Evidence map›Paper›PMID 39095702›Full record

ArticleBMC geriatrics2024

Population-level trends in self-reported healthcare utilization among older adults in Mexico with and without cognitive impairment.

José Eduardo Cabrero Castro, Rebeca Wong, Rafael Samper Ternent, Brian Downer

Abstract read
In one paragraph

Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

José Eduardo Cabrero CastroDepartment of Population Health & Health Disparities, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX, 77555, USA. jecabrer@utmb.edu.
Rebeca WongDepartment of Population Health & Health Disparities, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX, 77555, USA.
Rafael Samper TernentDepartment of Management, Policy & Community Health, UTHealth Houston School of Public Health, 1200 Pressler Street, Houston, TX, USA.
Brian DownerDepartment of Population Health & Health Disparities, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX, 77555, USA.

Funding

UTMB OAIC Research Education Component (REC)P30AG024832 · NIA · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI JAMES S. GOODWIN, MD, MELISSA M. MORROW · 2005 to 2026
$26.7M
The Mexican Health and Aging Study - IIR01AG018016 · NIA · UNIVERSITY OF TEXAS MED BR GALVESTON · PI Rebeca Wong · 1999 to 2026
$22.6M
The Texas Resource Center on Minority Aging Research (RCMAR)P30AG059301 · NIA · UNIVERSITY OF TEXAS MED BR GALVESTON · PI Kyriakos S Markides, Fernando Riosmena · 2018 to 2026
$5.2M
The influence of social and cultural context on life course pathways for Alzheimer's disease, related dementias, and care resources for older Mexican adultsRF1AG068988 · NIA · UNIVERSITY OF TEXAS MED BR GALVESTON · PI DOWNER, BRIAN GREGORY · 2021 to 2021
$1.0M
The influence of social and cultural context on life course pathways for Alzheimer's disease, related dementias, and care resources for older Mexican adultsR01AG068988 · NIA · UNIVERSITY OF TEXAS MED BR GALVESTON · PI DOWNER, BRIAN GREGORY · 2024 to 2025
$632k
National Institute on Aging,United States 5P30AG024832-17NIA NIH HHS 1RF1AG068988-01A1NIA NIH HHS P30 AG024832NIA NIH HHS P30 AG059301NIA NIH HHS R01 AG018016NIA NIH HHS R01 AG068988NIA NIH HHS RF1 AG068988
6 · The paper itself

Abstract

backgroundOlder adults with cognitive impairment exhibit different patterns of healthcare utilization compared to their cognitively healthy counterparts. Despite extensive research in high-income countries, similar studies in low- and middle-income countries are lacking. This study aims to investigate the population-level patterns in healthcare utilization among older adults with and without cognitive impairment in Mexico.

methodsData came from five waves (2001-2018) of the Mexican Health and Aging Study. We used self-reported measures for one or more over-night hospital stays, doctor visits, visits to homeopathic doctors, and dental visits in the past year; seeing a pharmacist in the past year; and being screened for cholesterol, diabetes, and hypertension in the past two years. Cognitive impairment was defined using a modified version of the Cross Cultural Cognitive Examination that assessed verbal memory, visuospatial and visual scanning. Total sample included 5,673 participants with cognitive impairment and 34,497 without cognitive impairment interviewed between 2001 and 2018. Generalized Estimating Equation models that adjusted for time-varying demographic and health characteristics and included an interaction term between time and cognitive status were used.

resultsFor all participants, the risk for one or more overnight hospital stays, doctor visits, and dental visits in the past year, and being screened for diabetes, hypertension, and high cholesterol increased from 2001 to 2012 and leveled off or decreased in 2015 and 2018. Conversely, seeing a homeopathic doctor decreased. Cognitive impairment was associated with higher risk of hospitalization (RR = 1.13, 1.03-1.23) but lower risk of outpatient services (RR = 0.95, 0.93-0.97), cholesterol screening (RR = 0.93, 0.91-0.96), and diabetes screening (RR = 0.95, 0.92-0.97). No significant difference was observed in the use of pharmacists, homeopathic doctors, or folk healers based on cognitive status. Interaction effects indicated participants with cognitive impairment had lower risk for dental visits and hypertension screening but that these trajectories differed over time compared to participants without cognitive impairment.

conclusionsWe identified distinct population-level trends in self-reported healthcare utilization and differences according to cognitive status, particularly for elective and screening services. These findings highlight the necessity for policy interventions to ensure older adults with cognitive impairment have their healthcare needs met.

Indexed as

Cognitive DysfunctionPatient Acceptance of Health CareSelf ReportAgedAged, 80 and overFemaleHospitalizationHumansMaleMexicoCognitive impairmentHealthcare access: healthcare policyHealthcare utilization

Identifiers

PMID39095702
PMCPMC11295330

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.