The influence of social and cultural context on life course pathways for Alzheimer's disease, related dementias, and care resources for older Mexican adults

社会和文化背景对阿尔茨海默病、相关痴呆症以及墨西哥老年人护理资源生命历程的影响

• 批准号: 10213435
• 负责人: Brian Gregory Downer
• 金额: $ 104.42万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10213435
• 关键词: Adult; Adult Children; Age; Aging; Alzheimer' s Disease Pathway; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Caring; Child; Childhood; Cognitive; Country; Data; Data Files; Dementia; Disadvantaged; Economic Conditions; Economics; Education; Elderly; Event; Exposure to; Extended Family; Family; Family Planning Policy; Family Sizes; Friends; Generations; Health; Health Insurance; Health Services Accessibility; Health Status; Health behavior; Health care facility; Healthcare; Housing; Incidence; Individual; Inequality; Infrastructure; Institution; Insurance Coverage; Knowledge; Latin America; Life; Life Cycle Stages; Life Expectancy; Link; Long-Term Care; Medicine; Mexican; Mexican Americans; Mexico; Migration Policy; Participant; Pathway interactions; Pensions; Persons; Policies; Population; Public Health; Research; Resources; Risk; Risk Factors; Series; Shock; Social Change; Testing; Time; Work; aged; aging population; care burden; care systems; caregiving; contextual factors; cultural values; dementia care; dementia risk; expectation; family support; health care service; health knowledge; human old age (65+); informal care; middle age; protective factors; social

ABSTRACT Many older Mexican adults rely on adult children, extended family, and friends (i.e., informal care resources) to meet financial, housing, and daily needs. Older adults with strong networks may not worry about having few financial resources, living in poor housing, or not being able to access long-term care services, because they expect that these needs will be met by their adult children. However, this expectation may become less realistic as family sizes have become smaller, adult children are increasingly moving away for work, and cultural values change. Additionally, Mexico has limited healthcare resources and infrastructure (i.e., formal care resources) to meet the needs of an aging population. This is concerning because the incidence of Alzheimer's disease and related dementias (ADRD) in Mexico is among the highest in Latin America. This has important implications for the demand for healthcare services and the need for support from family. The life course is the temporal sequence of events, transitions, and trajectories in important life domains, such as education, family composition, and health. A person's life course is shaped by contextual factors. In Mexico, contextual factors that have likely shaped ADRD risk and the availability of care resources in old age include migration policies, family planning policies, economic shocks, and healthcare and pension reforms. These events have caused successive generations of older adults to be born into and age within very different contexts. Knowledge of contextual and individual life course factors that influence ADRD risk, access to care resources, and use of care resources are established gaps in aging research. We will use the Mexican Health and Aging Study to complete three specific aims. (1) Identify life course pathways for ADRD in an older adult population that has overcome social, economic, and health disadvantages in childhood and middle age. (2) Determine how changing social and cultural contexts over the life course have impacted the availability of informal and formal care resources for older adults in Mexico. (3) Determine how older adults in a country with a poor infrastructure for an aging population meet their long-term care needs as they transition from cognitively unimpaired to ADRD. This project is expected to produce evidence on the life course pathways that influence ADRD risk as well as the availability and use of care resources for older adults in a country with low institutional support, high inequality, and the likely high care burden of ADRD for families and institutions. The expected findings of this research are also relevant to the US. Poor economic conditions and rejoining family are among the many factors that motivate Mexicans to migrate to the US. This, along with the aging of the Mexican-American population, makes it critical to understand how risk factors across life stages impact older adults' risk for ADRD.

抽象的 许多年长的墨西哥成年人依靠成年子女，大家庭和朋友（即非正式护理资源） 满足财务，住房和日常需求。拥有强大网络的老年人可能不必担心很少 财政资源，生活在贫困的住房或无法获得长期护理服务，因为他们 预计他们的成年子女将满足这些需求。但是，这种期望可能变得不太现实 随着家庭规模变得越来越小，成年子女越来越多地搬走工作，文化价值观 改变。此外，墨西哥的医疗保健资源和基础设施（即正式护理资源）有限 满足人口老龄化的需求。这是因为阿尔茨海默氏病和 墨西哥的相关痴呆症（ADRD）是拉丁美洲最高的痴呆症。这对 对医疗服务的需求以及家庭支持的需求。 生活过程是重要生命领域中事件，过渡和轨迹的时间顺序 作为教育，家庭组成和健康。一个人的生活课程是由上下文因素塑造的。在墨西哥， 可能塑造ADRD风险和老年护理资源的可用性的上下文因素包括 移民政策，计划生育政策，经济冲击以及医疗保健和养老金改革。这些事件 在非常不同的情况下，导致连续几代老年人出生并在年龄中出生。 了解影响ADRD风险，获得护理资源的情境和个人生活课程因素， 并在老龄化研究中确定了护理资源的使用差距。我们将使用墨西哥健康和衰老 研究完成三个特定目标。 （1）确定老年人人口中ADRD的生活途径 这已经克服了童年和中年的社会，经济和健康缺点。 （2）确定如何 在生活过程中改变社会和文化背景已影响非正式和正式的可用性 墨西哥老年人的护理资源。 （3）确定基础设施较差的国家的老年人 对于老龄化的人口，他们从认知没有损害到ADRD过渡时满足了他们的长期护理需求。 预计该项目将在影响ADRD风险以及 在机构支持低，高的国家的老年人的可用性和利用 不平等，以及对家庭和机构的ADRD的高层照料负担。预期的发现 研究也与美国有关。经济状况不佳和重新加入家庭是众多因素之一 这激励墨西哥人迁移到美国。这与墨西哥裔美国人人口的老龄化一起 使了解跨越生命阶段的风险因素如何影响老年人的ADRD风险至关重要。