The Role of Inflammation and Psycho-Behavioral Factors as Mediators Between Acculturation and Time to Incident Dementia Among Older Mexican Americans.

Background: The mechanisms through which acculturation influences the onset of cognitive impairment and dementia are not well understood, especially among older Hispanics. Objective: To investigate whether inflammation and psycho-behavioral factors mediate the relationship between acculturation and incident dementia among older Mexican Americans. Methods: We analyzed the Sacramento Area Latino Study on Aging (1998-2007, SALSA), a longitudinal study (N = 1,194) with 10 years of follow-up, and used g-computation for mediation analysis with pooled logistic regression to evaluate whether acculturation (assessed by the Revised Acculturation Rating Scale for Mexican Americans [ARSMA-II]) affected dementia or cognitive impairment but not dementia (CIND) through inflammation (i.e., interleukin 6 [IL-6], tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein [hs-CRP]), smoking, alcohol consumption, and depressive symptoms. The potential mediators were assessed at baseline. Results: The 10-year average adjusted risk ratio (aRR) for the effect of high U.S. acculturation and dementia/CIND was 0.66, 95% CI (0.36, 1.30). The indirect effects were: IL-6 (aRR = 0.98, 95% CI (0.88, 1.05)); TNF-α (aRR:0.99, 95% CI (0.93, 1.05)); hs-CRP: (aRR = 1.21, 95% CI (0.84, 1.95)); current smoking: aRR = 0.97, 95% CI (0.84, 1.16); daily/weekly alcohol consumption (aRR = 1.00, 95% CI (0.96, 1.05)); and depressive symptom score (aRR = 1.03, 95% CI (0.95, 1.26)). Hs-CRP yielded a proportion mediated of -26%, suggesting that hs-CRP could suppress the potential effect of high U.S. acculturation. The other factors explored resulted in little to no mediation. Conclusions: The effect of acculturation on time to incident dementia/CIND varied over time. Our study suggests that inflammation could suppress the effect between high U.S. acculturation and dementia risk.

Interplay of premigration crisis exposure and postmigration cultural stress on depressive symptoms among Venezuelan crisis migrants in Colombia.

OBJECTIVES: A growing body of research points to a relationship between exposure to migration-related cultural stress and mental health problems. However, such research is often conducted with the tacit assumption that postmigration experiences are the primary-if not singular-driver of psychological distress. In the present study, we aim to extend the cultural-stress paradigm by examining the influences of both premigration crisis exposure and postmigration cultural stress on depression in a sample of Venezuelan crisis migrants in Colombia. METHOD: Survey data for the present study were collected from Venezuelan youth (N = 429, ages 12-17, Mage = 14.0 years, 49% female) and adults (N = 566, ages 18+, Mage = 35.1 years, 82% female) in Bogota and Medellin, Colombia between April and June 2023. RESULTS: Both crisis exposure and discrimination were independently related to depressive symptoms. However, when examined in a multivariate model along with discrimination, crisis exposure was not a significant predictor of depressive symptoms among youth, and its influence weakened considerably among adults. Among both youth and adults, a Crisis Exposure × Discrimination interaction term significantly predicted depressive symptoms, indicating that discrimination was a more robust predictor of depressive symptoms among those endorsing lower levels of crisis exposure than among those reporting high levels of crisis exposure. CONCLUSION: Our research provides new insights into the experiences of Venezuelan migrant youth and adults in Colombia. It provides further support for the importance of drawing from a crisis-informed cultural-stress framework when working with crisis migrant populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effect of Financial Strain on the Health Outcomes of Older Mexican-Origin Adults: Findings From the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE).

