Population Study Of Chinese Elderly Research Articles

Social Disconnectedness, Perceived Loneliness, and Cognitive Functioning: The Role of Neighborhood Environment.

Social disconnectedness and loneliness pose significant challenges for older Chinese immigrants. Yet, it remains unclear whether they are associated with an increased risk of cognitive decline in this population. This study aimed to investigate the association of social disconnectedness and loneliness with cognitive functioning and examine the moderation role of neighborhood contexts. This longitudinal analysis examined a sample of individuals aged 60 years and older from the Population Study of Chinese Elderly in Chicago (N = 2,044). Global cognition was assessed using the averaged z-scores of cognitive performance tests. Social disconnectedness was constructed using 5 indicators about structural aspects of social relationships. Loneliness was assessed with the R-UCLA loneliness scale. Neighborhood socioeconomic status (NSES) and neighborhood segregation index were constructed using 2010-2014 American Community Survey data at the census tract level. Individual perceptions about neighborhood environments were used to construct neighborhood cohesion index and neighborhood disorder index (NDI). Latent growth curve models with adjusted cluster robust standard errors were estimated. More loneliness was associated with a higher level of initial cognitive functioning (B = 0.030, p < .01), but also with a faster decline rate over time (B = -0.007, p < .01) after adjusting for covariates. High NSES and less neighborhood segregation buffered the negative effects of loneliness on cognitive decline, respectively. High NDI amplified the positive relationship between loneliness and initial functioning, but accelerated the rate of cognitive decline associated with loneliness. The study revealed that perceived loneliness, but not social disconnectedness, is a risk factor for cognitive decline among older Chinese immigrants. Living in a neighborhood with low socioeconomic status, more segregation, and high disorder elevated the detrimental effect of loneliness on long-term cognitive decline. Further research needs to investigate the complex interplay between social relationships, neighborhood environment, and cognition.

NEIGHBORHOOD SEGREGATION AND CHARACTERISTICS OF OLDER CHINESE IMMIGRANTS LIVING IN GREATER CHICAGO

Abstract Neighborhoods profoundly influence health of older adults, with those living in more affluent neighborhoods tending to be happier and healthier. However, which neighborhoods to live, is shaped by pull and push factors, particularly among racial/ethnic minorities that disproportionally live in segregated neighborhoods characterized by social and economic deprivation. Residential segregation, however, is not well-examined among older Asian Americans. This study aimed to close this gap by investigating neighborhood, sociodemographic, and health behavior characteristics among older Chinese immigrants living in segregated neighborhoods. Data were drawn from 3,097 participants from Population Study of Chinese Elderly (PINE). Residential segregation was operationalized using Index of Concentrations at the Extremes (ICE), and the tertiles of ICE scores were used to categorize neighborhoods into four groups, ranging from neighborhoods extremely segregated toward Chinese speakers to segregated toward English-only speakers. Results showed that, compared to neighborhoods segregated toward English-only speakers, neighborhoods extremely segregated toward Chinese speakers had lower neighborhood socioeconomic status and cohesion but higher neighborhood disorder. Also, participants in neighborhoods segregated toward Chinese speakers were more likely to be unmarried but less likely to live alone, receive less education, and live in the U.S. longer. These participants also reported lower acculturation and racial discrimination, were more likely to smoke, and had lower adoption of preventive health practices than those living in neighborhoods segregated with English-only speakers. Findings highlight challenges and opportunities among older Chinese immigrants living in segregated neighborhoods and provide insights into existing mixed findings on health impacts of residential segregation among this understudied population.

RESIDENTIAL SEGREGATION AND DEPRESSIVE SYMPTOMS IN OLDER CHINESE IMMIGRANTS: MEDIATING ROLE OF SOCIAL PROCESSES

Abstract Older Chinese immigrants are particularly at risk for depression due to acculturative stress and language barriers. Residential segregation with respect to language use may play an important role in mental health of historically marginalized immigrant populations. Previous research provided mixed evidence about the segregation effect among older Latino and Asian immigrants. Guided by a model of social processes, we examined the direct and indirect effects of residential segregation on depressive symptoms via multiple mechanisms of acculturation, discrimination, social network, social support, social strain, and social engagement. Four waves of depressive symptoms were assessed in the Population Study of Chinese Elderly (2011-2019, N=1,970), and linked to the 2010-2014 American Community Survey estimates of neighborhood context. Residential segregation was measured by the Index of Concentrations at the Extremes that simultaneously assesses Chinese and English language use within a given census tract. Latent growth curve models with adjusted cluster robust standard errors were estimated after controlling for individual-level factors. Residents of segregated Chinese-speaking neighborhoods had fewer baseline depressive symptoms but a slower decline rate than those living in segregated toward English-only speaking neighborhoods. Racial discrimination, social strain, and social engagement partially mediated the association between segregation and initial level; social strain and social engagement also partially mediated the association with decline in depressive symptoms. This study demonstrates the importance of residential segregation and social processes in shaping mental well-being among older Chinese immigrants and suggests potential mechanisms to alleviate mental health risks.

