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Disparities in the Prevalence and Correlates of Disability in Older Immigrants in the USA: a Systematic Review of the Literature

  • Manka NkimbengEmail author
  • Joycelyn Cudjoe
  • Ruth-Alma Turkson-Ocran
  • Yvonne Commodore-Mensah
  • Roland J. ThorpeJr
  • Sarah L. Szanton
Article
  • 15 Downloads

Abstract

Background

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.

Objective

To synthesize the evidence on the prevalence and factors associated with disability in older adult immigrants.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Immigrants Older adults Disability Activities of daily living Instrumental activities of daily living 

Notes

Acknowledgments

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.

Funding

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.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

References

  1. 1.
    World Health Organization. Summary: World Report on Ageing and Health 2015.Google Scholar
  2. 2.
    Disability and Health Fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs352/en/. Accessed 01/17, 2017.
  3. 3.
    Disability and Functioning (Noninstitutionalized Adults 18 Years and Over). Available at: http://www.cdc.gov/nchs/fastats/disability.htm.
  4. 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
  5. 5.
    Taş Ü, Verhagen AP, Bierma-Zeinstra SMA, et al. Incidence and Risk Factors of Disability in the Elderly: The Rotterdam Study. Prev Med. 2007;44:272–8.  https://doi.org/10.1016/j.ypmed.2006.11.007.CrossRefGoogle Scholar
  6. 6.
    Martin LG, Schoeni RF. Trends in Disability and Related Chronic Conditions among the Forty-And-Over Population: 1997–2010. Disability and Health Journal. 2014;7:S14.  https://doi.org/10.1016/j.dhjo.2013.06.007.CrossRefGoogle Scholar
  7. 7.
    Cigolle CT, Langa KM, Kabeto MU, Tian Z, Blaum CS. Geriatric conditions and disability: the health and retirement study. Ann Intern Med. 2007;147:156–64.CrossRefGoogle Scholar
  8. 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. 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
  10. 10.
    de Leon M, Carlos F, Eschbach K, Markides KS. Population Trends and Late-Life Disability in Hispanics from the Midwest. J Aging Health. 2011;23:1166–88.  https://doi.org/10.1177/0898264311422100.CrossRefGoogle Scholar
  11. 11.
    Tran TV, Nguyen T, Chan KT. Acculturation and functional disability among older Vietnamese-Americans. Journal of Ethnic & Cultural Diversity in Social Work: Innovation in Theory, Research & Practice. 2014;23:20–35.  https://doi.org/10.1080/15313204.2013.871996.CrossRefGoogle Scholar
  12. 12.
    Reichard A, Stolzle H, Fox MH. Health Disparities Among Adults with Physical Disabilities or Cognitive Limitations Compared to Individuals with No Disabilities in the United States. Disability and Health Journal. 2011;4:59–67.  https://doi.org/10.1016/j.dhjo.2010.05.003.CrossRefGoogle Scholar
  13. 13.
    Freedman VA, Schoeni RF, Martin LG, Cornman JC. Chronic conditions and the decline in late-life disability. Demography. 2007;44:459–77.  https://doi.org/10.1353/dem.2007.0026.CrossRefGoogle Scholar
  14. 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. 15.
    Immigrants in the United States. Available at: https://www.americanimmigrationcouncil.org/research/immigrants-in-the-united-states. Accessed 12/08, 2017.
  16. 16.
    Population Reference Bureau. Elderly Immigrants in the United States. Today’s Research on Aging 2013.Google Scholar
  17. 17.
    Scommegna P. Elderly immigrants in the United States. Immigration and America's Cities: A Handbook on Evolving Services 2016:33.Google Scholar
  18. 18.
    Older Immigrants in the United States. Available at: http://www.migrationpolicy.org/article/older-immigrants-united-states. Accessed 06/30, 2016.
  19. 19.
    Baugh R, Witsman K. U.S. Lawful Permanent Residents: 2015. DHS Office of Immigration Statistics 2017.Google Scholar
  20. 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. 21.
    Mather M. Fact sheet: aging in the United States 2016.Google Scholar
