Limited English Proficiency and Trajectories of Depressive Symptoms Among Mexican American Older Adults.

BACKGROUND AND OBJECTIVES: This study examined the effect of limited English proficiency (LEP) on trajectories of depressive symptoms among Mexican American older adults in the United States. RESEARCH DESIGN AND METHODS: The sample was drawn from Waves 1 to 6 (1993-2007) of the Hispanic Established Population for Epidemiological Studies of the Elderly (H-EPESE). A total of 2,945 Mexican American older adults were included in the analyses. A latent growth curve modeling was conducted. RESULTS: After adjusting for covariates, results show that Mexican American older adults with LEP had higher levels of depressive symptoms than those with English proficiency (EP) at baseline as well as over a 14-year period. Differential trajectories were observed between those with LEP and EP over time, indicating that those with LEP had a significantly steeper curve of depressive symptom trajectories over time than those with EP. DISCUSSION AND IMPLICATIONS: These results suggest that LEP is a risk factor not merely for greater depressive symptomatology at each time point, but for an accelerated trajectory of depressive symptoms over time among Mexican American older adults. Overall, the findings emphasize the need to assist not only the informal support system of Mexican American older adults with LEP, but also the formal system.

Acculturation and depressive symptoms among Mexican American elders new to the caregiving role: results from the Hispanic-EPESE.

OBJECTIVE: The purpose of this study was to identify characteristics associated with becoming a caregiver among Mexican American (MA) elders and to examine predictors of depressive symptoms among the new caregivers 2 years later. METHOD: Drawn from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE), 152 MA recent caregivers and 2,023 other MAs were compared. Residualized change regression analysis was conducted. RESULTS: At baseline, MAs who had recently become caregivers exhibited a significantly greater number of depressive symptoms compared to those who had not. Controlling for background characteristics, physical health, social support, and baseline depressive symptoms, regression analysis revealed that 2 years later higher acculturation was related to a greater number of depressive symptoms among those who at baseline were new caregivers. DISCUSSION: Better knowledge of the within-group differences among MA elderly caregivers, especially with respect to acculturation, may better inform interventions for this at-risk group.

Cultural equivalence in depressive symptoms in older white, black, and Mexican-American adults.

OBJECTIVES: To examine cultural equivalence in responses to depressive symptom items of three racial or ethnic elderly groups. DESIGN: Cross-sectional analyses of two national data sets. SETTING: The New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE) and the five-state Hispanic EPESE (H-EPESE). PARTICIPANTS: Whites (n=1,876) and blacks (n=464) were drawn from the New Haven EPESE and Mexican Americans (n=2,623) were drawn from the H-EPESE. MEASUREMENT: The original 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS: From differential item functioning analyses, a lack of measurement equivalence was found for 16 depressive symptom items. Mexican Americans were predisposed to endorse 12 depressive symptoms. Blacks were more likely than whites to endorse two interpersonal items (unfriendly and disliked). Mexican Americans were more likely than whites to respond to four positive affect items (good, hopeful, happy, and enjoyed) and more likely than blacks to endorse three positive items (good, happy, and enjoyed). CONCLUSION: Results suggested response bias to depressive symptom items in racially and ethnically diverse older adults. Mexican Americans were more likely than whites to endorse the large number of depressive symptom items. Blacks were much more likely to respond in patterns similar to those of the whites. Findings from this study provide a foundation for developing culturally appropriate depression measures in health disparities research.