• Research Categories: Health Sciences, Public Health; Health Sciences, Rehabilitation and Therapy

Abstract

Introduction Older Mexican Americans are living longer with multiple chronic conditions (MCCs). This has placed greater demands on caregivers to assist with basic activities of daily living (ADL) or instrumental activities of daily living (IADL). To understand the needs of older Mexican-American care recipients, we examined the impact of MCC on ADL and IADL limitations. Methods We analyzed data from 485 Mexican American care-receiving/ caregiving dyads. Selected MCCs in the analysis were diabetes, hypertension, stroke, heart disease, arthritis, emphysema/chronic obstructive pulmonary disease, cognitive impairment, depression, and cancer. Care recipients were dichotomized as having 3 or more conditions or as having 2 or fewer conditions. Three comorbidity clusters were established on the basis of the most prevalent health conditions among participants with comorbid arthritis and hypertension. These clusters included arthritis and hypertension plus: diabetes (cluster 1), cognitive impairment (cluster 2), and heart disease (cluster 3). Results Care recipients with 3 or more chronic conditions (n = 314) had higher odds of having mobility limitations (OR = 1.98; 95% CI, 1.34-2.94), self-care limitations (OR = 2.53; 95% CI, 1.70-3.81), > 3 ADL limitations (OR = 2.00; 95% CI, 1.28-3.17), and > 3 IADL limitations (OR = 1.88; 95% CI, 1.26-2.81). All clusters had increased odds of ADL and severe ADL limitations. Of care recipients in cluster 2, those with arthritis, hypertension, and cognitive impairment had significantly higher odds of mobility limitations (OR = 2.33; 95% CI, 1.05-5.24) than those with just arthritis and hypertension. Conclusion MCCs were associated with more ADL and IADL limitations among care recipients, especially for those with hypertension and arthritis plus diabetes, cognitive impairment, or heart disease. These findings can assist in developing programs to meet the needs of older Mexican-American care recipients.