The dementia care study (D-CARE): Recruitment strategies and demographic characteristics of participants in a pragmatic randomized trial of dementia care.

INTRODUCTION: Pragmatic research studies that include diverse dyads of persons living with dementia (PLWD) and their family caregivers are rare. METHODS: Community-dwelling dyads were recruited for a pragmatic clinical trial evaluating three approaches to dementia care. Four clinical trial sites used shared and site-specific recruitment strategies to enroll health system patients. RESULTS: Electronic health record (EHR) queries of patients with a diagnosis of dementia and engagement of their clinicians were the main recruitment strategies. A total of 2176 dyads were enrolled, with 80% recruited after the onset of the pandemic. PLWD had a mean age of 80.6 years (SD 8.5), 58.4% were women, and 8.8% were Hispanic/Latino, and 11.9% were Black/African American. Caregivers were mostly children of the PLWD (46.5%) or spouses/partners (45.2%), 75.8% were women, 9.4% were Hispanic/Latino, and 11.6% were Black/African American. DISCUSSION: Health systems can successfully enroll diverse dyads in a pragmatic clinical trial.

Longitudinal associations between cognitive functioning and depressive symptoms among couples in the Mexican Health and Aging Study.

OBJECTIVE: To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time and replicate previous findings from the United States (US) in Mexico. DESIGN: Longitudinal, dyadic path analysis with the actor-partner interdependence model. SETTING: Data were from the three most recent interview waves (2012, 2015, and 2018) of the Mexican Health and Aging Study (MHAS), a longitudinal national study of adults aged 50+ years in Mexico. PARTICIPANTS: Husbands and wives from 905 community-dwelling married couples (N = 1,810). MEASUREMENTS: The MHAS cognitive battery measured cognitive function. Depressive symptoms were assessed using a modified nine-item Center for Epidemiologic Studies Depression Scale. Baseline covariates included age, education, number of children, limitation with any activity of daily living, limitation with any instrumental activity of daily living, and pain. RESULTS: As hypothesized, there were significant within-individual associations in which one person's own cognitive functioning and own depressive symptoms predicted their own follow-up cognitive functioning and depressive symptoms, respectively. In addition, a person's own cognitive functioning predicted their own depressive symptoms, and a person's own depressive symptoms predicted their own cognitive functioning over time. As hypothesized, there was a significant partner association such that one person's depressive symptoms predicted more depressive symptoms in the partner. CONCLUSION: Findings from this study of older Mexican couples replicates findings from studies of older couples in the US, showing that depressive symptoms in one partner predict depressive symptoms in the other partner over time; however, there was no evidence for cognition-depression partner associations over time.

20 years of the Mexican Health and Aging Study.

The Mexican Health and Aging Study (MHAS) is a longitudinal study using a national sample of approximately 15,000 community-dwelling adults aged 50 years old and older in Mexico. Spanning over 20 years (2001-2021), six waves of data collection establish the MHAS as the leading data platform for the study of aging in Latin America.

The impact of insomnia symptoms on obesity among Mexicans aged 50 and older.

OBJECTIVE: To examine the association between insomnia and obesity in Mexican adults aged 50 and older. MATERIALS AND METHODS: We used data from the Mexican Health and Aging Study (2015-2018). Self-reported insomnia was measured using the modified insomnia severity index with scores ranging from zero to six. Obesity was categorized using body mass index (BMI ≥ 30 kg/m2). We used generalized estimating equations to assess the association between insomnia and obesity over three years. RESULTS: Insomnia was associated with obesity (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.01,1.11), among those with no obesity at baseline. Among those with obesity, insomnia was not associated with changes in BMI. Lastly, obesity was not associated with changes in insomnia symptoms. CONCLUSION: This work highlights the association between insomnia and obesity among older Mexican adults and demonstrates the importance of further studies on the effects of insomnia within this population.

Midlife Vascular Factors and Prevalence of Mild Cognitive Impairment in Late-Life in Mexico.