Predictors of health across the life-course do not maintain the same significance in very late life and the role of financial strain in health outcomes of very old adults remain unclear. Data from adults aged 74 + in waves 5 and 7 of the Hispanic Established Population for the Epidemiological Study of the Elderly (n = 772) study was used to evaluate the role of financial strain on the health of older Mexican Americans who have the highest poverty rate of any racial or ethnic group in the United States. We evaluate the association between episodic (one wave) and persistent financial strain (two waves), with follow-up health outcomes (self-rated health, ADL (limitations in activities of daily living)/IADL (limitations in instrumental activities of daily living) disability, and depressive symptoms). Adults with persistent strain were twice as likely to experience depressive symptoms and three times more likely to experience IADL limitations than the unstrained. Our findings highlight the role of stress proliferation and allostatic load processes leading to deteriorated health over time.

Experiences of cultural stress among U.S. citizen migrants: A mixed method approach.

On September 20, 2017, Hurricane Maria made landfall in Puerto Rico, devastating the archipelago and forcing thousands of Puerto Ricans to migrate to the U.S. mainland. Guided by a cultural stress theory framework, the present mixed method study examined how various cultural stressors impact participants' daily interactions and mental health outcomes. A total of 319 adult Hurricane Maria survivors residing on the U.S. mainland participated in the study. A mixed method sequential explanatory design was used. First, we used latent profile analysis (LPA) and multinomial logistic regression to identify the varied cultural stress experiences that participants had. Then we used data from semistructured interviews to better understand the experiences of participants classified into the different LPA profiles. Four profiles were identified: "moderate cultural stress" (35%), "overall low" (29%), "high cultural stress" (26%), and "low language stress" (10%). Multinomial regression indicated that members of the moderate cultural stress, high cultural stress, and low language stress profiles all reported significantly higher depressive and anxiety symptoms compared to members of the overall low profile. Qualitative data exemplified the daily experiences of participants placed into each profile, demonstrating that participants have rich and varied experiences that can contribute to their mental health symptoms. The present study documents the contributions of hurricane trauma and cultural stress vis-à-vis current mental health symptoms. Clinicians working with Hurricane Maria survivors should be cognizant of and inquire about migration-related cultural stressors including discrimination, feelings of being unwelcomed, and difficulty communicating in the destination community's dominant language. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Yearly and Daily Discrimination-Related Stressors and Mexican Youth's Mental Health and Sleep: Insights From the First Wave of a Three-Wave Family Study.

OBJECTIVE: Research is needed to examine discrimination-related stressors and their social and psychological shaping of mental health and sleep outcomes of Latinx youth. The background, design, and methodology of a longitudinal study of Mexican families in Indiana and the initial findings of associations between discrimination-related stressors and youth mental health and sleep outcomes are presented. METHOD: Initiating wave 1 of a 3-wave (yearly) longitudinal study, investigators surveyed an ethnically homogeneous sample of 344 Mexican-origin adolescents (ages 12-15) and their primary caregivers, assessing risks and protective factors for mental health and sleep outcomes. Youth also completed a one-time 21-day daily diary after wave 1. Self-reported measures of youth mental health, sleep, and discrimination across wave 1 and the daily diary were evaluated to compare the cross-sectional (wave 1) and daily associations between discrimination and youth mental health and sleep outcomes. RESULTS: Of youth, 88.1% reported at least one incident of lifetime discrimination. Almost one-third had elevated depressive symptoms, 44.5% had probable generalized anxiety disorder, and 50.9% had poor sleep quality. Between-youth correlations at wave 1 and in the daily diary were consistent in that perceived racial discrimination was positively correlated with worse mental health and poorer sleep quality. Smaller within-youth correlations were observed in the daily diary, but there was striking variability in the effect of discrimination across youth. CONCLUSION: The present results illustrate the powerful methods of combining yearly and daily time data to investigate how and for whom discrimination-related stressors lead to adverse outcomes. PLAIN LANGUAGE SUMMARY: Latinx youth are the largest and fastest growing minoritized youth group in the United States. This study surveyed 344 Mexican-origin adolescents and their primary caregivers to assess risk and protective factors for mental health and sleep outcomes. The authors found that 88.1% of youth reported at least one incident of lifetime discrimination, 29.7% reported elevated depressive symptoms, 44.5% reported elevated anxiety symptoms, and 50.9% reported poor sleep quality. Youth who experienced racial discrimination were more likely to have worse mental health and lower sleep quality than those who did not experience racial discrimination. DIVERSITY & INCLUSION STATEMENT: We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. CLINICAL TRIAL REGISTRATION INFORMATION: Seguimos Avanzando - Latino Youth Coping With Discrimination; https://clinicaltrials.gov/; NCT04875208.

