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

7. 项目总结/文摘

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.