OBJECTIVE: To estimate the prevalence of mild cognitive impairment (MCI) and its subtypes and investigate the impact of midlife cardiovascular risk factors on late-life MCI among the aging Mexican population. METHOD: Analyses included a sample of non-demented adults over the age of 55 living in both urban and rural areas of Mexico (N = 1807). MCI diagnosis was assigned based on a comprehensive cognitive assessment assessing the domains of memory, executive functioning, language, and visuospatial ability. The normative sample was selected by means of the robust norms approach. Cognitive impairment was defined by a 1.5-SD cut-off per cognitive domain using normative corrections for age, years of education, and sex. Risk factors included age, education, sex, rurality, depression, insurance status, workforce status, hypertension, diabetes, stroke, and heart disease. RESULTS: The prevalence of amnestic MCI was 5.9%. Other MCI subtypes ranged from 4.2% to 7.7%. MCI with and without memory impairment was associated with older age (OR = 1.01 [1.01, 1.05]; OR = 1.03 [1.01, 1.04], respectively) and residing in rural areas (OR = 1.49 [1.08, 2.06]; OR = 1.35 [1.03, 1.77], respectively). Depression (OR = 1.07 [1.02, 1.12]), diabetes (OR = 1.37 [1.03, 1.82]), and years of education (OR = 0.94 [0.91, 0.97]) were associated with MCI without memory impairment. Midlife CVD increased the odds of MCI in late-life (OR = 1.76 [1.19, 2.59], which was driven by both midlife hypertension and diabetes (OR = 1.70 [1.18, 2.44]; OR = 1.88 [1.19, 2.97], respectively). CONCLUSIONS: Older age, depression, low education, rurality, and midlife hypertension and diabetes were associated with higher risk of late-life MCI among older adults in Mexico. Our findings suggest that the causes of cognitive impairment are multifactorial and vary by MCI subtype.

Socioeconomic Disparities and Gender Inequalities in Dementia: a Community-Dwelling Population Study from a Middle-Income Country.

The proportion of the world's older adults and of its dementia cases is increasing in low and middle-income countries. This is particularly true in Colombia. There, the number of individuals with dementia may increase five-fold by 2050. Yet research is lacking on dementia in such settings. This work estimates the prevalence of dementia in a community-dwelling population in Colombia. It also assesses how gender-based differences in cardiovascular conditions and socioeconomic disparities affect dementia. This work analyzes data on 2000 respondents at least 60 years of age in the Health, Well-Being, And Aging (SABE) study in Bogota. Respondents with dementia are those who have cognitive impairment and at least two limitations in instrumental activities of daily living. The SABE study finds 8.4% of respondents have dementia. Age, cardiovascular risks, and socioeconomic disparities contributed to higher odds of dementia. The contributors to dementia can differ for men and women. For example, socioeconomic disparities were a larger contributor to dementia for women than men. The findings support the cognitive reserve hypothesis on dementia. This holds that pre-existing cognitive processes and compensatory mechanisms influence dementia. Women in Latin America are more likely to suffer from socioeconomic disparities that limit their cognitive reserve. This research points to several policy implications that can help offset these disparities and reduce the prevalence of dementia.

Epigenetic variations due to nutritional status in early-life and its later impact on aging and disease.

Epigenetics refers to changes in gene function, not resulting from the primary DNA sequence, influenced by the environment. It provides a link between the molecular regulation of the genome and the environmental signals exposed during the life of individuals (including lifestyle, social behavior, development, and nutrition). Notably, early development (intrauterine or postnatal) is highly influenced by the adverse socioeconomic status that leads to malnutrition or obesity; these conditions induce changes over the fetal epigenetic programming and can be transferred by transgenerational inheritance, inducing alterations of the transcription of genes related to several metabolic and neurological processes. Moreover, obesity during pregnancy, and excessive gestational weight gain are associated with an increased risk of fatal pregnancy complications, and adverse cardio-metabolic, respiratory and cognitive-related outcomes of the future child. However, most of our knowledge in this field comes from experimental animal models, that partially resemble the nutritional effects of humans. In this context, nutritional effects implicated in historical famines represent valuable information about the transgenerational effects of undernutrition and stress. In the present review, we attempt to describe the most outstanding results from the most studied famines about the impact of malnutrition on the epigenome.

The effect of educational attainment on cognition of older adults: results from the Mexican Health and Aging Study 2001 and 2012.

