Hostname: page-component-669899f699-tzmfd Total loading time: 0 Render date: 2025-04-25T09:14:09.862Z Has data issue: false hasContentIssue false
  • English
  • Français

Perceived discrimination and nativity status: risk of cognitive impairment among Latin American older adults

Published online by Cambridge University Press:  01 December 2023

Lize Tibiriçá Open the ORCID record for Lize Tibiriçá [Opens in a new window] ,
Dylan J. Jester ,
Jordan N. Kohn Open the ORCID record for Jordan N. Kohn [Opens in a new window] ,
Allison P. Williams ,
Linda K. McEvoy  and
Barton W. Palmer Open the ORCID record for Barton W. Palmer [Opens in a new window]
Lize Tibiriçá*
Affiliation:
Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, CA, USA
Dylan J. Jester
Affiliation:
Women’s Operational Military Exposure Network (WOMEN), VA Palo Alto Health Care System, Palo Alto, CA, USA
Jordan N. Kohn
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA
Allison P. Williams
Affiliation:
Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, CA, USA
Linda K. McEvoy
Affiliation:
Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
Barton W. Palmer
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA Veterans Affairs San Diego Healthcare System, Mental Illness Research, Education and Clinical Center (MIRECC), San Diego, CA, USA
*
Correspondence should be addressed to: Lize Tibiriçá, Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr MC 0664, La Jolla, CA, 92093, USA. Email: ldecarvalho@ucsd.edu.
Get access

Abstract

Objectives:

We examined the association between perceived discrimination and the risk of cognitive impairment with no dementia (CIND) and Alzheimer’s disease and related dementias (ADRD) while considering the potential effects of nativity status.

Design:

A prospective analysis of discrimination and nativity status with dementia and cognitive impairment was conducted among Latinx adults aged 51 years and older who participated in the Health and Retirement Study.

Setting:

A national representative sample.

Participants:

A sample of 1,175 Latinx adults aged 51 years and older.

Measurements:

Demographics, cognitive functioning, perceived discrimination, and nativity status (US-born vs. non-US born) were assessed. Traditional survival analysis methods (Fine and gray models) were used to account for the semi-competing risk of death with up to 10 years of follow-up.

Results:

According to our results, neither everyday discrimination nor nativity status on their own had a statistically significant association with CIND/ADRD; however, non-US-born Latinx adults who reported no discrimination had a 42% lower risk of CIND/ADRD (SHR = 0.58 [0.41, 0.83], p = .003) than US-born adults.

Conclusions:

These results highlight the need for healthcare providers to assess for discrimination and provide support and resources for those experiencing discrimination. It also highlights the need for better policies that address discrimination and reduce health disparities.

