Objective. We reviewed recent evidence on the apparent Hispanic mortality paradox. Methods. Recent studies using vital statistics, national community surveys linked to the National Death Index, Medicare data linked to application records for social security cards maintained in the Social Security Administration NUDIMENT file, and mortality follow-up by regional studies are reviewed critically. Results. Data based on vital statistics show the greatest mortality advantage compared with non-Hispanic Whites for all Hispanics combined. The advantage is greatest among older people. National Community Surveys linked to the National Death Index show a narrowing of the advantage, and one study suggests that the Mexican Origin mortality advantage can be attributed to selective return migration of less healthy immigrants to Mexico. The Medicare–NUDIMENT data that avoid problems of other data sets also show an advantage in mortality among Hispanic elders, although the advantage is considerably lower than is found using the vital statistics method. Discussion. Although some research has recently begun to question whether indeed all Hispanic groups enjoy a mortality advantage, the majority of the evidence continues to support a mortality advantage at a minimum among Mexican Americans and especially in old age, at least among men, which may provide partial, albeit indirect, support for a selective return migration or “salmon bias” effect. There is a need to further explore the existence of a selective return migration effect with expanded data bases that include more subjects from the various Hispanic origins. To date, the majority of the evidence continues to support the Hispanic paradox at least among people of Mexican origin and calls for additional attention to this interesting and highly important phenomenon.

Background. Cognitive decline and dementia are associated with disability and premature death in old age. We examined whether low handgrip strength predicts subsequent cognitive decline in older Mexican Americans. Methods. We worked with a 7-year prospective cohort of 2160 noninstitutionalized Mexican Americans aged 65 years or older from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE) who had a Mini-Mental State Examination (MMSE) score ≥ 21 at baseline. Measures included: (i) sociodemographic factors (age, gender, and education), handgrip strength, and near and distant visual impairment from baseline interview; and (ii) MMSE, body mass index (BMI), and medical conditions (stroke, heart attack, diabetes, depression, and hypertension) from four waves of data collection. Results. Using general linear mixed models, we found a significant trend with scores in the lowest quartile of handgrip strength at baseline to be associated with lower MMSE scores over time (estimate = −1.28, standard error = 0.16; p <.0001). There was a significant handgrip Strength-by-Time interaction with MMSE scores. Participants in the lowest handgrip strength quartile had a greater cognitive decline over time (estimate = −0.26, standard error = 0.07; p <.001) than did those participants in the highest quartile. This association remained statistically significant after controlling for potential confounding factors. Conclusion. Older Mexican Americans with reduced handgrip strength at baseline demonstrated a statistically significant decline in cognitive function over a 7-year period. By contrast, participants in the highest handgrip strength quartile maintained a higher level of cognitive function.

Background. The purpose of this analysis was to examine the association of sociodemographic variables and health-related conditions with 5-year declines in cognitive function among Mexican American elderly persons. Methods. The cognitive function of 1759 participants was assessed by using the Mini-Mental State Examination (MMSE) in 1993/1994 and again in 1998/1999. Cognitive decline was defined by two sets of criteria: ⁽¹⁾ a drop to 17 or below on the MMSE at follow-up, and ⁽²⁾ a decline of at least three points, the mean change in MMSE scores among respondents who obtained scores at or above the 5th percentile distribution at baseline. Results. Cognitive decline was significantly associated with sociodemographic variables including age, education, marital status, and household composition. In addition, respondents with reported vision impairment, stroke, and diabetes were at increased risk for cognitive decline after controlling for multiple potential confounders. Conclusion. Although age and education have been reported as the more salient predictors of cognitive deterioration, other sociodemographic and several medical conditions including stroke and diabetes should be considered as part of cognitive aging studies among Mexican American elders.

Previous research on frailty in older adults has focused on morbidity and mortality. The purpose of this study was to elicit the relationship between being non-frail, pre-frail, or frail and health related quality of life in a representative sample of older Mexican Americans surveyed in 2005–2006.