August 26, 2019

Science Daily/Rutgers University

First of their kind studies reveal the impact of immigration, gender, psychological distress, education, social engagement, and oral health on Chinese Americans' cognitive function.

The U.S. Chinese population is growing -- and graying -- rapidly. From 2000 to 2010, the Chinese American population aged 65 and over grew at a rate four times higher than the overall U.S. older adult population. As of 2016, 14% of the approximately four million Chinese Americans were aged 65 and older. As this population ages, they are increasingly susceptible to memory loss and lacking the necessary supports for healthy aging, according to four new Rutgers studies published in the Journal of the American Geriatrics Society.

The studies are the first to extensively study memory loss and dementia in the context of immigration, gender, psychological distress, education, social engagement, and oral health among older Chinese Americans. The papers explore the risk factors and offer recommendations for healthcare providers to overcome the linguistic, cultural, and socioeconomic barriers facing this vulnerable population.

"Research has found that as many as 34% of American adults aged 60 and older are cognitively impaired," said XinQi Dong, director of Rutgers University's Institute for Health, Health Care Policy and Aging Research. " Further, more than one in four people aged 65 and older will be diagnosed with dementia in their lifetime. Although these facts are known to apply to the general American population, there is little information about Alzheimer's disease and related dementias or the contributing factors among Asian Americans."

For the studies, researchers administered multiple cognitive function tests to 2,713 Chinese Americans aged 60 and older. They measured the effects of immigration and gender, psychological distress, education level and social engagement, and oral health on the three domains of cognitive function -- global cognition, episodic memory, and working memory.

Key findings:

·      Older Chinese American women experience higher rates of cognitive impairment.

·      Depression, chronic conditions, and disability are associated with cognitive decline.

·      Lower education levels increase the risk of cognitive impairment. A one-year increase in education decreases the risk by 25%.

·      Difficulties performing functional and instrumental activities of daily living are predictive of the risk of developing cognitive impairment.

·      Higher levels of perceived stress are associated with poorer episodic memory, perceptual speed, and working memory in older Chinese American adults

·      Stress negatively affects the brain and cognitive functioning throughout life.

·      Older Chinese Americans who face increased stressors from linguistic and cultural barriers have poorer cognitive functioning and faster cognitive decline.

·      41.5% of Asian Americans reported not receiving annual oral health examinations, which is linked to decreased quality of life, depression, hypertension, poor cognition, and cognitive decline.

"Chinese older adults are confronting significant life challenges and health disparities due to multiple social, structural, cultural and linguistic barriers," said Dong. "A thorough understanding of Chinese Americans' cognitive risk factors is necessary to guide the development of policy and interventions to delay the onset of memory loss," Dong continued.

"Researchers, social workers, and policymakers must collaborate to reduce health disparities and expand access to culturally-sensitive care for older Chinese American adults," he continued. "Developing programs and interventions that reduce stress, increase activity engagement, and improve quality of care, is necessary to limit memory loss among the aging U.S. Chinese population."

The studies can be found in the August 2019 Journal of the American Geriatrics Society, "Special Issue: Transforming Asian Health Equity: Findings from the PINE/PIETY Study": https://onlinelibrary.wiley.com/toc/15325415/2019/67/S3

https://www.sciencedaily.com/releases/2019/08/190826121927.htm