Objective: This paper seeks to document changes in the effect of educational attainment on cognitive function of older adults in Mexico, and measure gender differences using data from two time periods. Methods: The data come from the Mexican Health and Aging Study (MHAS), taking the cross-sections of adults aged 60 years or older interviewed in 2001 and 2012. We perform an OLS regression using standardized z-scores for five individual cognitive domains and for total cognition. Results: Total cognitive scores and educational attainment were higher for men than women in both years. When cognitive components were analyzed separately, women had higher verbal memory and verbal recall scores than men. The gender gap in overall cognition score was smaller in 2012 compared to 2001, while the gender gap in educational attainment was larger in 2012 than in 2001. Even though men had higher educational attainment than women, the effect of educational attainment on cognition was higher for women. Similarly, the difference between total scores for each task for men compared to women decreased between 2012 and 2001, except for verbal learning and verbal recall where the gender difference widened. Conclusions: If younger cohorts of women continue to progressively achieve higher levels of education, the gender gap in old-age cognition should close. Additional work should determine the mechanisms through which added formal education seems to translate into higher cognitive gains for women compared to men.

Frailty and sarcopenia in Bogotá: results from the SABE Bogotá Study.

BACKGROUND: Latin American countries like Colombia are experiencing a unique aging process due to a mixed epidemiological regime of communicable and non-communicable diseases. AIMS: To estimate the prevalence of frailty and sarcopenia among older adults in Colombia and identify variables associated with these conditions. METHODS: Data come from the "Salud Bienestar y Envejecimiento" (SABE) Bogotá Study, a cross-sectional study conducted in 2012 in Bogotá, Colombia. Sociodemographic, health, cognitive and anthropometric measures were collected from 2000 community-dwelling adults aged 60 years and older. Frailty variable was created using the Fried phenotype and sarcopenia following the European Working Group on Sarcopenia in Older People algorithm. Logistic regression analyses were used to identify factors associated with frailty and sarcopenia. RESULTS: A total of 135 older adults are frail (9.4 %), while 166 have sarcopenia (11.5 %). Older age and female gender have a significant association with both conditions (Frailty: Age OR 1.05, 95 % CI 1.03-1.06, Gender OR 1.44, 95 % CI 1.12-1.84; Sarcopenia: Age 1.04, 95 % CI 1.02-1.07, Gender OR 1.51, 95 % CI 1.05-2.17). Depression was also significantly associated with frailty (OR 1.17, 95 % CI 1.12-1.22), while smoking was significantly associated with sarcopenia (OR 2.38, 95 % CI 1.29-4.37). Finally, higher function, measured by independence in IADL (Instrumental Activities of Daily Living) was significantly associated with less frailty (OR 0.74, 95 % CI 0.64-0.86). Education, higher number of comorbidities, better MMSE score, activities of daily living disability and alcohol consumption were not significantly associated with frailty or sarcopenia. CONCLUSIONS: Frailty, sarcopenia and multimorbidity are overlapping, yet distinct conditions in this sample. There are potentially reversible factors that are associated with frailty and sarcopenia in this sample. Future studies need to analyze the best way to prevent these conditions, and examine individuals that have frailty, sarcopenia and comorbidities to design interventions to improve their quality of life.

Mortality inequality among older adults in Mexico: the combined role of infectious and chronic disease.

OBJECTIVE: To assess the effects of education and chronic and/or infectious disease, and the interaction between both variables, on the risk of dying among Mexicans 60 years and older. METHODS: Using data from the Mexican Health and Aging Study (MHAS), logistic regressions were performed to estimate the risk of mortality for older Mexicans between 2001 and 2003. Estimated mortality risks associated with chronic disease, infectious disease, and a combination of both were used to estimate additional life expectancy at age 60. RESULTS: Compared to the group with some schooling, the probability of dying over the twoyear inter-wave period was 26% higher among those with no schooling. Not having at least one year of formal education translated into a shorter additional life expectancy at age 60 by 1.4-2.0 years. Having chronic and/or infectious disease also increased the risk of mortality during the same period CONCLUSIONS: These results indicate that 1) a mixed epidemiological regime (the presence of both chronic and infectious disease) adds to the mortality health burden experienced by older people, and 2) there are persistent inequalities in mortality risks based on socioeconomic status.

Does a Reduction in Receiving Assistance With Daily Activities Among Older Adults in Mexico Indicate An Increase in Unmet Needs or a Decrease in Needs for Care?

