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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

基本信息

批准号：
10631231
负责人：
Fengyan Tang
金额：
$ 54.69万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2025-03-31
项目状态：
未结题

项目摘要

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.项目摘要/摘要本研究旨在探讨活动投入型态(AEP)的预防作用。并检查AEP是否可以缓解与移民相关的风险和与社区相关的风险社区居住的美国华裔老年移民中的痴呆症。以快速增长的速度，美国华人从2000年到2015年，人口从290万增加到490万，其中14%的人年龄在65岁以上。这个这一人群患阿尔茨海默氏症及相关痴呆(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%的人可能存在基线时的认知损害(CI)，两年随访时约8%的事件CI。The Rapid ADRD的增长和中国老年人最近的移民呼唤以人口为基础的健康建立在日常活动基础上的干预。在社区参与式研究的指导下我们与20多个社区组织和社会服务机构在大芝加哥地区。因此，四波PINE数据(T1：2011-13；T2：2013-15；T3：2015-17；T4：2017-19) 都被收集起来了。据我们所知，PINE是唯一一项收集了以人口为基础的美国华裔老年人样本的认知数据。在这个二次分析中对美国中国老龄化人口进行最大和最全面的研究，我们将巩固离散活动根据活动类型、金额和随时间的变化来衡量AEP的独特模式。我们将发展通过连接松树受访者的居住人口普查区域，建立了中国移民社区数据库 2010年与个人层面的数据。我们将使用现代测试工具测试认知评估的有效性在这个研究不足的人群中使用心理测量学方法。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、社会无序)利用潜在增长建模方法。具体地说，我们的目标是1)检查AEP对变化轨迹的预防作用评估AEP是否改变了移民相关因素对认知下降的影响；以及 3)评估AEP是否改变了邻里因素对认知减退的影响。调查结果将指向基于不同参与模式的活动干预策略，个体和社区特征，以及中国老年人可以依赖的人与环境的契合性在认知促进中优化邻里资源。基于满足以下条件的日常活动的干预迫切需要个人需求和与背景相适应，以符合成本效益的方式解决认知问题损害和增加家庭照看的负担。本研究将告知如何积极参与与寿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，这是对于面临语言和社会孤立的年长中国移民来说，这一点尤为重要。