Stressors, Sleep, and Cognitive Function among Asian Americans

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PROJECT SUMMARY / ABSTRACT The Asian American population is rapidly growing and will be the largest immigrant group by 2065. Alzheimer's Disease and Related Dementias (ADRD) is the fastest-growing cause of death for Asian Americans in California, and are likely to increase as the number of U.S. deaths from Alzheimer's disease between 2000-2017 has increased by 145%. During COVID-19, Asian American Medicare beneficiaries with ADRD faced greater excess mortality compared to their non-Hispanic White counterparts. The number of Californian Asian Americans living with ADRD will more than double by 2040, totaling more than 241,000. The ADRD incidence, prevalence, and mortality data for Asian Americans are underestimated because Asian Americans may not report ADRD symptoms unless family caregivers require assistance with behavioral issues, and Asian Americans receive fewer diagnostic evaluations and do not receive timely diagnoses compared to non-Hispanic Whites. Stressful experiences such as discrimination and cumulative life stress increase cognitive impairment or ADRD, however, data are sparse among Asian Americans. Poor sleep has been associated with CI and ADRD through mechanisms such as inflammation increasing β-amyloid burden, although data are lacking in the understudied Asian American population. This study builds on the biopsychosocial model of health and disease, which posits that biological, psychological, and social processes interactively shape health and illness within individuals, and subgroups of the population. Data for the proposed study will be collected as a part of the parent longitudinal R01 study examining associations among immigrant stressors, sleep, and cardiometabolic risks in 750 Chines, Korean, and Vietnamese Americans residing in Southern California. In the proposed supplement study, we will add a 10- minute global cognitive function examination tool (the Montreal Cognitive Assessment (MoCA)) to the parent study and collect data from 50 Chinese, 50 Korean, and 50 Vietnamese participants who are 60 ≥ years old and already participating in the parent study. This innovative supplement study will be one of the first studies to examine the interplay of immigrant stressors, sleep, and cognitive function among Asian Americans. Findings from this study will contribute to designing a larger-scale longitudinal study to examine in-depth causal associations and identify modifiable targets for intervention to reduce sleep and ADRD disparities in understudied Asian Americans. Relevance to ADRD: Both specific aims of the proposed application focus on examining predictors of cognitive function using a validated assessment for detecting mild cognitive impairment, a precursor to ADRD.