Older Korean Americans' concern about Alzheimer's disease: the role of immigration-related factors and objective and subjective cognitive status

Age moderates associations between dementia worry and subjective cognition

The present study assessed whether dementia worry is associated with adults' subjective cognitive difficulties, and whether any associations are moderated by age. Participants were 477 adults aged 18-90 years. They completed standard, subjective measures of dementia worry and everyday cognitive difficulties (i.e. attention, language, verbal and visual-spatial memory, and visual-perceptual ability). Moderated regression analyses included dementia worry as a predictor of specific cognitive difficulties, and age as a moderator. Covariates included gender, trait cognitive and somatic anxiety, general aging-related anxiety, depression, stress, mental health treatment status, and health status. Greater overall dementia worry, and specifically more frequent dementia worry, were both associated with greater attentional difficulty in middle-aged and older adults, but not in young adults. Cognitions about developing dementia in reaction to memory lapses were also associated with greater cognitive difficulties across the adult lifespan for multiple cognitive domains. Results highlight a robust relationship between dementia worry and subjective attentional difficulties, especially in middle-aged and older adults. Worry frequency is also more influential with adult aging. A cognitive or meta-cognitive mechanism may underlie subjective cognitive concerns across the adult lifespan.

Generation and age of immigration on later life cognitive performance in KHANDLE

OBJECTIVES

We examined the association of generational status and age at immigration with later life cognitive outcomes in a diverse sample of Latinos and Asian Americans.

DESIGN

Baseline data were obtained from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study, and a prospective cohort is initiated in 2017.

SETTING

Older adults in Northern California.

PARTICIPANTS

Our cohort consisted of Asians (n = 411) and Latinos (n = 340) who were on average 76 years old (SD = 6.8).

MEASUREMENTS

We used multivariable linear regression models to estimate associations between generational status and age at immigration (collapsed into one five-level variable) with measures of verbal episodic memory, semantic memory, and executive function, adjusting for age, gender, race and ethnicity, and own- and parental education.

RESULTS

Generational status and age at immigration were associated with cognitive outcomes in a graded manner. Compared to third-generation or higher immigrants, first-generation immigration in adulthood was associated with lower semantic memory (β = -0.96; 95% CI: -1.12, -0.81) than immigration in adolescence (β = -0.68; 95% CI: -0.96, -0.41) or childhood (β = -0.28; 95% CI: -0.49, -0.06). Moreover, immigration in adulthood was associated with lower executive function (β = -0.63; 95% CI: -0.78, -0.48) than immigration in adolescence (β = -0.49; 95% CI: -0.75, -0.23). Similarly, compared to third-generation individuals, first-generation immigrants had lower executive functioning scores.

CONCLUSIONS

Our study supports the notion that sociocontextual influences in early life impact later life cognitive scores. Longitudinal studies are needed to further clarify how immigration characteristics affect cognitive decline.

Perceptions and Beliefs of Memory Loss and Dementia Among Korean, Samoan, Cambodian, and Chinese Older Adults: A Cross-Cultural Qualitative Study

Older adults who are Asian American and Pacific Islander (AAPI) represent one of the fastest growing populations in the United States and face a significant burden of Alzheimer's disease and related dementias (ADRD). Little is known about ADRD among AAPI subgroups. The current study aimed to: (a) explore perceptions and beliefs of memory loss and dementia among Korean, Samoan, Cambodian, and Chinese older adults in the United States; and (b) identify culturally relevant facilitators and barriers of participation in a brain health program among four AAPI subgroups. Seven focus groups comprising 14 Cambodian, 21 Chinese, 14 Korean, and 13 Samoan older adults were conducted. Data were analyzed using inductive and indigenous coding approaches. Similar and unique perceptions and experiences related to memory loss were identified. Future research could include developing and testing culturally tailored and language congruent strategies regarding ADRD education and resources to facilitate ADRD early detection among AAPI older adults. [Journal of Gerontological Nursing, 48(6), 40-48.].