ABSTRACT
Many older Mexican adults rely on adult children, extended family, and friends (i.e., informal care resources) to
meet financial, housing, and daily needs. Older adults with strong networks may not worry about having few
financial resources, living in poor housing, or not being able to access long-term care services, because they
expect that these needs will be met by their adult children. However, this expectation may become less realistic
as family sizes have become smaller, adult children are increasingly moving away for work, and cultural values
change. Additionally, Mexico has limited healthcare resources and infrastructure (i.e., formal care resources) to
meet the needs of an aging population. This is concerning because the incidence of Alzheimer's disease and
related dementias (ADRD) in Mexico is among the highest in Latin America. This has important implications for
the demand for healthcare services and the need for support from family.
The life course is the temporal sequence of events, transitions, and trajectories in important life domains, such
as education, family composition, and health. A person's life course is shaped by contextual factors. In Mexico,
contextual factors that have likely shaped ADRD risk and the availability of care resources in old age include
migration policies, family planning policies, economic shocks, and healthcare and pension reforms. These events
have caused successive generations of older adults to be born into and age within very different contexts.
Knowledge of contextual and individual life course factors that influence ADRD risk, access to care resources,
and use of care resources are established gaps in aging research. We will use the Mexican Health and Aging
Study to complete three specific aims. (1) Identify life course pathways for ADRD in an older adult population
that has overcome social, economic, and health disadvantages in childhood and middle age. (2) Determine how
changing social and cultural contexts over the life course have impacted the availability of informal and formal
care resources for older adults in Mexico. (3) Determine how older adults in a country with a poor infrastructure
for an aging population meet their long-term care needs as they transition from cognitively unimpaired to ADRD.
This project is expected to produce evidence on the life course pathways that influence ADRD risk as well as
the availability and use of care resources for older adults in a country with low institutional support, high
inequality, and the likely high care burden of ADRD for families and institutions. The expected findings of this
research are also relevant to the US. Poor economic conditions and rejoining family are among the many factors
that motivate Mexicans to migrate to the US. This, along with the aging of the Mexican-American population,
makes it critical to understand how risk factors across life stages impact older adults' risk for ADRD.