Keywords

Latinxcognitiondiscriminationnativity status
Type
Original Research Article
Information
International Psychogeriatrics , Volume 36 , Special Issue 9: Issue Theme: Social Determinants of Health , September 2024 , pp. 818 - 830
Copyright
© International Psychogeriatric Association 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Arellano-Morales, L. et al. (2015). Prevalence and correlates of perceived ethnic discrimination in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Journal of Latina/o Psychology, 3, 160–176. https://doi.org/10.1037/lat0000040.CrossRefGoogle ScholarPubMed
Barnes, L. L. et al. (2005). Racial differences in the progression of cognitive decline in Alzheimer disease. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 13, 959–967. https://doi.org/10.1176/appi.ajgp.13.11.959.CrossRefGoogle ScholarPubMed
Barnes, L. L., Lewis, T. T., Begeny, C. T., Yu, L., Bennett, D. A. and Wilson, R. S. (2012). Perceived discrimination and cognition in older African Americans. Journal of the International Neuropsychological Society, 18, 856–865. https://doi.org/10.1017/S1355617712000628. CrossRefGoogle ScholarPubMed
Cantu, P. A., Hayward, M. D., Hummer, R. A. and Chiu, C. T. (2013). New estimates of racial/ethnic differences in life expectancy with chronic morbidity and functional loss: evidence from the national health interview survey. Journal of Cross-Cultural Gerontology, 28, 283–297. https://doi.org/10.1007/s10823-013-9206-5.CrossRefGoogle ScholarPubMed
Cintron, D. W. et al. (2021). Does discrimination mediate the association between education and later-life cognitive outcomes in a cohort of Black Americans? An example of parametric g-estimation with latent variables in the STAR study. Alzheimer’s and Dementia, 17, e055252. https://doi.org/10.1002/alz.055252.CrossRefGoogle Scholar
Crimmins, E. M., Kim, J. K., Langa, K. M. and Weir, D. R. (2011). Assessment of cognition using surveys and neuropsychological assessment: the health and retirement study and the aging, demographics, and memory study. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 66B, i162–i171. https://doi.org/10.1093/geronb/gbr048.CrossRefGoogle Scholar
Crowe, M. et al. (2013). Indicators of childhood quality of education in relation to cognitive function in older adulthood. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 68, 198–204.CrossRefGoogle ScholarPubMed
Fisher, G., Faul, J. and Weir, D. (2005). Documentation of Chronic Disease Measures in the Health and Retirement Study (HRS/AHEAD). Ann Arbor, Michigan: Institute for Social Research, University of Michigan.CrossRefGoogle Scholar
Fisher, G. G. et al. (2011). Caring for individuals with dementia and cognitive impairment, not dementia: findings from the aging, demographics, and memory study. Journal of the American Geriatrics Society, 59, 488–494. https://doi.org/10.1111/j.1532-5415.2010.03304.x.CrossRefGoogle Scholar
Gallagher, D., Kiss, A., Lanctot, K. and Herrmann, N. (2018). Depression and risk of Alzheimer dementia: a longitudinal analysis to determine predictors of increased risk among older adults with depression. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 26, 819–827. https://doi.org/10.1016/j.jagp.2018.05.002.CrossRefGoogle ScholarPubMed
Garcia, M., Reyes, A. and Downer, B. (2018). Racial/ethnic and nativity differentials in cognitive trajectories among adults in the United States. Innovation in Aging, 2, 47–47. https://doi.org/10.1093/geroni/igy023.176.CrossRefGoogle Scholar
Garcia, M. A. et al. (2020). Age of migration and cognitive function among older Latinos in the United States. Journal of Alzheimer’s Disease, 76, 1493–1511. https://doi.org/10.3233/jad-191296.CrossRefGoogle ScholarPubMed
Garcia, M. A., Downer, B., Chiu, C. T., Saenz, J. L., Ortiz, K. and Wong, R. (2021). Educational benefits and cognitive health life expectancies: racial/ethnic, nativity, and gender disparities. The Gerontologist, 61, 330–340. https://doi.org/10.1093/geront/gnaa112.CrossRefGoogle ScholarPubMed
Garcia, M. A., Downer, B., Chiu, C. T., Saenz, J. L., Rote, S. and Wong, R. (2019). Racial/ethnic and nativity differences in cognitive life expectancies among older adults in the United States. The Gerontologist, 59, 281–289. https://doi.org/10.1093/geront/gnx142.CrossRefGoogle ScholarPubMed
Garcia, M. A., Garcia, C., Chiu, C.-T., Raji, M. and Markides, K. S. (2018). A comprehensive analysis of morbidity life expectancies among older Hispanic subgroups in the United States: variation by nativity and country of origin. Innovation in Aging, 2, 1–12. https://doi.org/10.1093/geroni/igy014.CrossRefGoogle ScholarPubMed
Garcia, M. A., Saenz, J., Downer, B. and Wong, R. (2018). The role of education in the association between race/ethnicity/nativity, cognitive impairment, and dementia among older adults in the United States. Demographic Research, 38, 155–168. https://doi.org/10.4054/DemRes.2018.38.6.CrossRefGoogle ScholarPubMed