  22. 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. 23.
    Congressional Budget Office Projections of Expenditures for Long-Term Care Services for The Elderly 1999.Google Scholar
  24. 24.
    Willink A, Davis K, Schoen C, Wolff J. Physical and/or cognitive impairment, out-of-pocket spending, and Medicaid entry among older adults. J Urban Health. 2016;93:840–50.CrossRefGoogle Scholar
  25. 25.
    Koroukian SM, Schiltz N, Warner DF, Sun J, Bakaki PM, Smyth KA, et al. Combinations of chronic conditions, functional limitations, and geriatric syndromes that predict health outcomes. J Gen Intern Med. 2016;31:630–7.CrossRefGoogle Scholar
  26. 26.
    Bentley JP, Brown CJ, McGwin G Jr, et al. Functional status, life-space mobility, and quality of life: a longitudinal mediation analysis. Qual Life Res. 2013;22:1621–32.CrossRefGoogle Scholar
  27. 27.
    Department of Health and Human Services. Long-Term Services and Supports for Older Americans: Risks and Financing Research Brief 2016.Google Scholar
  28. 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
  29. 29.
    Souza L, Fuller-Thomson E. Acculturation and Disability Rates Among Filipino-Americans. J Immigrant Minority Health. 2013;15:471 10p.  https://doi.org/10.1007/s10903-012-9708-1.CrossRefGoogle Scholar
  30. 30.
    Gubernskaya Z, Bean FD, Van Hook J. (Un)Healthy Immigrant Citizens: Naturalization and Activity Limitations in Older Age. J Health Soc Behav. 2013;54:427–43.  https://doi.org/10.1177/0022146513504760.CrossRefGoogle Scholar
  31. 31.
    Lum TY, Vanderaa JP. Health disparities among immigrant and non-immigrant elders: the Association of Acculturation and Education. J Immigr Minor Health. 2010;12:743–53.CrossRefGoogle Scholar
  32. 32.
    Ro A, Gee GC. Disability status differentials among Asian immigrants in the United States: the added dimensions of duration and age. Race and Social Problems. 2012;4:83–92.  https://doi.org/10.1007/s12552-012-9069-3.CrossRefGoogle Scholar
  33. 33.
    Lara M, Gamboa C, Kahramanian MI, Morales LS, Hayes Bautista DE. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. AnnuRev Public Health. 2005;26:367–97.CrossRefGoogle Scholar
  34. 34.
    Sadarangani TR, Jun J. Newly Arrived Elderly Immigrants: A Concept Analysis of “Aging Out of Place”. J Transcult Nurs. 2015;26:117 8p.  https://doi.org/10.1177/1043659614549074.CrossRefGoogle Scholar
  35. 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
  36. 36.
    Kim BJ, Choi Y. The relationship between activities of daily living (ADL), chronic diseases, and depression among older Korean immigrants. Educ Gerontol. 2015;41:417–27.  https://doi.org/10.1080/03601277.2014.982006.CrossRefGoogle Scholar
  37. 37.
    Katz S, Ford AB, Moskowitz RW, et al. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–9.CrossRefGoogle Scholar
  38. 38.
    Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–86.CrossRefGoogle Scholar
  39. 39.
    Immigrant. Available at: http://www.merriam-webster.com/dictionary/immigrant. Accessed 13 May 2016.
  40. 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
  41. 41.
    Wong R, Díaz JJ, Higgins M. Health Care Use Among Elderly Mexicans in the United States and Mexico: The Role of Health Insurance. Res Aging. 2006;28:408 16p.CrossRefGoogle Scholar
  42. 42.
    Sorkin D, Tan AL, Hays RD, et al. Self-Reported Health Status of Vietnamese And Non-Hispanic White Older Adults in California. J Am Geriatr Soc. 2008;56:1543–8.  https://doi.org/10.1111/j.1532-5415.2008.01805.x.CrossRefGoogle Scholar
  43. 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
  44. 44.
    Yang MS, Burr JA, Mutchler JE. The prevalence of sensory deficits, functional limitations, and disability among older southeast Asians in the United States. J Aging Health. 2012;24:1252–74.CrossRefGoogle Scholar
  45. 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
  46. 46.
    Al Snih S, Ray L, Markides KS. Prevalence of Self-Reported Arthritis Among Elders from Latin America and the Caribbean and among Mexican Americans from the Southwestern United States. J Aging Health. 2006;18:207–23.CrossRefGoogle Scholar