Factors Associated with Depressive Symptoms among Mexican-Origin Adults in a Community Sample at the US Mexico Border Region.

Using baseline data from three partnering federally qualified health centers, we examined factors associated with depressive symptoms among Mexican-origin adults at risk of chronic disease living in three counties in Southern Arizona (i.e., Pima, Yuma, and Santa Cruz). Multivariable linear regression models identified correlates of depressive symptoms for this population controlling for sociodemographic characteristics. Among 206 participants, 85.9% were female and 49% were between 45 and 64 years of age. The proportion of depressive symptoms was 26.8%. Low levels of physical pain and high levels of hope and social support were also reported. Physical pain was positively and significantly related to depressive symptoms (ß = 0.22; 95% CI = 0.13, 0.30). Conversely, hope was negatively and significantly associated with depressive symptoms (ß = -0.53; 95% CI = -0.78, -0.29). A better understanding of factors related to depressive symptoms among Mexican-origin adults is necessary to fulfill their mental health needs, as well as to achieve health equity and to eliminate health disparities in the US-Mexico border region.

The more you need, the less you get: Intersectionality and the inverse care law in the Brazilian depression care cascade.

Substantial research has shown that the population distribution of major depressive disorder (MDD) is strongly influenced by race, gender, and socioeconomic position. However, a deeper understanding of inequities in access to care for MDD according to these social markers is yet to be reached. We use data from the 2019 Brazilian National Health Survey, which includes 87,187 respondents aged 18 years and over, to test two hypotheses derived from the inverse care law: women, Black, and low-education respondents have higher frequencies of MDD, but lower access to each step of the depression care cascade, including diagnosis by a health professional, regular healthcare visits, and access to specialised treatment (H1); low-education Black women show the highest MDD frequency and the lowest access to care across the entire cascade (H2). Partially supporting H1 and H2, our results reveal a bottleneck in the first step of the depression care cascade. While no racial inequities were observed in the MDD prevalence, Black individuals were less likely than whites to be diagnosed by a health professional (OR 0.74). Women (OR 2.64) and low-education (OR 1.18) were more likely to have probable MDD in relation to men and high-education respondents, respectively, but only women (OR 1.58) were more likely to be diagnosed. Low-education Black women were equally more likely to have probable MDD (OR 3.11) than high-education white men. Conversely, high-education white women emerged as the most likely to be diagnosed with MDD (OR 1.63). Our findings suggest the inverse care law applies to the depression care cascade in Brazil through indication that its healthcare system perpetuates a multilayered system of oppression that overlooks multiply marginalised individuals. We also show that adequate screening by health care professionals should mitigate the complex patterns of inequity revealed by our study.

Risk factors for poor asthma control and impaired quality of life in a Caribbean population.

OBJECTIVE: Asthma, a major cause of disability and reduced quality of life, has a high global prevalence and burden of death. Despite the propitious guidelines, a substantial portion of asthmatics reportedly have poorly controlled disease. In the current study, we have examined risk factors for uncontrolled asthma in specialty clinics and its association with impaired quality of life. METHODS: A multicentre cross-sectional survey of asthma patients, 18 years and older, was conducted in Trinidad. Asthma Control Test (ACT) and the Juniper Mini Asthma Quality of Life Questionnaire (Mini AQLQ-J) were used to assess the disease control and quality of life, respectively. Data were analyzed using the Chi-square test and multivariable logistic regression controlling for gender. RESULTS: Of a total of 428 patients included, asthma was uncontrolled in 72.4% and asthma related quality of life was moderate to severely impaired in 86% of the studied population. In the multivariate regression models, poorly controlled asthma was associated with obesity (OR 2.25; 95% CI 1.30-3.39), late-onset asthma (OR 1.72; 95% CI 1.04-2.84), features of sleep apnea (OR 1.77; 95% CI 1.01-3.07) and depression (OR 2.01; 95% CI 1.04-3.86). Impaired quality of life was associated with Indo-Caribbean ethnicity (OR 3.19; 95% CI = 1.68-6.06). CONCLUSIONS: In this Caribbean population, uncontrolled asthma was independently associated with obesity, late-onset disease, and comorbidities of sleep apnea and depression. Poor asthma-related quality of life was independently associated with Indo-Caribbean ethnicity.

