Preventing Cognitive Decline and Dementia Among Older Chinese Immigrants: The Role of Activity, Engagement, Immigration Experience, and Neighborhood Environments

预防中国老年移民的认知衰退和痴呆症：活动、参与、移民经验和社区环境的作用

• 批准号: 9973330
• 负责人: Fengyan Tang
• 金额: $ 57.22万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9973330
• 关键词: Acculturation; Address; Adult; Age; Age-associated memory impairment; Aging; Alzheimer' s disease related dementia; American; Area; Benefits and Risks; Censuses; Characteristics; Chicago; Chinese People; Cognition; Cognitive; Cognitive deficits; Communities; Community Surveys; Data; Data Analyses; Databases; Dementia; Diagnosis; Disadvantaged; Discrimination; Elderly; Environment; Episodic memory; Ethnic group; Frequencies; Goals; Growth; Health; Immigrant; Immigration; Impaired cognition; Individual; Intervention; Interview; Language; Life; Linguistics; Link; Longitudinal cohort study; Maintenance; Measures; Methods; Modeling; Modernization; Neighborhoods; Not Hispanic or Latino; Outcome; Pattern; Persons; Population; Preventive; Process; Psychometrics; Resources; Respondent; Risk; Risk Factors; Role; Sampling; Shapes; Short-Term Memory; Social Work; Social isolation; Social support; Socioeconomic Status; Source; Speed; System; Testing; Time; United States National Institutes of Health; active lifestyle; aged; aging population; base; cognitive benefits; cognitive change; cognitive function; cognitive testing; community based participatory research; cost effective; dementia risk; density; displaced person; epidemiology study; experience; family burden; family caregiving; follow-up; health disparity; health equity; healthy lifestyle; improved; lifetime risk; neighborhood disadvantage; population based; prevent; protective effect; protective factors; racial and ethnic; rapid growth; response; secondary analysis; social; social cohesion; social deficits; supportive environment

7. Project Summary/Abstract This proposed study aims to investigate the preventive effect of activity engagement profiles (AEP) on cognitive decline and to examine whether AEP mitigate immigration-related and neighborhood-related risks for dementia among community-dwelling US Chinese aging immigrants. With a fast growth rate, the US Chinese population increased from 2.9 to 4.9 million between 2000 and 2015, with 14% of them aged 65+ years. The lifetime risk of developing Alzheimer and related dementias (ADRD) in this population is comparable to that of non-Hispanic Whites. Our preliminary data analysis indicated that over 15% might have the presence of cognitive impairment (CI) at baseline, and about 8% incident CI at two-year follow-up interviews. The rapid growth of ADRD and of recent immigration of Chinese older adults call for population-based health interventions that are built on everyday activities. Guided by the community-based participatory research principles we have collaborated with over 20 community-based organizations and social services agencies in the Greater Chicago area. As such, four-wave PINE data (T1:2011-13; T2:2013-15; T3: 2015-17; T4:2017-19) have been collected. To our knowledge, PINE is the only longitudinal epidemiological study that has collected cognition data in a population-based sample of US Chinese older adults. In this secondary analysis of the largest and most comprehensive study of US Chinese aging population, we will consolidate discrete activity measures into unique patterns of AEP based on activity type, amount, and change over time. We will develop a database of Chinese immigrant communities by linking the PINE respondents’ residential census tract in 2010 with the individual-level data. We will test the validity of cognitive assessment using modern psychometric methods in this understudied population. The cognitive benefits of AEP will be examined in conjunction with immigration-related factors, individual characteristics, and neighborhood characteristics (e.g., ethnic density, neighborhood socioeconomic status, social cohesion, social disorder) using latent growth modeling approaches. Specifically, we aim to 1) examine the preventive effects of AEP on change trajectories of cognition; 2) assess whether AEP modify the effects of immigration-related factors on cognitive decline; and 3) assess whether AEP modify the effects of neighborhood factors on cognitive decline. Findings will point to activity intervention strategies based on distinct engagement patterns, the interplay between individual and neighborhood characteristics, and the person-environment fit wherein Chinese older adults can rely on and optimize neighborhood resources in cognitive promotion. Interventions based on daily activities that meet individual needs and fit in the context are urgently needed and would be cost-effective to address cognitive impairment and increasing burden on family caregiving. The present study will inform how active engagement with life and maintenance of cognitive function are interrelated to define and shape the aging process, which is especially important to older Chinese immigrants facing linguistic and social isolation.

7.项目总结/摘要 本研究旨在探讨活动参与模式（AEP）对预防青少年抑郁症的作用。 认知能力下降，并检查AEP是否减轻移民相关和邻里相关的风险， 社区居住的美国华裔老年移民中的痴呆症。随着快速增长，美国华人 2000年至2015年，人口从290万增加到490万，其中14%的人年龄在65岁以上。的 在这一人群中，发生阿尔茨海默病和相关痴呆（ADRD）的终生风险与 非西班牙裔白人我们的初步数据分析表明，超过15%的人可能存在 在基线时有认知障碍（CI），在两年随访访谈时约有8%的事件CI。快速 ADRD的增长和最近中国老年人的移民要求以人群为基础的健康 建立在日常活动基础上的干预措施。以社区参与式研究为指导 我们与20多个社区组织和社会服务机构合作， 大芝加哥地区。因此，四波PINE数据（T1：2011-13; T2：2013-15; T3：2015-17; T4：2017-19） 已经收集起来了。据我们所知，PINE是唯一一项收集了 认知数据在一个人口为基础的样本，美国中国老年人。在这一次要分析中， 最大和最全面的研究美国中国老龄化人口，我们将巩固离散活动 根据活动类型、数量和随时间的变化，测量AEP的独特模式。我们将开发 一个华人移民社区的数据库，将PINE受访者的居住人口普查区域连接起来， 2010年，个人数据。我们将测试的有效性认知评估使用现代 心理测量学方法在这个未充分研究的人群。AEP的认知益处将在 结合移民相关因素、个人特征和邻里特征（例如， 种族密度、邻里社会经济地位、社会凝聚力、社会混乱） 建模方法。具体而言，我们的目标是1）检查AEP对变化轨迹的预防作用 2）评估AEP是否改变了移民相关因素对认知能力下降的影响; 3)评估AEP是否改变了邻居因素对认知能力下降的影响。调查结果将指向 基于不同参与模式的活动干预策略，个体和 邻里特征，以及中国老年人可以依赖的人-环境匹配， 在认知提升中优化邻里资源。基于日常活动的干预措施， 个人需求和适应环境是迫切需要的，这将是符合成本效益的，以解决认知 损害和增加家庭生计负担。本研究将告知如何积极参与 与生命和认知功能的维持是相互关联的，以定义和塑造衰老过程， 对于面临语言和社会孤立的年长华人移民来说，这一点尤为重要。