  47. 47.
    Thomson EF, Nuru-Jeter A, Richardson D, et al. The Hispanic Paradox and older adults' disabilities: is there a healthy migrant effect? Int J Environ Res Public Health. 2013;10:1786–814.  https://doi.org/10.3390/ijerph10051786.CrossRefGoogle Scholar
  48. 48.
    Melvin J, Hummer R, Elo I, et al. Age Patterns of Racial/Ethnic/Nativity Differences in Disability and Physical Functioning in the United States. Demogr Res. 2014;31:497–510.  https://doi.org/10.4054/DemRes.2014.31.17.CrossRefGoogle Scholar
  49. 49.
    Mehta NK, Elo IT. Migrant Selection and The Health of U.S. Immigrants from the Former Soviet Union. Demography. 2012;49:425–47.  https://doi.org/10.1007/s13524-012-0099-7.CrossRefGoogle Scholar
  50. 50.
    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;71:780–6.CrossRefGoogle Scholar
  51. 51.
    Wakabayashi C. Effects of immigration and age on health of older people in the United States. J Appl Gerontol. 2010;29:697–719.CrossRefGoogle Scholar
  52. 52.
    Rejeski WJ, Mihalko SL. Physical activity and quality of life in older adults. J Gerontol Ser A Biol Med Sci. 2001;56:23–35.CrossRefGoogle Scholar
  53. 53.
    Beswick AD, Rees K, Dieppe P, Ayis S, Gooberman-Hill R, Horwood J, et al. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet. 2008;371:725–35.CrossRefGoogle Scholar
  54. 54.
    Stuck AE, Walthert JM, Nikolaus T, et al. Risk Factors for Functional Status Decline in Community-Living Elderly People: A Systematic Literature Review. Soc Sci Med. 1999;48:445–69.  https://doi.org/10.1016/S0277-9536(98)00370-0.CrossRefGoogle Scholar
  55. 55.
    Batalova J. Senior Immigrants in the United States 2012;2016.Google Scholar
  56. 56.
    Rote S, Markides K. Aging, social relationships, and health among older immigrants. Generations. 2014;38:51–7.Google Scholar
  57. 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
  58. 58.
    Okafor MT, Carter-Pokras OD, Picot SJ, et al. The Relationship of Language Acculturation (English Proficiency) to Current Self-Rated Health Among African Immigrant Adults. J Immigr Minor Health. 2013;15:499–509.  https://doi.org/10.1007/s10903-012-9614-6.CrossRefGoogle Scholar
  59. 59.
    Dupre ME, Gu D, Vaupel JW. Survival differences among native-born and foreign-born older adults in the United States. PLoS One. 2012;7:e37177.CrossRefGoogle Scholar
  60. 60.
    Dallo FJ, Booza J, Nguyen ND. Functional Limitations and Nativity Status among Older Arab, Asian, Black, Hispanic, and White Americans. J Immigr Minor Health. 2015;17:535–42.  https://doi.org/10.1007/s10903-013-9943-0.CrossRefGoogle Scholar
  61. 61.
    Palloni A, Arias E. Paradox lost: explaining the Hispanic adult mortality advantage. Demography. 2004;41:385–415.CrossRefGoogle Scholar
  62. 62.
    Mejía S, Miguel A, Gutiérrez LM, Villa AR, Ostrosky-Solis F. Comparative analysis of cognitive impairment among Mexicans and Spanish-speaking Immigrant’s elders. J Aging Health. 2006;18:292–314.CrossRefGoogle Scholar
  63. 63.
    Anderson M. African Immigrant Population in U.S. Steadily Climbs. Pew Research Center 2017.Google Scholar
  64. 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. 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.
  66. 66.
    Dong X, Wong E, Simon MA. Study design and implementation of the PINE study. J Aging Health. 2014;26:1085–99.CrossRefGoogle Scholar
  67. 67.
    Centers for Disease Control and Prevention, (CDC). About the National Health Interview Survey 2017.Google Scholar
  68. 68.
    Gitlin L, Czaja S. Behavioral intervention research: designing, evaluating, and implementing: springer publishing company 2015.Google Scholar
  69. 69.
    Szanton SL, Leff B, Wolff JL, Roberts L, Gitlin LN. Home-based care program reduces disability and promotes aging in place. Health Aff. 2016;35:1558–63.  https://doi.org/10.1377/hlthaff.2016.0140.CrossRefGoogle Scholar

Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.Johns Hopkins School of NursingBaltimoreUSA
  2. 2.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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