Risk Factors Associated With Depression And Anxiety In Older Adults Of Mexican Origin

European Scientific Journal August 2016 edition vol.12, No.24 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 Risk Factors Associated With Depression And Anxiety In Older Adults Of Mexican Origin Dr. Raquel E. Gonzalez Deer Oaks Behavioral Health Organization, Laredo, TX Dr. Magy Martin Walden University, Minneapolis, Minnesota Dr. Don Martin Youngstown State University, Youngstown, Ohio doi: 10.19044/esj.2016.v12n24p1 URL:http://dx.doi.org/10.19044/esj.2016.v12n24p1 Abstract Older adults of Mexican origin are often underserved, especially those residing in nursing homes. The purpose of this study was to examine if there was a relationship among risk factors associated with depression and anxiety in older adults of Mexican origin. Using a quantitative correlational design, the relationships were assessed with a demographic questionnaire, the Geriatric Depression Scale (GDS), and the Beck Anxiety Inventory (BAI). A sample of 150 elders of Mexican origin residing in nursing homes in a Texas–Mexico border city were examined using two multiple regression analyses. Data analysis indicated that there was a relationship between risk factors associated with depression and anxiety. Data from this study confirmed that a high score on ADLs predicted greater depression and anxiety while female gender predicted higher anxiety and frequent family support predicted low anxiety. Keywords: Risk factors, older adults, depression, anxiety, nursing homes Introduction In recent years, older adults have received more attention from various professions, but the demand for mental health and health care services is greater than the availability of professionals (Karel et al., 2012). According to the U.S. Department of Health and Human Services (DHHS, 2009), Administration on Aging, 38.9 million Americans are 65 and over, and that number is projected to double in the next 40 years. Currently, older adults constitute 12.8% of the U.S. population (Cummings, Kropf, Cassie, & Bride, 2004). The percentage of individuals in nursing homes or other longterm care facilities is 5% (Tatchell, Jordan, Waite, & Tatchell, 2003). Two 1 European Scientific Journal August 2016 edition vol.12, No.24 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 million elders live in nursing homes, and more than 1.5 million older adults reside in assisted-living facilities; these numbers are expected to double by 2020 (National Institutes of Health [NIH], 2002). As a result of these placements, older adults must adjust to lives of loss and abandonment associated with institutional placement, physical disabilities, and emotional distress (Brandburg, Symes, Mastel-Smith, Hersch, & Walsh, 2013). Therefore, various professionals must gain the fundamental knowledge regarding effective strategies that will promote quality of life through a multimodal treatment process that addresses medical, functional, and cognitive disorders, in addition to treatment of late-life mental health disorders (Cummings et al., 2004). By 2050, 58% of elderly individuals will be members of an ethnic minority group, with 20% being Hispanic. The older Hispanic population is expected to grow dramatically “from under 3 million in 2010 to 17.5 million in 2050” (Federal Interagency Forum on Aging-Related Statistics, 2012, p. 4). These statistics are representative of the nation overall, but in Texas, the Texas State Data Center projected increase from 2.6 million in 2011 to 7.5 million in 2040 for the population aged 65 and older (Texas Health and Human Services System [THHSS], 2010). Also, the State Data Center projected the Hispanic population will increase from 530,000 in 2011 to 2.7 million in 2040, which is approximately 422% (THHSS, 2010). Texas has the second largest aging Hispanic population and this population will continue to rise in the future (Texas Department of Aging [TDoA], 2002). By 2040, half of the state’s elderly population will consist of members of ethnic minority groups. The burgeoning majority of them— primarily Spanish speaking—currently reside in the state’s southern counties and along the Texas–Mexico border, where they comprise 13% of the total population. The federal government has deemed all counties along the Texas–Mexico border to be medically underserved, which includes mental health (TDoA, 2002), and thus makes this study necessary and significant. Hispanic elders are the fastest growing population. Their use of long-term care facilities significantly differs from that of non-Hispanic White elders. When residing in nursing homes, their overall functional status also differs from those of non-Hispanic White elders (Choido, Kanten, Gerety, Mulrow, & Cornell, 1994). Mexican American elders in nursing homes are more likely to experience higher levels of impairment in cognition and physical functioning compared to non-Hispanic Whites (Choido et al., 1994). For example, a South Texas study determined that the activities of daily living (ADLs) scores for Mexican-American nursing home residents were worse than those of non-Hispanic Whites, as the Mexican Americans were more dependent on assistance for ADLs (Mulrow, Choido, Gerety, Basu, & Nelson, 1996). 2 European Scientific Journal August 2016 edition vol.12, No.24 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 In long-term settings such as nursing homes, mental health services are essential, especially for ethnic minority older adults. The literature on the effectiveness of various psychological treatment modalities for ethnic minority groups—as well as the risk factors associated with anxiety and depression, specifically among elders of Mexican origin (Chavez-Korell et al., 2012; Vink, Aartsen, & Schoevers, 2008)—is limited. While the need is significant; too few mental health professionals from ethnic and non-ethnic minority groups are interested in geropsychology (Karel et al., 2012). To increase awareness of mental health and the need for psychological services among the aging population, this study sought to determine the risk factors associated with depression and anxiety in older adults of Mexican origin residing in nursing homes. Furthermore, researchers could then compare these results to those from studies of non-ethnic community-dwelling older adults to determine both commonalities and generalizability. Depression affects 2 million Americans over the age of 65 (Kieffer & Reese, 2002), especially those residing in nursing homes (12 to 18%)(E. D. Jones & Beck-Little, 2002). Depression in older adults contributes to increased mortality and negatively affects their overall well-being and daily functioning (Kieffer & Reese, 2002). Anxiety is also common in later life; it has been linked to a physical disability, self-reported increased health complications, and reduced quality of life, as well as frequent access to medical specialists and benzodiazepine medications (Le Roux, Gatz, & Wetherell, 2005). Late-onset anxiety can also be attributed to adverse events, such as i (...truncated)