Identifying risk factors of Alzheimer's disease and related dementias in older Chinese immigrants

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Project Summary Chinese immigrant population has been increasing for the last few decades. Despite their increasing numbers, very little is known about the health of Chinese immigrants. As the immigrant population becomes older, there is a pressing need to understand their cognitive health and risk of developing Alzheimer’s Disease and Related disorder (AD/ADRD), a common health problem in older individuals. AD/ADRD is a loss of cognitive function – ability to think, remember, or reason – to such an extent that it interferes with an individual’s day-to-day life and activities. Among all the study on immigration and cognition, only a few of them was focused specifically on Chinese immigrants. To date, existing findings on the linkages of immigration and cognition are mixed. Some studies reported worse cognitive function in immigrants than the US-born, whereas others found better cognitive function or no difference. In terms of measurement, immigration measures were limited to country born, age at immigration, and length of stay. Very little attention has been given to the influence of pre-immigration (e.g., reasons for immigration and early-life conditions) and post-immigration experiences (e.g., acculturation) on cognitive changes. In addition, cognitive function was largely defined by global cognition. Little is known regarding the effect of immigration on changes in specific cognitive domains, including areas of memory, executive function, and language (known as early cognitive markers of AD/ADRD). Previous studies have reported clusters of factors which explain the relationship between immigration and cognition, including: age, gender, education, depression, vascular health, and genetic risk factors. New York City has by far the highest Chines population of any city outside Asia. The Alzheimer’s Disease Research Center (ADRC) at Mount Sinai, located in New York City, has a successful record of engaging and evaluating Chinese American older adults, with an existing cohort of over 200 older Chinese immigrants who were fully characterized according to demographic variables, medical illnesses, psychological conditions, functional status, and genetic risks following a standard dementia evaluation. The purpose of this study is to expand the dementia evaluation to include measures of pre- and post-immigration experiences. We aim to: (1) elucidate the associations between immigration and cognition using comprehensive measures of immigration history along with a cognitive re- evaluation; and (2) identify potential mediators and moderators influencing such associations by leveraging the fullness of the baseline data. 100 well-characterized older Chinese immigrants will be recruited from the ADRC at Mount Sinai for the proposed study. This study will provide preliminary data for a larger study to examine the associations between immigration and cognition among older Chinese immigrants. Understanding mechanisms through which immigration experiences influence cognitive outcomes among the immigrant population will guide the development of tailored interventions to prevent AD/ADRD.