Variation in associations of education, occupation and income with functional limitations in older Mexican-Americans

Purpose The primary aim of this project was to examine the particular dimensions of socioeconomic status that may be associated with distinct components of functional limitation among older Mexican American men and women. Methods Using baseline data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, a cross-sectional analysis was conducted with multivariate logistic regression models. The exposures of interest were education (≥12 vs. <12 years), past occupational category (white collar vs. skilled manual labor, service worker, farm labor, other labor, and homemaking), and household income (≥$15,000 vs. <$15,000). The three outcome variables were one or more versus no limitations in 7 activities of daily living (ADL) and 10 instrumental activities of daily living (IADL), and a performance-oriented mobility assessment (POMA) score of ≥9 versus <9 out of a maximum possible score of 12. Results Not completing at least 12 years of education was associated with a twofold higher likelihood of having an IADL limitation for women (odds ratio OR = 2.09, 95% confidence interval CI = 1.38–3.16) and men (OR = 2.18, 95% CI = 1.35–3.53), but not significantly associated with other indicators of functional limitation. Compared with male white collar workers, men who had been skilled manual laborers, farm workers, or other laborers were 1.87 (95% CI = 1.19–2.95) to 2.80 (95% CI = 1.72–4.58) times as likely as those who had been white collar workers to have a POMA score below 9. Homemakers had significantly higher odds of all three measures of functional or mobility impairment compared with women white collar workers (ranging from 1.61, 95% CI = 1.05–2.46 for IADL limitations to 2.39, 95% CI = 1.55–3.62 for a low POMA score). Low income was associated only with ADL limitations in men (OR = 1.87, 95% CI = 1.06–3.28). Conclusion Education, occupation, and income may possibly be linked to separate aspects of functional limitation, which vary by gender.