David V. Espino

Ethnic Differences in Mini‐Mental State Examination (MMSE) Scores: Where You Live Makes a Difference

OBJECTIVES: To examine differences in correlates of the Mini‐Mental State Examination (MMSE) in a population‐based sample of older Mexican Americans and European Americans and to provide empirical validation of the MMSE as an indicator of cognitive impairment in survey research in older Mexican Americans by comparing MMSE classification against performance on timed tasks with varying levels of cognitive demand.

The Influence of Noncognitive Factors on the Mini-Mental State Examination in Older Mexican-Americans: Findings from the Hispanic EPESE

Mini-Mental State Examination data from the Hispanic Established Population for the Epidemiologic Study of the Elderly baseline survey, a population-based study of community-dwelling Mexican Americans aged 65 and older, were used to examine the relationship between cognitive impairment, sociodemographics, and health-related characteristics. The rate of cognitive impairment found in this group of older Mexican Americans, using the conventional cut point of 23/24 on the MMSE, was 36.7%. Using a more conservative cut point of 17/18 indicated an overall rate of severe cognitive impairment of 6.7%. Rates of impairment varied significantly with age, education, literacy, marital status, language of interview, and immigrant status and were associated with high and moderate levels of depressive symptoms, and history of stroke. Importantly, although education was strongly related to poor cognitive performance, it was not a significant predictor of severe cognitive impairment. Multivariate analyses further indicated that as a screen for cognitive impairment in older Mexican Americans, the MMSE is strongly influenced by these noncognitive factors. Scores may reflect test bias, secondary to cultural differences or the level of education in this population.

Cognitive impairment and mortality in older mexican americans.

OBJECTIVES: To examine the extent to which cognitive status and decline in cognitive status predict mortality in older Mexican Americans.

An introduction to geriatrics for first-year medical students

OBJECTIVE: To prepare medical students to better serve their older patients while raising awareness of geriatrics as a career choice.

Correlates of prescription and over-the-counter medication usage among older Mexican Americans: The hispanic EPESE study

OBJECTIVES: To determine the prevalence rates of prescription and over‐the‐counter (OTC) medication usage among community‐dwelling older Mexican Americans.

Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: Results of the Hispanic EPESE study

OBJECTIVES: To determine the rates and risk factors associated with hip fractures in the community‐dwelling older Mexican‐American population.

Undertreatment of Hypertension in Older Mexican Americans

OBJECTIVE: To identify the prevalence of hypertension and factors associated with nontreatment and poor control of hypertension in Mexican Americans aged 65 years and older.

Higher church attendance predicts lower fear of falling in older Mexican-Americans.

Several studies have shown that involvement in religious activity appears to benefit health. To estimate the association between church attendance and fear of falling, we used a sample of 1341 non-institutionalized Mexican-Americans aged 70 and over from the third wave (1998–1999) of the Hispanic Established Population for the Epidemiological Study of the Elderly, followed until 2000–2001. Baseline potential predictors of fear of falling were church attendance, socio-demographics, history of falls, summary measure of lower body performance (tandem balance, eight-foot walk, and repeated chair stands), functional status, depressive symptoms, cognitive status, and medical conditions. Fear of falling at the two-year follow-up was measured as no fear, somewhat afraid, fairly afraid, and very afraid. Chi-square statistic and multiple logistic regression analysis were used to estimate associations between the outcome and the potential predictors. Multiple logistic regression analysis showed that frequent church attendance was an independent predictor of lower fear of falling (odds ratio = 0.73, 95% confidence interval 0.58–0.92, P = 0.008) two years later. Other independent predictors of fear of falling were female gender, poorer objective lower body performance, history of falls, arthritis, hypertension, and urinary incontinence. Frequent church attendance is associated with decreased fear of falling in older Mexican-Americans.

Mortality Differences Between Elderly Mexican Americans and Non-Hispanic Whites in San Antonio, Texas

Objective: To identify differences in causes of death between elderly Mexican Americans (MA) and non‐Hispanic whites (NHW).

Prevalence and Severity of Urinary Incontinence in Elderly Mexican-American Women

Objectives: To measure prevalence and characteristics of urinary incontinence in older Mexican‐American women.