Depressive symptoms among mothers with young children-the role of family migration and social networks in Mexico.

BACKGROUND: Women who remain in migratory sending communities as their family members migrate internationally are at risk for depression. Limited research examines the association between the number of absent household members and a woman's mental health. AIMS: This study examines the association between residing in a migrant household and depressive symptoms for women in Mexico while accounting for social networks and social support. METHODS: Logistic regression analysis was employed using the Social Networks and Health Information Survey (SNHIS) (n = 320), a random household survey conducted in a medium-sized municipality in Guanajuato, Mexico. RESULTS: Multivariate results suggest that residing in a household with two or more migrants was associated with increased odds of depressive symptoms, while having immediate kin in the community reduced the odds of depressive symptoms. Social relationships in the community and social support were associated with reduced odds of depressive symptoms. Their inclusion in the models reduced the significance of but did not significantly mediate the association between residing in a household with multiple migrants and depressive symptoms. CONCLUSIONS: Services aimed at improving women's health should target women who reside in households with multiple migrants and focus on reducing the stress and mental health impacts associated with these relationships.

Contribution of Alcohol and Nicotine Dependence to the Prevalence of Depressed Mood in Different Ethnic Groups in The Netherlands: The HELIUS Study.

Objective: Ethnic minorities report different levels of drinking and smoking and higher rates of depression compared to native populations. In this study we aimed to investigate in six ethnic groups whether tobacco and alcohol use were associated with depressive symptoms, which are more prevalent in ethnic minorities.Methods: Cross-sectional data from the multi-ethnic Healthy Life in an Urban Setting (HELIUS) study sample (N = 22,471) was used, comprising 4,580 native Dutch participants which were compared with participants from five ethnic minority groups (3,259 South Asian Surinamese, 4,292 African Surinamese, 2,262 Ghanaian, 3,891 Turkish, and 4,187 Moroccan).Results: Alcohol misuse was positively associated with depressed mood in all ethnic groups except for the Dutch and the Ghanaians. Nicotine dependence was positively associated with depressed mood in all ethnic groups except for the Ghanaian group.Conclusions: Alcohol misuse and nicotine dependence were significantly associated with depressed mood in most but not all ethnic groups and especially in men. However, across all groups the contribution of alcohol misuse and nicotine dependence to depressed mood was small. Prospective multi-ethnic studies should confirm whether the relations are causal and elucidate their direction.

Prenatal Depression and Risk of Short Interpregnancy Interval in a Predominantly Puerto Rican Population.

Background: Short interpregnancy interval (IPI) is associated with risk of adverse pregnancy outcomes; however, few studies have evaluated the role of depression as a risk factor for short IPI. Puerto Rican women in the United States experience disparities in adverse birth outcomes and have the highest birth rates. Methods: We analyzed the association between prenatal depressive symptoms and IPI in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women in Western Massachusetts (2006-2011). Depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) in early, mid, and late pregnancy. We calculated follow-up time as the difference between the date of delivery of the index pregnancy and the last menstrual period of the subsequent pregnancy using medical records and billing data. We defined short IPI as ≤18 months. Results: Of 1262 eligible women, 35% (n = 440) had at least probable minor depression (EPDS scores ≥13) and 25% (n = 315) had probable major depression (EPDS scores ≥15). Participants were followed for a median of 3.7 years (interquartile range = 1.4-6.0 years) and 240 (20.6%) participants experienced a short IPI. After adjusting for risk factors, women with probable minor depression (adjusted odds ratio [aOR] = 1.39, 95% confidence interval [CI] = 1.02-1.88) and probable major depression (aOR = 1.42, 95% CI = 1.02-1.97) during pregnancy had increased odds of short IPI. Conclusions: Prenatal depressive symptoms were common in this Puerto Rican population and were associated with a modest increase in odds of short IPI. Further examination of the pathways through which mental health may affect IPI in vulnerable populations is warranted.

