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

• 批准号: 10171756
• 负责人: Fengyan Tang
• 金额: $ 55.33万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10171756
• 关键词: Acculturation; Address; Adult; Age; Age-associated memory impairment; Aging; Alzheimer' s disease related dementia; American; Area; Benefits and Risks; Censuses; Characteristics; Chicago; Chinese People; Cognition; Cognitive; Cognitive deficits; Communities; Community Surveys; Data; Data Analyses; Databases; Dementia; Diagnosis; Disadvantaged; Discrimination; Elderly; Environment; Episodic memory; Ethnic group; Frequencies; Goals; Growth; Health; Immigrant; Immigration; Impaired cognition; Individual; Intervention; Interview; Language; Life; Linguistics; Link; Longitudinal cohort study; Maintenance; Measures; Methods; Modeling; Modernization; Neighborhoods; Not Hispanic or Latino; Outcome; Pattern; Persons; Population; Preventive; Process; Psychometrics; Resources; Respondent; Risk; Risk Factors; Role; Sampling; Shapes; Short-Term Memory; Social Work; Social isolation; Social support; Socioeconomic Status; Source; Speed; System; Testing; Time; United States National Institutes of Health; active lifestyle; aged; aging population; base; cognitive benefits; cognitive change; cognitive function; cognitive testing; community based participatory research; cost effective; dementia risk; density; displaced person; epidemiology study; experience; family burden; family caregiving; follow-up; health disparity; health equity; healthy lifestyle; improved; lifetime risk; neighborhood disadvantage; population based; prevent; protective effect; protective factors; racial and ethnic; rapid growth; response; secondary analysis; social; social cohesion; social deficits; supportive environment

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. 项目总结/摘要 这项拟议的研究旨在调查活动参与概况（AEP）对 认知能力下降，并检查 AEP 是否可以减轻与移民相关和邻里相关的风险 居住在美国的华人老年移民的痴呆症增长速度很快。 2000年至2015年间，人口从2.9万人增加到490万人，其中14%的人年龄在65岁以上。 该人群终生患阿尔茨海默病及相关痴呆症 (ADRD) 的风险与 我们的初步数据分析表明，超过 15% 的人可能存在 基线时发生认知障碍 (CI)，两年随访时发生 CI 约 8%。 ADRD 的增长和最近中国老年人的移民呼吁以人口为基础的健康 以社区参与性研究为指导的干预措施。 我们已与 20 多个社区组织和社会服务机构合作 同样，大芝加哥地区的四波 PINE 数据（T1：2011-13；T2：2013-15；T3：2015-17；T4：2017-19） 据我们所知，PINE 是唯一已收集的纵向流行病学研究。 在对美国华裔老年人的人口样本认知数据的二次分析中。 规模最大、最全面的美国华人老龄化研究，我们将整合离散活动 我们将根据活动类型、数量和随时间的变化制定独特的 AEP 模式。 通过将 PINE 受访者的居住人口普查区联系起来，建立一个中国移民社区数据库 2010年，我们将使用现代个人数据来测试认知评估的有效性。 AEP 的认知益处将在以下研究中进行检验。 结合移民相关因素、个人特征和邻里特征（例如， 使用潜在增长（种族密度、社区社会经济地位、社会凝聚力、社会混乱） 具体来说，我们的目标是 1) 检查 AEP 对变化轨迹的预防作用。 2) 评估 AEP 是否可以改变移民相关因素对认知能力下降的影响； 3）评估AEP是否可以改变邻里因素对认知能力下降的影响。 活动干预策略基于不同的参与模式、个体与个体之间的相互作用 邻里特色、人与环境的契合，保证了中国老年人的可依赖、可依赖 基于符合日常活动的认知促进干预措施，优化邻里资源。 迫切需要个人需求并适应具体情况，并且对于解决认知问题具有成本效益 本研究将说明如何积极参与。 与生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老年中国移民来说尤其重要。