Garcia, M. A. and Tarraf, W. (2021). A nuanced portrait of how race/ethnicity and nativity influence cognitive trajectories among older adults in the United States. Alzheimer’s and Dementia, 17, e056644. https://doi.org/10.1002/alz.056644.CrossRefGoogle Scholar
Goldman, N. (2016). Will the Latino mortality advantage endure? Research on Aging, 38, 263–282. https://doi.org/10.1177/0164027515620242.CrossRefGoogle ScholarPubMed
Hayward, M. D., Hummer, R. A., Chiu, C. T., González-González, C. and Wong, R. (2014). Does the Hispanic paradox in U.S. adult mortality extend to disability? Population Research and Policy Review, 33, 81–96. https://doi.org/10.1007/s11113-013-9312-7.CrossRefGoogle ScholarPubMed
Hobfoll, S. E. (1989). Conservation of resources: a new attempt at conceptualizing stress. American Psychologist, 44, 513–524. https://doi.org/10.1037/0003-066X.44.3.513.CrossRefGoogle ScholarPubMed
Hobfoll, S. E. (2001). The influence of culture, community, and the nested-self in the stress process: advancing conservation of resources theory. Applied Psychology, 50, 337–421. https://doi.org/10.1111/1464-0597.00062.CrossRefGoogle Scholar
Hobfoll, S. E. (2002). Social and psychological resources and adaptation. Review of General Psychology, 6, 307–324. https://doi.org/10.1037//1089-2680.6.4.307.CrossRefGoogle Scholar
Jester, D. J. et al. (2023). Differences in social determinants of health underlie racial/ethnic disparities in psychological health and well-being: study of 11,143 older adults. The American Journal of Psychiatry, 180, 483–494. https://doi.org/10.1176/appi.ajp.20220158.CrossRefGoogle ScholarPubMed
Jester, D. J. et al. (2023). Impact of educational attainment on time to cognitive decline among marginalized older adults: cohort study of 20,311 adults. Journal of the American Geriatrics Society, 71, 2913–2923. https://doi.org/10.1111/jgs.18340.CrossRefGoogle Scholar
Langa, K. M. et al. (2005). The aging, demographics, and memory study: study design and methods. Neuroepidemiology, 25, 181–191. https://doi.org/10.1159/000087448.CrossRefGoogle ScholarPubMed
LeBlanc, A. J., Frost, D. M. and Wight, R. G. (2015). Minority stress and stress proliferation among same-sex and other marginalized couples. Journal of Marriage and Family, 77, 40–59. https://doi.org/10.1111/jomf.12160.CrossRefGoogle ScholarPubMed
Lin, P. J. et al. (2021). Dementia. Medical Care, 59, 679–686. https://doi.org/10.1097/MLR.0000000000001577.CrossRefGoogle ScholarPubMed
Lindsay, J. et al. (2002). Risk factors for Alzheimer’s disease: a prospective analysis from the Canadian Study of Health and Aging. American Journal of Epidemiology, 156, 445–453. https://doi.org/10.1093/aje/kwf074.CrossRefGoogle ScholarPubMed
Lipsey, M. W. and Wilson, D. B. (2001). Practical Meta-analysis. Thousand Oaks: Sage Publications, Inc.Google ScholarPubMed
Manly, J. J., Tang, M. X., Schupf, N., Stern, Y., Vonsattel, J. P. and Mayeux, R. (2008). Frequency and course of mild cognitive impairment in a multiethnic community. Annals of Neurology, 63, 494–506. https://doi.org/10.1002/ana.21326.CrossRefGoogle Scholar
Mayeda, E. R., Glymour, M. M., Quesenberry, C. P. and Whitmer, R. A. (2016). Inequalities in dementia incidence between six racial and ethnic groups over 14 years. Alzheimer’s and Dementia: the Journal of the Alzheimer’s Association, 12, 216–224. https://doi.org/10.1016/j.jalz.2015.12.007.CrossRefGoogle ScholarPubMed
Meza, E. et al. (2022). Perceived discrimination, nativity, and cognitive performance in a multiethnic study of older adults: findings from the kaiser healthy aging and diverse life experiences study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 77, e65–e73. https://doi.org/10.1093/gerona/glab170.CrossRefGoogle Scholar
Michaels, E. et al. (2019). Coding the Everyday Discrimination Scale: implications for exposure assessment and associations with hypertension and depression among a cross section of mid-life African American women. Journal of Epidemiology and Community Health, 73, 577–584. https://doi.org/10.1136/jech-2018-211230.CrossRefGoogle ScholarPubMed
Mouzon, D. M., Taylor, R. J., Nguyen, A. W., Ifatunji, M. A. and Chatters, L. M. (2020). Everyday discrimination typologies among older African Americans: gender and socioeconomic status. The Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 75, 1951–1960. https://doi.org/10.1093/geronb/Gbz088.CrossRefGoogle ScholarPubMed
Nianogo, R. A., Rosenwohl-Mack, A., Yaffe, K., Carrasco, A., Hoffmann, C. M. and Barnes, D. E. (2022). Risk factors associated with Alzheimer disease and related dementias by sex and race and ethnicity in the US. JAMA Neurology, 79, 584–591. https://doi.org/10.1001/jamaneurol.2022.0976.CrossRefGoogle ScholarPubMed