Stress and depression in the context of migration among Haitians in the United States.

Our global communities are becoming increasingly more diverse and interwoven; thus, research that enhances our understanding of the multidimensional relationship between depression and migration among distinct ethnic groups is imperative. This study examined the relationship between migration-related stress and depression and the extent to which that relationship is modified by other factors, through the lens of the stress process model. This cross-sectional pilot study used purposive sampling methods to recruit 76 first-generation Haitian immigrants living in South and West Florida from February 2018-May 2018. Descriptive statistics, bivariate and multiple regressions were utilized to assess associations among migration-related stress (Demands of Immigration Scale), depression (Center for Epidemiological Studies Depression (CESD), Zanmi Lasante Depression Symptom Inventory (ZLDSI)), and key demographic variables. Findings showed a strong positive correlation between migration-related stress and depression (CESD (ß =.606, 95% CI [.296, .556]) and ZLDSI (ß = .624, 95% CI [.242, .440]). Relative to the standardized coefficient, migration-related stress was the strongest predictor of depression after controlling for other predictors. Presence at the 2010 earthquake was the only significant moderator, showing an amplifying effect between migration-related stress and depression (ZLDSI) for those in Haiti during the 2010 earthquake. Consideration of pre-migration factors and the degree of migration-related stress encountered while adapting to life post-migration is critical because they play a significant role in shaping immigrants' depression realities. Community-based services that incorporate or partner with established immigrants to strengthen support for the most vulnerable immigrants early on after migration could serve to mitigate migration-related stressors and facilitate mental health promotion and prevention.

Depression, sexual behavior, and HIV treatment outcomes among transgender women, cisgender women and men who have sex with men living with HIV in Brazil and Thailand: a short report.

One in five transgender women (TW) are living with HIV, yet little has been published about their health outcomes. We analyzed data from TW (n = 37), cisgender women (CW, n = 165), and cisgender men who have sex with men (MSM, n = 151) in Thailand and Brazil. We hypothesized: (1) TW will have higher odds of depressive symptoms, lower odds of condom use and greater odds of a detectable viral load compared to MSM and CW; and (2) TW will have lower odds of condom use and higher odds of detectable viral load. We found that TW had higher odds of depression (OR 2.2, 95%CI: 1.0, 4.8, p = 0.04) and were less likely than MSM (22% v. 42%, p = 0.01) to use condoms with partners of unknown serostatus. In multivariable models, TW had lower odds than MSM of using condoms with partners with unknown serostatus (OR 0.38, 95%CI: 0.15, 0.90) and CW had lower odds than MSM of using condoms with HIV-negative partners (0.60 [0.38, 0.95], p = 0.029). We found no significant differences in detectable viral load. Disaggregating data by gender is important to understand factors that contribute to viral suppression and HIV transmission risk among people living with HIV.

The Role of Parents' Ethnic-Racial Socialization Practices in the Discrimination-Depression Link among Mexican-Origin Adolescents.

