Stability in Physical Function among Older Mexican Americans

Studies of older adults have identified risk factors for declining ability. Factors associated with long-term maintenance of function into old age are less emphasized. We used latent class mixture models to identify subgroups of change in Activities of Daily Living (ADL) over time in a sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, including participants at all levels of ability  (N = 2763) and a subsample without ADL limitations at baseline (N=2493). Three distinct trajectories of limitations were identified in both samples and characterized as stable, slow and rapid increase in limitations. Compared to the rapid increase group, the stable groups had more men, were high school educated, and were overweight. In both samples, the rapid increase groups had the highest rates of diabetes, hypertension, and cognitive impairment. Stroke had a significant impact in the total and subsample for the stable group (β = 0.98, p <0.001 and β = 1.12, p <0.001), the slow increase group (β = 0.40, p <0.001 and β = 0.36, p <0.001) and the rapid increase group (β = 0.25, p <0.001and β = 0.30, p <0.001). Church attendance was associated with reduced limitations in the total and subsamples but only for the slow increase group (β = -0.20, p <0.05; and β = -0.30, p <0.05 respectively). Among older Mexican Americans, substantial heterogeneity exists in changes in ADLs over time. Attempts at maintaining physical function may benefit from targeting reductions in cardiovascular risk factors and increases in engaging activities.