Self-reported prevalence and health correlates of functionallimitation among Massachusetts elderly Puerto Ricans, Dominicans, andnon-Hispanic white neighborhood comparison group

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Abstract
BACKGROUND: Limited data suggest that Puerto Ricans experience greaterdisability than other ethnic groups, but few studies have examined thefactors associated with this apparent difference. METHODS: We describe theprevalence of functional limitation and disability in a representativesample of Puerto Rican and Dominican elders in Massachusetts, and in aneighborhood comparison group of non-Hispanic whites (NHWs). We then relatedisability scores, based on both prevalence and severity of ADL or IADLlimitation, with self-reported history of diagnosed healthconditions--adjusting for age, sex, body mass index (BMI; weight kg/heightm(2)), income, education, living alone, smoking, and alcohol use. RESULTS:Seventy-five percent of Dominican women and 73% of Puerto Rican womenreported difficulty with at least one ADL, compared with 64% of NHW women.Puerto Rican men reported significantly more limitation than did NHW orDominican men. Conditions significantly associated with at least twodisability measures among the NHW included smoking, former heavy alcoholuse, arthritis, cataract, respiratory disease, and high BMI, but notstroke, diabetes, history of heart attack, or depression. The patterns forPuerto Ricans differed, with the strongest associations between disabilityand stroke, arthritis, diabetes, and depression, followed by history ofheart attack, high BMI, cataract, poverty status, and respiratory disease.Only arthritis and depression were consistently significantly associatedwith disability among this smaller sample of Dominican elders. CONCLUSIONS:Functional limitation and disability are more prevalent among Puerto Ricansand among Dominican women than among neighborhood NHWs in Massachusetts.Greater disability is associated with the presence of chronic healthconditions, which differ by ethnic group. Additional research is needed tofurther define the social and health factors that contribute to theseethnic differences.

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