Latino Older Adults and Mental Health: A Review and Commentary

Latinos are the largest and fastest growing minority population in the United States, and within that, the proportion of elderly Latinos is also increasing at a very rapid rate. This is due to an increase in longevity and improved health care. Depression and other mental health disorders are common in this group, yet few services exist at present that are culturally appropriate and that have been found, in randomized trials, to be effective with them. Part of the reason for this lag in research and development of clinical services is due to the multiple barriers to seeking and receiving mental health services that exist in Latino communities. This article reviews these barriers as well as existing programs that address them and therefore hold promise as mental health interventions. Although there is an increasing amount of research on older adults in this country, Latino older adults still remain underrepresented in research and underserved clinically. This article also highlights the need to increase appropriate normative data for valid testing, and emphasizes a call for more culturally competent and bilingual clinicians.     

Cause-specific mortality in individuals with lymphoplasmacytic lymphoma/Waldenström macroglobulinaemia, 2000–2016

Data on cause-specific mortality after lymphoplasmacytic lymphoma (LPL) and Waldenström macroglobulinaemia (WM) are lacking. We identified causes of death amongst 7289 adults diagnosed with incident first primary LPL (n = 3108) or WM (n = 4181) during 2000–2016 in 17 USA population-based cancer registries. Based on 3132 deaths, 16-year cumulative mortality was 23·2% for lymphomas, 8·4% for non-lymphoma cancers and 14·7% for non-cancer causes for patients aged <65 years at diagnosis of LPL/WM, versus 33·4%, 11·2% and 48·7%, respectively, for those aged ≥75 years. Compared with the general population, patients with LPL/WM had a 20% higher risk of death due to non-cancer causes (n = 1341 deaths, standardised mortality ratio [SMR] 1·2, 95% confidence interval [CI] 1·1–1·2), most commonly from infectious (n = 188; SMR 1·8, 95% CI 1·6–2·1), respiratory (n = 143; SMR 1·2, 95% CI 1·0–1·4), and digestive (n = 80; SMR 1·8, 95% CI 1·4–2·2) diseases, but no excess mortality from cardiovascular diseases (n = 477, SMR 1·1, 95% CI 1·0–1·1). Risks were highest for non-cancer causes within 1 year of diagnosis (n = 239; SMR_<1year 1·3, 95% CI 1·2–1·5), declining thereafter (n = 522; SMR_≥5years 1·1, 95% CI 1·1–1·2). Myelodysplastic syndrome/acute myeloid leukaemia deaths were notably increased (n = 46; SMR 4·4, 95% CI 3·2–5·9), whereas solid neoplasm deaths were only elevated among ≥5-year survivors (n = 145; SMR_≥5years 1·3, 95% CI 1·1–1·5). This work identifies new areas for optimising care and reducing mortality for patients with LPL/WM.