OBJECTIVES: The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care. METHODS: We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (n = 4,805) and 2018 (n = 6,494). ADL tasks were dressing, walking, bathing, getting in and out of bed, and toileting. Participants who reported difficulty with an ADL were asked if anyone helped them with the task. Logistic regression was used to estimate adjusted odds ratios (aOR) for cohort differences in ≥1 ADL limitations and help with ≥1 ADL. We used a decomposition analysis to identify participant characteristics that mediated cohort differences in receiving help with ≥1 ADL. RESULTS: The 2018 cohort had higher odds for ≥1 ADL limitations (aOR = 1.85, 95% CI = 1.60-2.14) but lower odds for help with ≥1 ADL (aOR = 0.66, 95% CI = 0.49-0.89). Among participants with ADL disability, the 2018 cohort had fewer living children and a lower prevalence of probable dementia. The lower number of living children and lower prevalence of probable dementia explained 9.34% and 43.7% of the cohort effect on receiving help with ≥1 ADL, respectively. DISCUSSION: The declining percentage of older adults in Mexico with ADL disability receiving assistance may not reflect increasing unmet needs. However, the increased prevalence of ADL disability will increase the number of older adults needing informal care.

The Patient Protection and Affordable Care Act and oral health care use among formerly incarcerated people in the United States.

BACKGROUND: Formerly incarcerated people report less frequent oral health care use, despite having more substantial oral health problems. This study aimed to determine whether the adoption of the Patient Protection and Affordable Care Act (ACA) has improved oral health care use among formerly incarcerated people in the United States. METHOD: Data were from Wave I (1994-1995), Wave IV (2008), and Wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (n = 9,108), a nationally representative cohort study in the United States. RESULTS: On the basis of the results of multiple logistic regression analysis with interaction terms, the authors found a positive and statistically significant interaction between prior incarceration and living in a state with ACA adoption on past-year oral health care use, net of potential confounding variables (incarceration × ACA: odds ratio, 1.587; 95% CI, 1.043 to 2.414). Substantively, the findings suggest that people with a history of incarceration are less likely to use oral health care, and this disparity is more likely to occur in states without ACA adoption. CONCLUSIONS: ACA adoption corresponds with improvements in the receipt of oral health care among formerly incarcerated people. PRACTICAL IMPLICATIONS: This study builds on prior evidence highlighting that the ACA is beneficial in connecting formerly incarcerated people to health care services and suggests that these benefits may extend to improving access to and use of oral health care.

History of Incarceration and Dental Care Use Among Older Adults in the United States.

INTRODUCTION: Dental care is a critical component of healthy aging; however, emerging evidence suggests that having been previously incarcerated is a risk factor for not using dental care services. This study investigates the relationship between prior incarceration and dental care among older adults and assesses whether wealth and dental insurance explain this relationship. METHODS: Data are from the Health and Retirement Study, a nationally representative sample of community-dwelling older adults in the United States, collected in 2012 and 2014. Multivariable logistic regression is used to assess the relationship between a history of incarceration and dental care. Mediation analyses were conducted using the Karlson-Holm-Breen method of indirect effects in non-linear models. Statistical analyses were conducted from February to April 2024. RESULTS: Adjusting for potential confounding variables, a respondent's prior incarceration is associated with a 25% lower odds of dental care use (adjusted odds ratio [aOR] = 0.748, 95% CI = 0.624, 0.896). The relationship between incarceration and dental care use is fully mediated-over 90% is explained by-wealth and having dental care insurance. Prior incarceration decreased the likelihood of dental care only among non-Hispanic White respondents. CONCLUSIONS: The findings offer new evidence that prior incarceration is a risk factor for lacking the ability to utilize dental care among older adults and suggest that broader consequences of incarceration for wealth accumulation and access to dental insurance underpin this relationship. These results suggest the urgent need to expand access to affordable dental care services for older adults with a history of incarceration.

Patient Priorities Care Increases Long-Term Service and Support Use: Propensity Match Cohort Study.

