Disparities in the Prevalence and Correlates of Disability in Older Immigrants in the USA: a Systematic Review of the Literature.

ABSTRACT

BACKGROUND: Disability in older adults leads to poor quality of life, is costly for the health system, and is a risk for mortality. Little is known about disability in older immigrants to the USA. OBJECTIVE: To synthesize the evidence on the prevalence and factors associated with disability in older adult immigrants. METHODS: We conducted searches in PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. Disability was defined as difficulty in performing basic or instrumental activities of daily living. Older adult was defined as 65 years and older. Immigrant status was defined as someone born outside of the USA. RESULTS: Eighteen articles met the inclusion criteria. Seven studied Hispanic/Latino immigrants, six studied Asian immigrants, four studied diverse older immigrant samples, and one studied European immigrants. Prevalence of disability ranged from 2 to 49% in Asians and 3 to 58.1% in Hispanic/Latinos. In a diverse sample of immigrants, the prevalence of disability was 19.3%. Correlates of disability included female gender, low income, limited education, single status, migration in late adulthood, obesity, arthritis, and diabetes. Factors protective against disability in older adult immigrants were acculturation, migrating at a younger age, exercise, alcohol intake, and church attendance. CONCLUSION: Disability prevalence was generally lower in Asian immigrants compared to Hispanic/Latino immigrants. Identification of the precise rates and factors associated with disability in older immigrants can inform health interventions for this population.