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Background: Limited data suggest that Puerto Ricans experience greater disability than other ethnic groups, but few studies have examined the factors associated with this apparent difference.Methods: We describe the prevalence of functional limitation and disability in a representative sample of Puerto Rican and Dominican elders in Massachusetts, and in a neighborhood comparison group of non-Hispanic whites (NHWs). We then relate disability scores, based on both prevalence and severity of ADL or IADL limitation, with self-reported history of diagnosed health conditions--adjusting for age, sex, body mass index (BMI; weight kg/height m(2)), income, education, living alone, smoking, and alcohol use.Results: Seventy-five percent of Dominican women and 73% of Puerto Rican women reported difficulty with at least one ADL, compared with 64% of NHW women. Puerto Rican men reported significantly more limitation than did NHW or Dominican men. Conditions significantly associated with at least two disability measures among the NHW included smoking, former heavy alcohol use, arthritis, cataract, respiratory disease, and high BMI, but not stroke, diabetes, history of heart attack, or depression. The patterns for Puerto Ricans differed, with the strongest associations between disability and stroke, arthritis, diabetes, and depression, followed by history of heart attack, high BMI, cataract, poverty status, and respiratory disease. Only arthritis and depression were consistently significantly associated with disability among this smaller sample of Dominican elders.Conclusions: Functional limitation and disability are more prevalent among Puerto Ricans and among Dominican women than among neighborhood NHWs in Massachusetts. Greater disability is associated with the presence of chronic health conditions, which differ by ethnic group. Additional research is needed to further define the social and health factors that contribute to these ethnic differences. [ABSTRACT FROM AUTHOR]

Objective: To report the prevalence of total and central obesity in a representative sample of Puerto Rican and Dominican elders in Massachusetts, to compare them with a neighborhood-based group of non-Hispanic white elders, and to examine associations of obesity indices with the presence of type 2 diabetes., Research Methods and Procedures: We examined the prevalence of overweight, obesity, and central obesity in 596 Hispanics of Caribbean origin, ages 60 to 92 years, and 239 non-Hispanic whites, and tested linear and logistic regression models to determine associations among body mass index (BMI), waist circumference (WC), and diabetes., Results: Obesity (BMI > or = 30 kg/m(2)) was prevalent among all ethnic groups, ranging from 17% to 29% for Dominican and Puerto Rican men, respectively, and from 29% to 40% for non-Hispanic white and Dominican women, respectively. These differences were not statistically significant. Among Hispanic men and women, diabetes was prevalent across all BMI and WC categories but tended to be greatest among those with BMI of 25 to 29 kg/m(2) (41% to 43%). In contrast, diabetes was most prevalent in the obese group (36% to 45%) of non-Hispanic whites. Both BMI and WC were associated with the presence of diabetes, but the coefficients were greater for non-Hispanic whites than for Hispanics., Discussion: Caribbean Hispanics and non-Hispanic whites living in the same Massachusetts localities had high prevalences of overweight and obesity. Total and central obesity exerted a differential effect on the presence of diabetes among ethnic groups; for Hispanics, diabetes was prevalent even among non-obese individuals, whereas for non-Hispanic white women, the prevalence of diabetes was strongly associated with total and central obesity. Additional research is needed to investigate the factors associated with the differential effect of obesity on the prevalence of type 2 diabetes among Hispanic and non-Hispanic white elders.

Objectives: We estimated prevalence and control of type 2 diabetes in Puerto Rican, Dominican, and non-Hispanic White (NHW) elders and associated them with sociodemographic and health behavior variables and with body mass index (BMI) and waist circumference., Methods: We used a cross-sectional analysis with a sample of Hispanic elders in Massachusetts and a comparison group of NHWs (1991-1997). The analysis included 379 Puerto Ricans, 113 Dominicans, and 164 NHWs, aged 60 to 96 years, with complete questionnaires and blood samples., Results: Type 2 diabetes was significantly more prevalent among Puerto Ricans (38%) and Dominicans (35%) than among NHWs (23%). Differences remained after covariates were adjusted for. Hispanics with diabetes were approximately 3 times more likely to use insulin than NHWs. Puerto Ricans were 2 times, and Dominicans 3 times, more likely to have glycosylated hemoglobin concentrations of 7% or above than NHWs. BMI and waist circumference were individually associated with diabetes. When included in the model together, waist circumference, but not BMI, remained independently associated with diabetes., Conclusions: Ethnicity was more strongly associated with diabetes status and control than were socioeconomic or measured health behavior variables, suggesting that genetic or other culturally related factors may explain these differences.

Background: Hispanic elders have a high prevalence of diabetes and poor glycemic control, leading to inadequate nutritional status, muscle wasting, and impaired function., Objective: We examined the association of type 2 diabetes with nutritional status measured by serum albumin concentrations and midupper arm muscle area (MAM) and with function measured by difficulty with at least one activity of daily living., Design: : Health history and disability were assessed by self report in 556 Hispanics with a mean (+/- SD) age of 69 +/- 7 y and 158 non-Hispanic whites (NHW; aged 71 +/- 7 y) from the Massachusetts Hispanic Elders Survey. Energy intake (in MJ/d) and protein intake (in g/d) were estimated with use of a food-frequency questionnaire. Body mass index (BMI; in kg/m(2)) and C-reactive protein concentrations (in mg/L) were also measured. Multiple logistic regression models by ethnic group were used., Results: There were no significant differences between Hispanics and NHWs in the proportion of those with low albumin concentrations or low MAM. Hispanic diabetic women had the lowest proportion of low MAM. The risk of low serum albumin concentration was twice as high in Hispanics taking insulin as in their NHW counterparts. Among Hispanics, low albumin concentration and low BMI were associated with low MAM; female sex, low albumin concentration, high BMI, and insulin use were significantly associated with risk of functional impairment., Conclusion: Type 2 diabetes is associated with poor nutritional status, muscle loss, and functional impairment among Hispanic elders.