Racial and Ethnic Differences in Activities of Daily Living Disability Among the Elderly: The Case of Spanish Speakers

Abstract 

Tirodkar MA, Song J, Chang RW, Dunlop DD, Chang HJ. Racial and ethnic differences in activities of daily living disability among the elderly: the case of Spanish speakers.

Objective

To compare incident disability patterns across racial and ethnic groups.

Design

Prospective cohort study with 6-year follow-up (1998–2004).

Setting

National probability sample.

Participants

A 1998 Health and Retirement Study sample of 12,288 non-Hispanic whites, 1952 African Americans, 575 Hispanics interviewed in Spanish (Hispanic-Spanish), and 518 Hispanics interviewed in English (Hispanic-English), older than 51 years, and free of disability at baseline.

Interventions

Not applicable.

Main Outcome Measure

Disability in activities of daily living (ADL) tasks (walking, dressing, transferring, bathing, toileting, feeding).

Results

Hispanic-Spanish reported disproportionately lower rates of walking disability (standardized rates, 4.31% vs Hispanic-English [8.57%], black [7.54%], white [7.20%]) despite higher reported Hispanic-Spanish frequencies of lower-extremity dysfunction than other racial and ethnic groups. Across the 6 ADL tasks, the development of walking disability was most frequent among Hispanic-English subjects, African Americans, and whites. In contrast, Hispanic-Spanish subjects reported dressing as the most frequent ADL task disability, whereas walking ranked fourth.

Conclusions

Aggregating all Hispanics, regardless of interview language, may be inappropriate. Future research on linguistic group differences in self-reported health outcomes is necessary to ensure that health status measures will be appropriate for use in diverse racial and ethnic groups.

Key Words: Activities of daily living, Hispanic Americans, Rehabilitation

List of Abbreviations: ADLs, activities of daily living, BMI, body mass index, CI, confidence interval, HR, hazard ratio, HRS, Health and Retirement Study, NHIS, National Health Interview Survey