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Having an adult child in the US, physical functioning, and unmet needs for care among older Mexican adults

Torres, Jacqueline M.a; Rudolph, Kara E.b; Sofrygin, Olegc; Wong, Rebecad; Walter, Louise C.e,f; Glymour, M. Mariaa

doi: 10.1097/EDE.0000000000001016
Original Article: PDF Only
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Background: Migration of adult children may impact the health of aging parents who remain in low- and middle-income countries. Prior studies have uncovered mixed associations between adult child migration status and physical functioning of older parents; none to our knowledge has examined the impact on unmet caregiving needs.

Methods: Data come from a population-based study of Mexican adults > 50 years. We used longitudinal targeted maximum likelihood estimation to estimate associations between having an adult child US migrant and lower-body functional limitations, and both needs and unmet needs for assistance with basic or instrumental activities of daily living (ADLs/IADLs) for 11806 respondents surveyed over an 11-year period.

Results: For women, having an adult child US migrant at baseline and 2-year follow-up was associated with fewer lower-body functional limitations (marginal risk difference (RD): -0.14, 95% CI: -0.26, -0.01) and ADLs/IADLs (RD: -0.08, 95% CI: -0.16, -0.001) at 2-year follow-up. Having an adult child US migrant at all waves was associated with more functional limitations at 11-year follow-up (RD: 0.04, 95% CI: 0.01, 0.06). Having an adult child US migrant was associated with a higher prevalence of unmet needs for assistance at 2 (RD: 0.13, 95% CI: 0.04, 0.21) and 11-year follow-up for women (RD: 0.07, 95% CI: -0.02, 0.15) and 11-year follow-up for men (RD: 0.08, 95% CI: 0.00, 0.16).

Conclusion: Having an adult child US migrant had mixed associations with physical functioning, but substantial adverse associations with unmet caregiving needs for a cohort of older adults in Mexico.

a.Department of Epidemiology & Biostatistics, School of Medicine. UC San Francisco, San Francisco, CA

bDepartment of Emergency Medicine, UC Davis, Sacramento, CA

cDivision of Research, Kaiser Permanente, Oakland, CA

dSealy Center on Aging, University of Texas – Medical Branch, Galveston, TX

eDivision of Geriatrics, School of Medicine, UC San Francisco, San Francisco, CA

fDivision of Geriatrics, Veterans Affairs Medical Center, San Francisco, CA

Acknowledgments: The Mexican Health and Aging Study (MHAS) is funded by the National Institutes of Health/National Institute on Aging (R01AG018016, R Wong, PI) and the National Institute of Statistics and Geography (INEGI) in Mexico. JMT is supported by the National Institutes of Health/National Institute on Aging (K01AG056602, J Torres, PI). KER is supported by the National Institutes of Health/National Institute on Drug Abuse (K99DA042127, K Rudolph, PI). OS is supported by the National Institutes of Health/National Institute of Allergy and Infectious Diseases (R01AI074345-07). MMG is supported by the National Institutes of Health and Aging (RF1AG05548601, MM Glymour and A Zeki Al Hazzouri, Multi-PI). LCW is supported by the National Institutes of Health/National Institute on Aging (K24AG041180).

No conflicts of interest to declare.

The data are publicly available for download at mhasweb.org; sample code for longitudinal Targeted Maximum Likelihood Estimation and sensitivity analysis are provided in the supplemental files. Further code (e.g. to set up all of the variables, for multiple imputation procedures) is available upon request.

550 16th Street, San Francisco, CA 94143, (415) 317 – 3261, Jacqueline.Torres@ucsf.edu

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