Pasos Para Prevenir: A Lifestyle Intervention to Improve Physical Activity View Digital Media
Presentation in a Themed Panel Jennifer Salinas
Mexican Americans who engaged in regular physical activity demonstrate a lower cognitive decline that their inactive counterparts. While interventions show promise at improving physical activity engagement and cognition in older Mexican Americans, few, if any have been tested on U.S.-Mexico border populations. This is an important are of research as the U.S.-Mexico border region has the highest concentration of Mexican Americans in the United States. Methods: Pasos Para Prevenir is a healthy eating and active living lifestyle program to prevent cancer an associated co-morbidities in El Paso County, Texas. Participants were recruited from senior centers, recreation centers, schools, businesses and community centers. Participants received between 1 to 5 sessions on obesity, physical activity and nutrition. Data was collected at baseline, 6 months and 12 months. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ). Measures of obesity and demographics were also collected and analyzed. Results: Participants who were older adults were less likely to meet physical activity guidelines at baseline compared to their younger counterparts. However, this difference became insignificant post-intervention at 6-months and 12-months. Participants who benefited the most from the intervention were those with less than a high school education, born in Mexico and spoke Spanish in the home. Discussion: Pasos Para Prevenir participation was associated with improvements in physical activity engagement among older Mexican Americans. Lifestyle interventions to improve physical activity engagement could be an effect strategy to reduce cognitive decline among older Mexican Americans living on the U.S.-Mexico border.
Medicare Beneficiaries with Alzheimer’s Disease and Related Dementias in Puerto Rico are Migrating to the US Mainland View Digital Media
Presentation in a Themed Panel Maricruz Rivera-Hernandez
The Department of Health in Puerto Rico has referred to the high prevalence of Alzheimer’s Disease and Related Dementias (ADRD) and higher rates of disability as Public Health Problems on the island.1,2 Persons with disabilities often report substantial unmet needs for home and community-based services.3–7 In addition, patients with ADRD are exposed to catastrophic levels of out-of-pocket spending, with much of this spending on nursing home care.7 Since Medicaid does not cover institutional care in Puerto Rico,8 people with ADRD in Puerto Rico may seek to migrate to the US, where they may be eligible for long-term services and support. This presentation will describe characteristics, health care utilization patterns and migration among older adults in Puerto Rico with ADRD. Using Medicare data including, Medicare claims, the Medicare Provider Analysis and Review, the Minimum Data Set, the Inpatient Rehabilitation Facility Patient Assessment Instrument, and the Outcome and Assessment Information Set, we identified beneficiaries with ADRD in Puerto Rico. There were 694,565 Medicare beneficiaries (18,287 with ADRD) in Puerto Rico. About 66.9% of beneficiaries with ADRD were women, had a mean age of 79.6 years (SD = 9.0) and 48.0% were enrolled in Medicare Advantage for 12 consecutive months. About 350 of those beneficiaries with ADRD migrated to the US mainland the following year. The recent ruling of the US Supreme Court 9 to further allow the exclusion of Puerto Rican residents from disability benefits (decided April 21, 2022) may further exacerbate disparities and migration among vulnerable populations, including among those with ADRD.
Living in a Post Pandemic World: Recovery and Long COVID
Presentation in a Themed Panel Noreen Sugrue, Marina del Rios
In May of 2022 the USA reached the unthinkable milestone of 1 million lives lost due to COVID. As the USA prepares to transition to a post COVID world, we confront another pandemic. Millions more who have “recovered” from acute COVID infection remain with longer term symptoms as they experience post-acute sequelae of COVID (PASC) more commonly known as “long COVID”. Anyone can be affected by long COVID, whether after asymptomatic or mildly symptomatic infection, severe cases requiring ICU admission, or anything in between. The symptoms associated with long COVID are numerous and result from the virus’ effect on the brain, the heart, the lungs, and the gut among others. Along with the long term health consequences of COVID, also requiring attention are the social and economic consequences. Latinos have been disproportionately affected by COVID, a result of unequal access to testing, the disproportionately high rates of infections and hospitalizations as well as mortality rates, especially among those aged 20-59. In addition, there are significant structural inequities surrounding accessing prevention options (i.e., social distancing, masking, and vaccines) and treatments (e.g. monoclonal antibodies and antiviral drugs). During this presentation we will present an overview of PASC in Latine people. Using the lens of equity, we will identify and analyze challenges, barriers, and opportunities as well as the potential interventions and actions to ensure that the needs of ‘long haulers’ within the Latino community are addressed. Because so much of the discussion around “long haulers” does not include attention to seniors, we will redress that gap in this presentation.
The Caregiver Stress Process Model: Mexican American Caregiver Turnover and Depressive
Presentation in a Themed Panel Sunshine Rote, Kyriakos (Kokos) Markides, Jacqueline Angel
Informed by the sociocultural caregiver stress process model, the purpose of this study is to explore the role of caregiver stressors and resources for Mexican American caregiver turnover and depressive symptoms. Using two waves of the Hispanic Established Epidemiologic Study of the Elderly Caregiver Supplement (H-EPESE CG, 2010/2011-2016 N=333), we estimate logistic and OLS regressions of caregiver turnover and caregiver depressive symptoms over five years. Objective stressors, particularly neuropsychiatric expressions of dementia, were significantly associated with greater risk for caregiver turnover between waves. Subjective stress, on the other hand, was associated with a lower risk for depressive symptoms over time for caregivers who remained in their role. Resources, including help outside of the family, was a significant factor in caregiver depressive symptoms over time. The findings demonstrate the need for dementia care supports for Mexican American caregivers and improving access to formal, long-term care services and supports.
