Disparities in the Prevalence and Correlates of Disability in Older Immigrants in the USA: a Systematic Review of the Literature
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Disability in older adults leads to poor quality of life, is costly for the health system, and is a risk for mortality. Little is known about disability in older immigrants to the USA.
To synthesize the evidence on the prevalence and factors associated with disability in older adult immigrants.
We conducted searches in PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. Disability was defined as difficulty in performing basic or instrumental activities of daily living. Older adult was defined as 65 years and older. Immigrant status was defined as someone born outside of the USA.
Eighteen articles met the inclusion criteria. Seven studied Hispanic/Latino immigrants, six studied Asian immigrants, four studied diverse older immigrant samples, and one studied European immigrants. Prevalence of disability ranged from 2 to 49% in Asians and 3 to 58.1% in Hispanic/Latinos. In a diverse sample of immigrants, the prevalence of disability was 19.3%. Correlates of disability included female gender, low income, limited education, single status, migration in late adulthood, obesity, arthritis, and diabetes. Factors protective against disability in older adult immigrants were acculturation, migrating at a younger age, exercise, alcohol intake, and church attendance.
Disability prevalence was generally lower in Asian immigrants compared to Hispanic/Latino immigrants. Identification of the precise rates and factors associated with disability in older immigrants can inform health interventions for this population.
KeywordsImmigrants Older adults Disability Activities of daily living Instrumental activities of daily living
This publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number TL1 TR001078 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS, or NIH.
Ruth-Alma Turkson-Ocran was supported by training grants under the National Institute of Nursing Research (NINR) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health under award numbers T32NR012704 and 3T32DK062707, respectively.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
- 1.World Health Organization. Summary: World Report on Ageing and Health 2015.Google Scholar
- 2.Disability and Health Fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs352/en/. Accessed 01/17, 2017.
- 3.Disability and Functioning (Noninstitutionalized Adults 18 Years and Over). Available at: http://www.cdc.gov/nchs/fastats/disability.htm.
- 4.Millan-Calenti JC, Tubio J, Pita-Fernandez S, et al. Prevalence of Functional Disability in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Associated Factors, as Predictors of Morbidity and Mortality. Arch Gerontol Geriatr. 2010;50:306–10. https://doi.org/10.1016/j.archger.2009.04.017.CrossRefGoogle Scholar
- 8.Ervin RB. Prevalence of functional limitations among adults 60 years of age and over: United States. Adv Data. 1999-2002;2006:1–7.Google Scholar
- 9.Holmes J, Powell-Griner E, Lethbridge-Cejku M, et al. Aging differently: physical limitations among adults aged 50 years and over: United States, 2001–2007. NCHS data brief 2009;20.Google Scholar
- 14.Egede LE. Major Depression in Individuals with Chronic Medical Disorders: Prevalence, Correlates and Association with Health Resource Utilization, Lost Productivity and Functional Disability. Gen Hosp Psychiatry. 2007;29:409–16. https://doi.org/10.1016/j.genhosppsych.2007.06.002.CrossRefGoogle Scholar
- 15.Immigrants in the United States. Available at: https://www.americanimmigrationcouncil.org/research/immigrants-in-the-united-states. Accessed 12/08, 2017.
- 16.Population Reference Bureau. Elderly Immigrants in the United States. Today’s Research on Aging 2013.Google Scholar
- 17.Scommegna P. Elderly immigrants in the United States. Immigration and America's Cities: A Handbook on Evolving Services 2016:33.Google Scholar
- 18.Older Immigrants in the United States. Available at: http://www.migrationpolicy.org/article/older-immigrants-united-states. Accessed 06/30, 2016.
- 19.Baugh R, Witsman K. U.S. Lawful Permanent Residents: 2015. DHS Office of Immigration Statistics 2017.Google Scholar
- 20.Vincent GK, Velkoff VA. The next four decades: the older Population in the United States: 2010 to 2050: US Department of Commerce, Economics and Statistics Administration, US Census Bureau 2010.Google Scholar
- 21.Mather M. Fact sheet: aging in the United States 2016.Google Scholar
- 22.Ortman JM, Velkoff VA, Hogan H. An aging nation: the older Population in the United States. Washington, DC: US Census Bureau 2014:25–1140.Google Scholar
- 23.Congressional Budget Office Projections of Expenditures for Long-Term Care Services for The Elderly 1999.Google Scholar
- 27.Department of Health and Human Services. Long-Term Services and Supports for Older Americans: Risks and Financing Research Brief 2016.Google Scholar
- 28.Garcia MA, Reyes AM. Physical functioning and disability trajectories by age of migration among Mexican elders in the United States. J Gerontol B Psychol Sci Soc Sci 2017Google Scholar
- 35.Szanton SL, Thorpe RJ, Boyd C, Tanner EK, Leff B, Agree E, et al. Community aging in place, advancing better living for elders: a bio-behavioral-environmental intervention to improve function and health-related quality of life in disabled older adults. J Am Geriatr Soc. 2011;59:2314–20.CrossRefGoogle Scholar
- 39.Immigrant. Available at: http://www.merriam-webster.com/dictionary/immigrant. Accessed 13 May 2016.
- 40.Ceria-Ulep CD, Dalusung-Angosta A, Magday-Asselstine RT, Castillo MA, Pagano IS, Li D, et al. Assessing physical activity and function in the Filipino older adults. J Cult Divers. 2013;20:30–9.Google Scholar
- 43.Howrey BT, Al Snih S, Jana KK, et al. Stability and change in activities of daily living among older Mexican Americans. J Gerontol A Biol Sci Med Sci 2015.Google Scholar
- 45.Son J. Are Immigrants from Asia Healthier than Immigrants from other Regions? Self-reported Health Status and Functional Difficulties of Immigrants in the USA. J Int Migr Integr. 2013;14:19–38 //dx.doi.org.proxy1.library.jhu.edu/10.1007/s12134-011-0223-3.Google Scholar
- 55.Batalova J. Senior Immigrants in the United States 2012;2016.Google Scholar
- 56.Rote S, Markides K. Aging, social relationships, and health among older immigrants. Generations. 2014;38:51–7.Google Scholar
- 57.Angel JL, Angel RJ, Markides KS. Late-life immigration, changes in living arrangements, and headship status among older Mexican-origin individuals. Soc Sci Q. 2000:389–403.Google Scholar
- 63.Anderson M. African Immigrant Population in U.S. Steadily Climbs. Pew Research Center 2017.Google Scholar
- 64.Yancey AK, Ortega AN, Kumanyika SK. Effective Recruitment and Retention of Minority Research Participants. Annu Rev Public Health. 2006;27:1–28. https://doi.org/10.1146/annurev.publhealth.27.021405.102113.CrossRefGoogle Scholar
- 65.Allen SM, Mor V, Raveis V, et al. Measurement of need for assistance with daily activities: quantifying the influence of gender roles. J Gerontol. 1993;48:S211. https://doi.org/10.1093/geronj/48.4.S204.
- 67.Centers for Disease Control and Prevention, (CDC). About the National Health Interview Survey 2017.Google Scholar
- 68.Gitlin L, Czaja S. Behavioral intervention research: designing, evaluating, and implementing: springer publishing company 2015.Google Scholar