© Geriatric Times. All rights reserved.

Diverse Populations in the News

by Geriatric Times Staff

Geriatric Times November/December 2001 Vol. II Issue 6

Women Perform Better Than Men in Cognitive Function Tests

According to a study published in the Journal of Neurology, Neurosurgery and Psychiatry (71[1]:29-32), elderly women outperform elderly men in tests of cognitive function, despite differences in limited education.

In this population-based study, 599 participants aged 85 years or older were assessed at their place of residence. Those with a score of 18 or above on the Mini-Mental State Examination (MMSE) were administered four additional neuropsychological tests to determine cognitive speed and memory.

While the proportion of women with limited formal education was significantly higher than that of men (70% versus 53%, p=0.001), women received better scores for cognitive speed and memory (33% versus 28% and 41% versus 29%, respectively; p<0.05). This advantage in speed and memory remained after adjusting for differences in education and presence of depressive symptoms.

The researchers concluded that limited formal education alone cannot account for differences in mental decline among men and women. Instead, the researchers support the hypothesis that biological differences (e.g., atherosclerosis) could be an important underlying factor in differences in cognitive decline -- RR

Ethnic Background as a Risk Factor in Osteoarthritis

Arthritis is the leading cause of disability in the United States, affecting approximately 43 million people, with the most common form, osteoarthritis (OA), affecting about 21 million adults, most of them age 45 or older. A review article in Biomechanics (8[4]:25-33) highlighted ethnic background as another factor in the risk for and development of OA.

According to the article, African-Americans are more likely to experience activity and work limitations from arthritis and are also at a higher risk for developing OA. Furthermore, African-American women are almost twice as likely as Caucasian women to have knee OA, even after controlling for factors such as age, income, education, marital status, smoking and obesity. Although African-American women had the same risk of hip OA as Caucasian women, the risk among men was 35% higher for African-Americans than Caucasians.

Another study cited in the article found a lower rate of radiographic hip OA among Chinese men and women in China compared to Caucasian men and women in the United States. Researchers found that Chinese individuals may also have a higher risk of knee OA than Caucasians, despite having a lower body mass index.

In terms of disability, although the prevalence rates of self-reported arthritis between Caucasians and non-Caucasians were almost identical, non-Caucasians were more likely to report difficulties in performing activities of daily living. However, there appeared to be no differences in pain assessment and overall physical function between African-Americans, Caucasians and Hispanics.

The article emphasized that arthritis studies on minorities are limited and that more research into these ethnic differences is necessary to better understand the importance of these factors in diagnosing and treating arthritis -- TB

Hispanic Elderly With Diabetes Need Better Information and Care

The mortality rate of Hispanics aged 65 to 74 years with diabetes is more than twice the rate of non-Hispanic whites, according to a study led by researchers at University of California, Los Angeles, causing it to be termed a "Latino disease."

A random sample of 602 Hispanic and 577 non-Hispanic white residents of Los Angeles County were surveyed by telephone revealing new findings about the attitude of many Hispanics toward diabetes. For example, Hispanic elderly are more likely to cite the role of emotional factors, such as susto, meaning strong emotional shock or trauma; nervios, meaning emotional upset (but not quite as strong as susto); and stress as causative factors for diabetes. Also, due to an incomplete knowledge of the potential of untreated diabetes to cause eye damage, nearly 13% of the Hispanic elderly with diabetes have never had an eye exam.

Researchers found that nearly one-quarter of Latino immigrants did not know that Medicare coverage is available to them. An additional 13% thought it was a welfare program and were therefore reluctant to enroll, and more than one in 10 immigrants found the Medicare application process difficult and did not know how to complete it.

The study resulted in two propositions. With the vast majority of Latino elderly more comfortable communicating in Spanish than in English, there is a tremendous need for linguistically appropriate educational materials. Also, service programs need to reach out actively to this population to increase their knowledge of diabetes.

Researchers concluded, "Overall, our final suggestion is to discard the notion that Latino elderly are so fatalistic that little will work with them…An incomplete knowledge about the diabetes disease process and an unsophisticated knowledge of the complex medical care delivery system should not be construed as fatalism" -- AV

HHS Awards Grant to Support Native American Caregivers

Earlier this year, U.S. Health and Human Services (HHS) secretary Tommy G. Thompson approved the release of $113 million in grants to the National Family Caregiver Support Program, which helps family members provide care for the elderly at home. Recently, Thompson also awarded $5 million in grants to implement the new Native American Caregiver Support Program that is a component of the National Family Caregiver Support Program.

Grants were given to over 100 tribal organizations to provide families of Native American and Native Hawaiian elderly with access to information, respite care, counseling, training and supplemental services to help maintain their caregiving roles, which include home- and community-based services. Nine tribal organizations received $100,000 each in demonstration grants in the following areas:

Assistant Secretary for Aging of HHS' Administration of Aging Josefina G. Carbonell told the press, "We have worked with the Tribal leaders to make sure that this vitally needed program provides the most culturally appropriate and proficient services that address the needs and expectations of the families and other caregivers of the Native American elders we serve" -- RG