Trajectories of Depressive Symptoms in Elderly Mexican Americans

The older population in the United States is expected to grow more diverse in the coming years. Older Latinos, in particular, accounted for 7% of the population aged 65 and older in 2010 and are projected to increase to 20% by 2050.1 The Mexican-origin population is the largest subgroup of Latinos in the United States, representing approximately half of the Latino population aged 65 and older according to the 2012 Census.2 Research on mortality risk indicates that Latinos, on average, tend to live longer than non-Latino whites but do so with higher rates of comorbidities, disability, and frailty in middle age and late life.3–7 Disability and comorbidities are accompanied by risk of depression. Elderly Latinos, especially Mexican Americans, tend to report more depressive symptoms in the past week8 and past year9 than non-Latino whites. The current study contributes to the Latino health and aging literature in three important ways. First, it goes beyond static analyses to understand diverse levels and changes in depressive symptoms to better describe variations in psychological distress over time. Understanding these patterns, as well as risk factors for increasing depressive symptoms, will indicate target subpopulations for intervention efforts. Second, a recent study found that Latinos in mid- and late life were at greater risk of depressive symptoms over a 10-year period than non-Latinos.10 Investigating trajectories in Latino subgroups is important given differences in cultural and economic needs. The Mexican-origin population has especially high rates of comorbidities and represents a disproportionate share of the poor11 and therefore was expected to be at risk for high depressive symptoms across the study waves. Third, the current study focused on the role of nativity status. The healthy immigrant hypothesis suggests that immigrants have a health advantage over native-born adults,7 although at older age, because of acculturative strain processes, there is a convergence or crossover. Recent research demonstrates that major depression is more prevalent in foreign-born Latinos than native-born Latinos but only in late life.10 Given the advanced age of the current study sample, it was expected that foreign-born Latinos would be at greater risk of high depressive symptoms than those who were native born. The current study used data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (Hispanic EPESE, 2004–05, 2007–08, 2010–11) (N = 1,487) on adults aged 75 and older. The current study identifies the latent structure of depressive symptoms over a 7-year study period, and factors associated with trajectory group membership. Identifying risk factors is especially important given depression's ability to limit the care and maintenance of chronic conditions such as diabetes mellitus and heart disease, which are highly prevalent in this population and increase the risk of mortality.12–15 In accordance with previous research on depression, it was expected low levels of social support, being foreign born, living alone, being female, low socioeconomic standing, and high levels of cognitive and functional limitations would put individuals at risk of high depressive symptoms.15–21