Lower frailty incidence in older Mexican Americans than in older European Americans: the San Antonio Longitudinal Study of Aging.
OBJECTIVE
To directly compare frailty incidence of older Mexican American (MA) and European American (EA) adults.


METHODS
Longitudinal, observational cohort study.


METHODS
Socioeconomically diverse neighborhoods in San Antonio, Texas.


METHODS
Three hundred one older MA and 305 older EA adults in the San Antonio Longitudinal Study of Aging (SALSA) who were nonfrail at baseline.


METHODS
Frailty was assessed at baseline, and three follow-ups conducted over an average of 9.9 years using well-established criteria from the Cardiovascular Health Study. Covariates were baseline age, sex, socioeconomic status (SES), prefrailty status, diabetes mellitus, and comorbidity. The adjusted ethnic odds (MA vs EA) of incident frailty were estimated using generalized estimating equations.


RESULTS
There was no ethnic difference in the unadjusted incidence of frailty over the three follow-up examinations (odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.62-1.52), even though baseline SES was significantly lower in MAs than EAs. After covariate adjustment, the odds of incident frailty were significantly lower for MAs than EAs (OR = 0.40, 95% CI = 0.23-0.72). Other significant predictors of frailty in the adjusted model were pre-frailty (present vs absent OR = 3.19, 95% CI = 1.86-5.47), education (1-year increment OR = 0.89, 95% CI = 0.83-0.96), and income (1-year increment OR = 0.88, 95% CI = 0.79-2.04).


CONCLUSIONS
These findings lend support to the Hispanic Paradox and suggest that MAs who live to older ages are less likely than similarly aged EAs to become frail. Further research is needed to identify the underlying biological and social mechanisms that explain this finding to enhance the development of interventions for the prevention and treatment of this clinical geriatric syndrome.
Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA. espinozas2@uthscsa.edu
Sara E
SE
Espinoza
Inkyung
I
Jung
Helen
H
Hazuda
D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D044465:White People / Q000706:statistics & numerical data*