Immigrant generational status, late-life social support and mental well-being, and cognitive change in the Kaiser Healthy Aging and Diverse Life Experiences cohort

UC North Ballroom

Title: Immigrant generational status, late-life social support and mental well-being, and cognitive change in the Kaiser Healthy Aging and Diverse Life Experiences cohort

Presenting Author: Joya Deb Lucky

Co-Authors: Chelsea Kuiper, Kazi Sabrina Haq, Shelli Vodovozov, Oanh L. Meyer, M. Maria Glymour, Paola Gilsanz, Elizabeth Rose Mayeda, Rachel A. Whitmer, Rachel L. Peterson

Word count: 300/300

Background: Social support and mental well-being may differentially provide risk/protection for late-life cognition among different immigrant generations of U.S. older adults.

Methods: In a longitudinal (KHANDLE) cohort, Asian and Latino participants were categorized as 1st-generation arriving age(n=73); 1st-generation arriving age≥18 (n=282); 2nd-generation (n=279); or ≥3rd-generation (n=174) immigrants. The NIH Toolbox Emotion Battery assessed emotional support, instrumental support and loneliness. The PROMIS© Depression Instrument assessed depressive symptoms. All were standardized (mean=0; SD=1) to the U.S. adult population and dichotomized at 0. Verbal episodic memory (VEM) and executive function (EF) were assessed up to 4 times (max. years=6.6) using the Spanish and English Neuropsychological Assessment Scales (SENAS). Linear mixed-effect models examined associations of social support and mental well-being with EF or VEM. Separate models tested interactions by immigrant generation. All models adjusted for age, sex, education, race/ethnicity, in-person vs. phone interview and SENAS language.

Results: Participants’ mean age was 76 years (SD=6.5). 1st-generation immigrants arriving at ages(mean=-0.18, SD=1.0) and highest loneliness (mean=0.25, SD=0.93) and depression (mean=-0.04, SD=0.80). In mixed effects models, instrumental and emotional support were not associated with baseline EF (instrumental β=0.02 [95% CI=-0.04, 0.07]; emotional β=0.02 [95% CI=-0.03, 0.08]) or VEM (instrumental β=-0.02 [95% CI=-0.08, 0.05]; emotional β=0.01 [95% CI=-0.06, 0.07]). Associations of instrumental support, emotional support, depression, and loneliness with longitudinal EF and VEM approached null. First-generation immigrants with low instrumental support had lower VEM (-0.12; 95% CI=-0.29 to 0.04) and 2nd-generation saw a rise (0.18; 95% CI=-0.01 to 0.36). No significant change in ≥3rd-generation immigrants (MEM=0.004; 95% CI=-0.23, 0.24; p-value=0.05). High depression symptoms caused EF declines only in ≥3rd-generation immigrants (-0.07; 95% CI=-0.11 to -0.04; p-value=0.04).

Conclusion: Low instrumental support for 1st-generation immigrants and high depressive symptoms for ≥3rd-generation immigrants may be important intervention targets to protect late-life cognition.