Paradies, Y. et al. (2015). Racism as a determinant of health: a systematic review and meta-analysis. PLoS ONE, 10, e0138511.CrossRefGoogle Scholar
Pascoe, E. A. and Smart Richman, L. (2009). Perceived discrimination and health: a meta-analytic review. Psychological Bulletin, 135, 531–554. https://doi.org/10.1037/a0016059.CrossRefGoogle Scholar
Pengpid, S. and Peltzer, K. (2021). Perceived discrimination and health outcomes among middle-aged and older adults in India: results of a national survey in 2017-2018. BMC Geriatrics, 21, 559. https://doi.org/10.1186/s12877-021-02508-z.CrossRefGoogle ScholarPubMed
Peters, M. E. et al. (2013). Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: The Cache County Study. American Journal of Geriatric Psychiatry, 21, 1116–1124. https://doi.org/10.1097/JGP.0b013e318267014b.CrossRefGoogle ScholarPubMed
Plassman, B. L. et al. (2011). Incidence of dementia and cognitive impairment, not dementia in the United States. Annals of Neurology, 70, 418–426. https://doi.org/10.1002/ana.22362.CrossRefGoogle Scholar
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. https://doi.org/10.1177/014662167700100306.CrossRefGoogle Scholar
Royse, S. K., Cohen, A. D., Snitz, B. E. and Rosano, C. (2021). Differences in Alzheimer’s disease and related dementias pathology among African American and Hispanic women: a qualitative literature review of biomarker studies. Frontiers in Systems Neuroscience, 15, 685957. https://doi.org/10.3389/fnsys.2021.685957.CrossRefGoogle ScholarPubMed
Rutter, M. (2012). Resilience as a dynamic concept. Development and Psychopathology, 24, 335–344. https://doi.org/10.1017/S0954579412000028.CrossRefGoogle ScholarPubMed
Sellers, R. M. and Shelton, J. N. (2003). The role of racial identity in perceived racial discrimination. Journal of Personality and Social Psychology, 84, 1079–1092. https://doi.org/10.1037/0022-3514.84.5.1079.CrossRefGoogle ScholarPubMed
Sonnega, A., Faul, J. D., Ofstedal, M. B., Langa, K. M., Phillips, J. W. and Weir, D. R. (2014). Cohort profile: the health and retirement study (HRS). International Journal of Epidemiology, 43, 576–585.CrossRefGoogle ScholarPubMed
Sutin, A. R., Stephan, Y., Carretta, H. and Terracciano, A. (2015). Perceived discrimination and physical, cognitive, and emotional health in older adulthood. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 23, 171–179. https://doi.org/10.1016/j.jagp.2014.03.007.CrossRefGoogle ScholarPubMed
Thames, A. D. et al. (2013). Effects of stereotype threat, perceived discrimination, and examiner race on neuropsychological performance: simple as black and white? Journal of the International Neuropsychological Society, 19, 583–593. https://doi.org/10.1017/S1355617713000076.CrossRefGoogle ScholarPubMed
Torres, L. and Ong, A. D. (2010). A daily diary investigation of Latino ethnic identity, discrimination, and depression. Cultural Diversity and Ethnic Minority Psychology, 16, 561–568. https://doi.org/10.1037/a00200652.CrossRefGoogle ScholarPubMed
US Census Bureau. (2021). Sex by age by nativity and citizenship status. Available at: https://data.census.gov/table?q=nativity+hispanicandtid=ACSDT1Y2021.B05003I.Google Scholar
Walen, H. R. and Lachman, M. E. (2000). Social support and strain from partner, family, and friends: costs and benefits for men and women in adulthood. Journal of Social and Personal Relationships, 17, 5–30. https://doi.org/10.1177/0265407500171001.CrossRefGoogle Scholar
Wang, K., Maglalang, D. D., Woo, B., De Fries, C. M., Hasche, L. K. and Falcón, L. M. (2022). Perceived discrimination and cognitive function among older Puerto Ricans in Boston: the mediating role of depression. International Journal of Geriatric Psychiatry, 37. https://doi.org/10.1002/gps.5717.CrossRefGoogle ScholarPubMed
Weden, M. M. et al. (2017). The Hispanic paradox: race/ethnicity and nativity, immigrant enclave residence and cognitive impairment among older US adults. Journal of the American Geriatrics Society, 65, 1085–1091. https://doi.org/10.1111/jgs.14806.CrossRefGoogle Scholar
Williams, D. R., Lawrence, J. A., Davis, B. A. and Vu, C. (2019). Understanding how discrimination can affect health. Health Services Research, 54, 1374–1388. https://doi.org/10.1111/1475-6773.13222.CrossRefGoogle ScholarPubMed
Williams, D. R., Yu, Yan, Jackson, J. S. and Anderson, N. B. (1997). Racial differences in physical and mental health: socio-economic status, stress and discrimination. Journal of Health Psychology, 2, 335–351. https://doi.org/10.1177/135910539700200305.CrossRefGoogle ScholarPubMed
Supplementary material: File

Tibiriçá et al. supplementary material

Tibiriçá et al. supplementary material
Download Tibiriçá et al. supplementary material(File)
File 15 KB