The present study investigated the moderating role of parents' ethnic-racial socialization practices (T1) in the link between adolescents' discrimination experiences (T1-T3) and adolescent anxiety and depression, respectively (T1-T3). Using a 3-wave longitudinal design with multiple informants (adolescent, mother, father) reporting on parents' ethnic-racial socialization practices, the data analytic sample comprised a total of 251 (T1) Mexican-origin families from the midwestern United States. Mother and father reports of their own ethnic-racial socialization practices (i.e., cultural socialization, preparation for bias, promotion of mistrust) were entered simultaneously into multilevel moderation models. Results from these multilevel moderation analyses indicated that fathers' promotion of mistrust was a significant moderator in the adolescent discrimination-depression link over time. Specifically, fathers' promotion of mistrust exacerbated the youth discrimination-depression association. Moreover, the difference between the moderating effects of fathers' versus mothers' promotion of mistrust on the youth discrimination-depression association was significant. Cultural socialization and preparation for bias did not significantly moderate the adolescent association between discrimination and mental health, regardless of parent gender (fathers or mothers) or mental health outcome (anxiety or depression). The results are discussed in light of a socioecological framework, with special emphasis on the importance of including (and differentiating between) both fathers and mothers in the investigation of ethnic-racial socialization and implications for future theory building, research, and clinical practice.

Sociocultural stressors across the perinatal period and risk for postpartum depressive symptoms in women of Mexican descent.

OBJECTIVES: In the United States, women of Mexican descent are affected by postpartum depression at disproportionate rates, often two to three times higher than the general population. Sociocultural stressors may contribute to this disparity. Traditionally, these stressors are measured at a single time point, and it is unknown if sociocultural stressors change from pregnancy to the postnatal period and if they are related to postpartum depressive symptoms. METHOD: Pregnant women of Mexican descent (N = 159) were assessed for acculturation (Mexican and Anglo orientation), perceived discrimination, acculturative stress, perceived stress, and depressive symptoms during the first trimester and postpartum period. RESULTS: Women reported increases in Mexican orientation, t(126) = -3.503, p = .01, and decreases in acculturative stress, t(159) = -3.503, p < .001, and perceived stress, t(159) = 6.332, p < .001, from pregnancy to postpartum. Only increases in Mexican orientation were associated with less postpartum depressive symptoms (R² = 0.050, B = -2.210, SE = 0.996, t = -2.120, p = .028), even when controlling for covariates. In addition, postnatal measurements of elevated acculturative stress and less Mexican orientation (R² = 0.127, B = 0.133, SE = 0.036, t = 3.721, p < .001; B = -2.194, SE = 0.769, t = -2.853, p < .001, respectively) were associated with more postpartum depressive symptoms; however, only Mexican orientation remained significant after covariates. CONCLUSIONS: Sociocultural stressors change across the perinatal period and contribute to postpartum depressive symptoms. Findings implicate a need for consideration of sociocultural stressors in postpartum depression prevention. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Ni de aquí, ni de allá: Puerto Rican acculturation-acculturative stress profiles and depression.

OBJECTIVE: Acculturation-acculturative stress profiles and their association with depression symptoms were examined in a sample of mainland Puerto Ricans (N = 367) using latent profile analysis. METHODS: Bidimensional behavioral acculturation, bidimensional ethnic identity, and acculturative stress were used as indicators to derive profiles. Differences in depressive symptoms across latent profile members were determined using an automatic mixture modeling with continuous outcomes approach. RESULTS: Three profiles were identified, each demonstrating a distinctive configuration of adherence to bidimensional behavioral acculturation, bidimensional ethnic identity, and level of acculturative stress. The largest profile resembled individuals following a partial marginalization strategy. Participants in this profile were also reported more depression symptoms than all other participants. CONCLUSIONS: The identification of a large partial marginalization profile offers important information about sociocultural indicators of depression among Puerto Ricans living in the United States. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Unfair treatment, coping strategies, and depression among Puerto Ricans in Boston.

