title: Racial/ethnic differences in the development of disability among older adults.
abstract: OBJECTIVE
  We investigated differences in the development of disability in activities of daily living among non-Hispanic Whites, African Americans, Hispanics interviewed in Spanish, and Hispanics interviewed in English.
  
  
  METHODS
  We estimated 6-year risk for disability development among 8161 participants 65 years or older and free of baseline disability. We evaluated mediating factors amenable to clinical and public health intervention on racial/ethnic difference.
  
  
  RESULTS
  The risk for developing disability among Hispanics interviewed in English was similar to that among Whites (hazard ratio [HR]=0.99; 95% confidence interval [CI] = 0.6, 1.4) but was substantially higher among African Americans (HR=1.6; 95% CI=1.3, 1.9) and Hispanics interviewed in Spanish (HR=1.8; 95% CI=1.4, 2.1). Adjustment for demographics, health, and socioeconomic status reduced a large portion of those disparities (African American adjusted HR=1.1, Spanish-interviewed Hispanic adjusted HR=1.2).
  
  
  CONCLUSIONS
  Higher risks for developing disability among older African Americans, and Hispanics interviewed in Spanish compared with Whites were largely attenuated by health and socioeconomic differences. Language- and culture-specific programs to increase physical activity and promote weight maintenance may reduce rates of disability in activities of daily living and reduce racial/ethnic disparities in disability.
authors.affiliation: Institute for Healthcare Studies, the Multidisciplinary Clinical Research Center in Rheumatology, and the Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill 60611, USA. ddunlop@northwestern.edu
authors.forename: Dorothy D
authors.initials: DD
authors.lastname: Dunlop
authors.forename: Jing
authors.initials: J
authors.lastname: Song
authors.forename: Larry M
authors.initials: LM
authors.lastname: Manheim
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.forename: Rowland W
authors.initials: RW
authors.lastname: Chang
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*