OBJECTIVES: Patient priorities care (PPC) is an evidence-based approach designed to help patients achieve what matters most to them by identifying their health priorities and working with clinicians to align the care they provide to the patient's priorities. This study examined the impact of the PPC approach on long-term service and support (LTSS) use among veterans. DESIGN: Quasi-experimental study examining differences in LTSS use between veterans exposed to PPC and propensity-matched controls not exposed to PPC adjusting for covariates. SETTING AND PARTICIPANTS: Fifty-six social workers in 5 Veterans Health Administration (VHA) sites trained in PPC in 2018, 143 veterans who used the PPC approach, and 286 matched veterans who did not use the PPC approach. METHODS: Veterans with health priorities identified through the PPC approach were the intervention group (n = 143). The usual care group included propensity-matched veterans evaluated by the same social workers in the same period who did not participate in PPC (n = 286). The visit with the social worker was the index date. We examined LTSS use, emergency department (ED), and urgent care visits, 12 months before and after this date for both groups. Electronic medical record notes were extracted with a validated natural language processing algorithm (84% sensitivity, 95% specificity, and 92% accuracy). RESULTS: Most participants were white men, mean age was 76, and 30% were frail. LTSS use was 48% higher in the PPC group compared with the usual care group [odds ratio (OR), 1.48; 95% CI, 1.00-2.18; P = .05]. Among those who lived >2 years after the index date, new LTSS use was higher (OR, 1.69; 95% CI, 1.04-2.76; P = .036). Among nonfrail individuals, LTSS use was also higher in the PPC group (OR, 1.70; 95% CI, 1.06-2.74; P = .028). PPC was not associated with higher ED or urgent care use. CONCLUSIONS AND IMPLICATIONS: PPC results in higher LTSS use but not ED or urgent care in these veterans. LTSS use was higher for nonfrail veterans and those living longer. The PPC approach helps identify health priorities, including unmet needs for safe and independent living that LTSS can support.

Caregiving to Older Adults With a Physical Limitation: Evidence From the Mexican Health and Aging Study.

Background and Objectives: Many older adults face physical limitations to performing activities of daily life (ADLs) and instrumental activities of daily life (IADLs) and seek help performing them. In Mexico, family caregivers, especially spouses and adult children, traditionally take care of older adults. However, a detailed characterization of the care received has not been thoroughly provided. We sought to identify socioeconomic, demographic, and health-related differences in receiving help among older adults reporting physical limitations. Research Design and Methods: Using the 2012 wave of the Mexican Health and Aging Study, we provided information on adults aged 60 and older who reported one or more physical limitations and whether they received help or not. We estimated 2 logistic regression models to obtain the odds ratios (ORs) of receiving help among individuals with an ADL limitation and those with an IADL limitation. Results: Adults with ADL limitations received, on average, approximately 10.7 hr of assistance per day, whereas those with at least 1 IADL limitation received around 7.7 hr of help per day. Women were more likely to receive help with ADLs than men (OR = 2.35). Individuals with chronic conditions such as hypertension, diabetes, and arthritis also received more help with both ADLs and IADLs. Discussion and Implications: Our work suggests that help received does respond to the care needs of older adults, but future research should focus on the burden of care for caregivers and expand this analysis using a longitudinal data approach.

COVID-19 And Mental Health Outcomes Of Older Adults: Evidence From Mexico.

Estimates using data from the Mexican Health and Aging Study, a national longitudinal sample of older adults in Mexico, show elevated risk for negative mental health outcomes for those experiencing COVID-19 infection or major COVID-19-related adverse events. Predicted elevated probabilities were greater for a major adverse event than for COVID-19 infection, and they varied across sociodemographic groups defined by age, sex, education, and urban-rural residence.

Considerations When Designing and Implementing Pragmatic Clinical Trials That Include Older Hispanics.

Introduction: Pragmatic clinical trials (PCTs) are designed to connect researchers with clinicians to assess the real-world effectiveness and feasibility of interventions, treatments, or health care delivery strategies in routine practice. Within PCTs larger, more representative sampling is possible to improve the external validity of the research. Older adults from underrepresented groups can benefit from PCTs given their historically lower engagement in clinical research. The current article focuses on older Hispanic adults with Alzheimer disease and related dementias (ADRDs). Older Hispanic adults represent 19% of the US population and have a higher prevalence of ADRDs than Whites. We provide data from 2 PCTs about the recruitment of older Hispanics with ADRDs and discuss unique challenges associated with conducting PCTs and propose strategies to overcome challenges. Data and Methods: The first PCT outlined is the Patient Priorities Care for Hispanics with Dementia (PPC-HD) trial. PPC-HD is testing the feasibility of implementing a culturally adapted version of the Patient Priorities Care approach for older Hispanic adults with multiple chronic conditions and dementia. The second PCT is the Dementia Care (D-CARE) Study, which is a multisite pragmatic study comparing the effectiveness of a health care system-based approach and a community-based approach to dementia care to usual care in patients with ADRDs and their family caregivers. Lessons Learned and Recommendations for Future Studies: The lessons learned are summarized according to the various stakeholders that need to work together to effectively recruit diverse participants for PCTs: individuals, health care systems, research teams, and communities. Individual-level considerations include communication, priorities, and flexibility. Health care system-level considerations are grounded in 4 principles of Community-Based Participatory Research and include collaboration/partnership, available resources, priorities of the health care system, and sustainability. Research team-level considerations include team members, intentionality, and communication. Community-level considerations highlight the importance of partnerships, community members, and appropriate incentives. Discussion: PCTs provide a unique and potentially impactful opportunity to test interventions in real-world settings that must be culturally appropriate to reach underrepresented groups. Collectively, considering variables at multiple levels to address the needs of older adults with ADRDs is crucial, and the examples and suggestions provided in this report are a foundation for future research.

