Cognitive impairment, multimorbidity, and mobility limitations among Mexican-origin older adults

TL;DR

This study examines how cognitive decline, chronic conditions, and mobility issues develop together in older Mexican-origin adults in the US and Mexico, and how migration status affects these patterns.

Contribution

The study reveals bidirectional associations between cognitive function, multimorbidity, and mobility limitations, and shows how these are influenced by migration status.

Findings

Higher baseline multimorbidity predicts faster mobility decline and cognitive decline.

Mobility limitations at baseline are linked to faster accumulation of chronic conditions.

Mexican Health and Aging Study participants experienced faster cognitive decline and mobility loss but slower chronic condition accumulation compared to US-born individuals.

Abstract

Age-related cognitive impairment (CI), multimorbidity (MM; 2+ chronic conditions), and mobility limitations (MLs) are burdensome, develop concurrently, and lead to disablement. Examining disablement processes among Mexican-origin older adults in the US and Mexico is critical given the rapid aging and persistent health challenges faced by these groups, and migration status may modify disablement processes. Using harmonized data from the Health and Retirement Study and Mexican Health and Aging Study (2012 & 2018), we estimated cross-lagged panel models to investigate concurrent change in cognitive function (CF; average proportion of maximum score on study-specific cognitive items, 0–10), MM (count of diagnosed diabetes, hypertension, heart attack, stroke, cancer, arthritis), and MLs (count of 11 functional limitations) among Mexican-origin adults aged ≥ 65. Study/country of residence and migration status were identified (HRS: US-born [n = 215], US-immigrant [n = 173]; MHAS: non-migrant [n = 3,770], and return migrant [n = 542]). Covariates (age, sex, education, marital/partnership status, obesity, rural residence, doctor visits) were harmonized at baseline (2012). Greater baseline MM preceded increasing MLs and faster decline in CF, greater baseline MLs were associated with faster MM accumulation, and greater baseline CF was associated with slower progression of MLs. Compared to US-born respondents, MHAS respondents experienced faster accumulation of MLs and faster decline in CF, but slower MM accumulation. Greater baseline MLs were associated with faster decline in CF among the US-born, but slower decline for the other groups. These findings indicate bidirectional associations between CF, MM, and MLs, and suggest disablement processes are patterned by migration status among Mexican-origin older adults.