695�C50). Also, depressive symptoms predicted agreement with ventilator use in the case of a license with Pfizer terminal condition in our cohort (OR = 1.43, CI: 1.08�C1.89).Table 2Characteristics associated with agreement with ventilator use in a terminal condition.Table 3Factors associated with older Mexican Americans’ positive attitudes toward Ventilator Support.4. DiscussionOur study is the first of which we are aware to examine attitudes towards ventilator use among older, community-dwelling older Mexican Americans in a hypothetical end-of-life scenario. Older Mexican Americans who were first or second generation American or were functionally independent were more likely to favor end-of-life artificial ventilation. In previous studies of older Mexican Americans cultural variables have not been shown to be significant in ethical decision making.

Our results indicate those older Mexican Americans who recently immigrated to the United States are more likely to favor aggressive end-of life care. This may indicate a general mistrust of the health care system with a reflexive response to favor aggressive care in terminal situations. It also may reflect the difficulties associated with language differences, especially when dealing with complex and life-ending decisions such as ventilator use. It is possible that assimilation results in older US born Mexican Americans making end-of-life decisions which are more consistent with the majority of Americans when compared to the relatively newer immigrant Mexican Americans [10]. Also of interest were that those who were IADL independent were more likely to prefer end-of life ventilation.

This is consistent with what has been seen previously in other older populations [11]. Healthier persons usually prefer ventilation in these situations, even in an end-of-life scenario [12]. That the more functionally independent older Mexican American may have difficulty translating his current functional status to that of a sicker, more frail person in a terminal condition is not unexpected.Depressive symptoms were also noted to be significant and has been seen in multiple studies as a significant factor in choosing ventilator use [11, 13]. The presence of depressive symptoms may ultimately be more important than other factors such as religiosity in understanding older Mexican American decision making with regard to the issue of ventilator use at the end of life. However, the practical difference (1.43 versus 2.18) on the 15-item GDS renders the depressive symptom variation seen in our sample to that of minimal importance from Dacomitinib a clinical perspective but may more accurately reflect the psychological stress in working through this hypothetical scenario.4.1.