Social and Leisure Activities Predict Transitions in Cognitive Functioning in Older Mexican Adults: A Latent Transition Analysis of the Mexican Health and Aging Study.

OBJECTIVES: Mexico has a rapidly aging population at risk for cognitive impairment. Social and leisure activities may protect against cognitive decline in older adults. The benefits of these behaviors may vary by patterns of cognitive impairment. The objectives of this study were to identify latent states of cognitive functioning, model the incidence of transitions between these states, and investigate how social and leisure activities were associated with state transitions over a 6-year period in Mexican adults aged 60 and older. METHODS: We performed latent transition analyses to identify distinct cognitive statuses in the 2012 and 2018 waves of the Mexican Health and Aging Study (N = 9,091). We examined the transition probabilities between these states and their associations with social and leisure activities. RESULTS: We identified 4 cognitive statuses at baseline: normal cognition (43%), temporal disorientation (30%), perceptual-motor function impairment (7%), and learning and memory impairment (20%). Various social and leisure activities were associated with reduced odds of death and disadvantageous cognitive transitions, as well as increased odds of beneficial transitions. DISCUSSION: Mapping the effects of popular social and leisure activities onto common patterns in cognitive functioning may inform the development of more enjoyable and effective health-protective behavioral interventions.

Older adults under a mixed regime of infectious and chronic diseases.

OBJECTIVE: Analyze the impact of a mixed regime of infectious and chronic conditions among older adults in Mexico on their health progression. MATERIALS AND METHODS: A total of 12 207 adults from the Mexican Health and Aging Study were included. Logistic regression analyses were conducted to assess the relationship between self-reported health (SRH) and covariates, including infectious and chronic diseases. Changes in SRH between 2001-2003 were analyzed using multinomial analysis. RESULTS: Older age, low SES, poor SRH and type of disease at baseline increase the odds of poor SRH at follow-up. Odds of poor SRH are highest for persons with both types of diseases (OR 2.63, SE 0.24), followed by only chronic (OR 1.86; SE 0.12) and finally only infectious (OR 1.55; SE 0.25). CONCLUSION: Mexico is experiencing a mixed regime of diseases that affects the health and well-being of older adults. Despite the rising importance of chronic diseases in countries like Mexico, it is premature to disregard the relevance of infectious diseases for public health.

Gender differences in activity-limiting pain trajectories over a 17-year period in the Mexican Health and Aging Study.

ABSTRACT: Pain increases with age, disproportionately affects women, and is a major contributor to decreased quality of life. Because pain is dynamic, trajectories are important to consider. Few studies have examined longitudinal trajectories of pain, by gender, in Mexico. We used data from 5 waves (over 2001-2018) of the Mexican Health and Aging Study, a nationally representative sample of Mexicans aged 50 years and older. Pain was categorized as self-reported frequent pain that makes it difficult to do usual activities. Latent class mixture models were used to create pain trajectories (n = 9824). The sample was majority female (56.15%), with a mean age of 61.72 years. We identified 2 pain trajectories: low-stable (81.88%) and moderate-increasing (18.12%). Women had 1.75 times the odds of being in the moderate-increasing group compared with men (95% confidence interval= 1.41, 2.17). In addition, having zero years of education was associated with higher odds of being in the moderate-increasing group, compared with having any years of education. Fair/poor self-rated health, obesity, arthritis, elevated depressive symptoms, and falls were positively associated with pain for both trajectory groups. Being married was positively associated with pain in the low-stable group. Insurance status was negatively associated with pain in the low-stable group, but positively associated with pain in the moderate-increasing group. We identified 2 trajectories of activity-limiting pain, among older Mexican adults (50+) over 17 years of follow-up. Understanding gender differences in pain trajectories in later life and the factors associated with trajectory development is crucial to improve quality of life, especially in vulnerable populations.