OBJECTIVES: Unfair treatment is a chronic social stressor with negative consequences for the mental health status of socially disadvantaged individuals. How individuals cope with stressful situations may reduce or amplify the mental burden associated with unfair treatment. The present study focuses on identifying coping strategies that mitigate the association between unfair treatment and the risk of clinical depression among Puerto Ricans, 1 of the largest Latinx subgroups in the U.S. METHOD: Data were from the third wave of the Boston Puerto Rican Health Study. Using logistic regression, we tested the moderating roles of 12 types of coping strategies in the associations between recent experiences of perceived unfair treatment and depression among 963 Puerto Rican adults, aged 49 to 81, living in the Boston, MA metropolitan area. RESULTS: Increased exposure to perceived unfair treatment was associated with higher odds of being at risk of clinical depression. Results suggest that coping strategies such as planning, acceptance, humor, and religion significantly mitigate the association between recent unfair treatment and depression. CONCLUSIONS: Our findings offer guidance on developing a culturally sensitive therapy for Puerto Ricans that promotes specific types of coping strategies to reduce the mental burden of unfair treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Impact of Living Alone and Intergenerational Support on Depressive Symptoms Among Older Mexican Americans: Does Gender Matter?

The study examined gender differences in the impact of living alone and intergenerational support on depressive symptoms among Mexican American older adults. The sample included 335 parent-adult child pairs which are nested within 92 Mexican American respondents, because each respondent reported their specific relationships with each child. Clustered regression analysis showed gender differences in the impact of living alone and intergenerational support on depressive symptoms among Mexican American older adults. In general, older men provided and received less intergenerational support than older women, but their depressive symptoms were more susceptible to living alone and different types of intergenerational support. Factors such as living alone, receiving instrumental support were associated with more depressive symptoms in older men than inolder women, whereas older men benefited more from the emotional closeness with children than older women. The findings highlight the need for a gender-specific approach to future research on this topic.

Loneliness, adolescence, and global mental health: Soledad and structural violence in Mexico.

In this article, we call into question recent public health claims that loneliness is a problem of epidemic proportions. Current research on this topic is hindered by an overreliance on limited survey data and by paradigmatic imbalance that delineates the study of loneliness to psychological, cognitive, neuroendocrinological and immunological effects, social functioning, physical health, mortality, and gene effects. The article emphasizes that scientific approaches to the phenomena of loneliness are more appropriately conceived and investigated as inherently matters for social, relational, cultural, and contextual analysis of subjective experience. Studies of loneliness and possible relationships to mental health status require investigations of social, environmental, and institutional structures as well as families, peers, friends, counselors, and health providers. This article takes a step in this direction through examining the lived experience of 35 high school students and their families living under conditions of social adversity in Tijuana, B.C., Mexico, with attention to anxiety and depression. Utilizing ethnographic interviews, observations, and psychological screening tools, we provide an overview for the group and illustrate the interrelations of subjective experience and social environment through a case study. These data reveal the vital role of understandings of loneliness, depression, and anxiety from the perspectives of adolescents themselves. We conclude that future studies of loneliness are best informed by in-depth data on subjective experience in relation to social features to advance understandings within the field of global mental health and allied fields.

The impact of comorbid depression-diabetes on proteomic outcomes among community-dwelling Mexican Americans with mild cognitive impairment.

BACKGROUND: Mexican Americans suffer from a disproportionate burden of modifiable risk factors, which may contribute to the health disparities in mild cognitive impairment (MCI) and Alzheimer's disease (AD). OBJECTIVE: The purpose of this study was to elucidate the impact of comorbid depression and diabetes on proteomic outcomes among community-dwelling Mexican American adults and elders. METHODS: Data from participants enrolled in the Health and Aging Brain among Latino Elders study was utilized. Participants were 50 or older and identified as Mexican American (N = 514). Cognition was assessed via neuropsychological test battery and diagnoses of MCI and AD adjudicated by consensus review. The sample was stratified into four groups: Depression only, Neither depression nor diabetes, Diabetes only, and Comorbid depression and diabetes. Proteomic profiles were created via support vector machine analyses. RESULTS: In Mexican Americans, the proteomic profile of MCI may change based upon the presence of diabetes. The profile has a strong inflammatory component and diabetes increases metabolic markers in the profile. CONCLUSION: Medical comorbidities may impact the proteomics of MCI and AD, which lend support for a precision medicine approach to treating this disease.