The influence of social and cultural context on life course pathways for Alzheimer's disease, related dementias, and care resources for older Mexican adults - 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.