FACTORS ASSOCIATED WITH HELP-SEEKING AMONG US CHINESE OLDER ADULTS WHO REPORTED ELDER MISTREATMENT

Abstract Purpose Elder mistreatment (EM) is an important public health issue. Guided by the Andersen’s Behavioral Model of Health Services Use, this study aimed to examine factors that impede or facilitate help-seeking intentions and behaviors among U.S. Chinese older adults who reported EM. Methods Data were from the Population Study of Chinese Elderly in Chicago (PINE). Different types of mistreatments, informal and formal help-seeking intentions and behaviors were assessed. Descriptive statistics, linear regression, and multinominal logistic regression were used. Results Among 450 participants who reported EM, 46.55% experienced psychological mistreatment, 29.91% had financial exploitation, 14.92% had caregiver neglect, 4.68% had physical mistreatment, 1.11% had sexual mistreatment, and 17.78% had multiple victimizations. Intentions of informal help-seeking was higher among victims who were female and married, and those who experienced financial exploitation and caregiver neglect. Formal help-seeking intentions were lower among victims who had a larger social network size. EM victims who were female, married, perceived more social support, experienced financial exploitation, and experienced caregiver neglect were more likely to seek help from informal resources. EM victims who had higher income, perceived more social support, and had multiple victimizations were more likely to seek formal resources. Conclusion/implication: Our findings suggest that the predisposing factors, enabling resources, and need factors that impacted seeking help from informal and formal resources among older Chinese Americans who reported mistreatment. Findings provided important insights for developing early screening programs and interventions, such as increasing help-seeking channels and improving access to care services.

IMPACTS OF ACCULTURATION ON HEALTH OF US OLDER CHINESE IMMIGRANTS

Abstract Acculturation from Asian- to Western-oriented values and cultural practices is a key aspect of social experience for many Asian Americans. The growing body of literature on this topic shows mixed findings on health impacts of acculturation and is largely relied on cross-sectional studies, preventing to draw definitive conclusions on the health impact of acculturation. The study aimed to examine long-term effects of acculturation on mental, physical, and cognitive health in U.S. older Chinese immigrants. Data were drawn from 2,811 participants (aged from 60 to 104 years) from the Population Study of Chinese Elderly in Chicago study. Acculturation was measured using a 12-item Acculturation Scale assessing language use, ethnic social relations, and media use. Health outcomes included depression assessed using the Patient Health Questionnaire-9, activities of daily living (ADL) assessed using the adapted Katz ADL Scale, and global cognition indexed by a composite score of episodic memory, working memory, executive function, and mental status. Results from latent growth curve models showed that high levels of acculturation were not associated with depression at baseline but predicted a faster decline in depression during the 6-year follow-up. Similarly, acculturation was not related to ADL at baseline but predicted a slower decline over time. Contrarily, acculturation was associated with better global cognition at baseline but was not related to long-term changes in cognition. These results suggest the long-term benefits of acculturation on mental and physical health among U.S. older Chinese immigrants. The health advantages related to acculturation, however, seem not to generalize to cognitive function.

DEMYSTIFYING IMPACTS OF NEIGHBORHOOD ENVIRONMENT ON HEALTH OF OLDER CHINESE AMERICANS

Abstract Residential segregation is a key social determinant of health that disproportionately affects racial/ethnic minority and immigrant populations. The health impact of residential segregation and subjective neighborhood environment, however, is poorly understood among older Asian Americans. Findings from the limited existing studies on this topic exclusively relied on cross-sectional data and/or masked distinctive differences across Asian subgroups due to the usage of aggregated data. The purpose of this symposium is to provide a better understanding of health impacts of residential segregation and subjective neighborhood environment among older Chinese Americans, the largest Asian subgroup in the U.S. Findings presented in this symposium were from the Population Study of Chinese Elderly in Chicago (PINE) study, a longitudinal study of community-dwelling older Chinese immigrants living in greater Chicago. Session 1 describes key characteristics of neighborhood, sociodemographic, and health behaviors of older Chinese immigrants living in segregated neighborhoods. Session 2 moves beyond to determine unique and joint effects of residential segregation and neighborhood socioeconomic status on 8-year change in cognitive functioning. Session 3 focuses on mental health by investigating main and indirect effects of residential segregation on depression via social processes. Session 4 tests the interactive effects of social support with residential segregation on cognitive functioning and depression. Lastly, Session 5 demonstrates how subjective neighborhood environment, directly and indirectly, affects depression via coping. In sum, findings provide innovative and important evidence to facilitate a better understanding of health implications of living in segregated neighborhoods among older Chinese Americans.

RELATIONSHIP BETWEEN INFORMAL AND FORMAL HELP-SEEKING BEHAVIORS FOR ELDER MISTREATMENT AMONG CHINESE IMMIGRANTS

Abstract Purpose Help-seeking minimizes the consequences from elder mistreatment (EM). However, formal help-seeking could be challenging for older immigrants due to cultural and linguistic barriers. Informal supporters have been shown to promote formal help-seeking among EM victims. This study aimed to examine whether informal help facilitates U.S. Chinese EM victims with seeking help from formal sources. Methods Data were derived from the Population Study of Chinese Elderly in Chicago. EM measurements included psychological, physical, sexual mistreatment, financial exploitation, and caregiver neglect. Seeking help from informal and formal sources were evaluated. Descriptive statistics and multinominal logistic regression were conducted. Results Among 450 EM victims, 53.48% of them sought informal help, 31.75% did not seek any help, 11.42% sought both informal and formal help, and 3.34% sought formal help. The most common informal sources were adult children, partners, and friends/neighbors. The most common formal sources were community social services organizations, followed by legal criminal justice systems. Compared to those who did not seek any help, victims who reported more emotional closeness within their social network and experienced financial exploitation were more likely to seek help from formal sources. However, informal help-seeking was not significantly associated with formal help-seeking. Conclusion/implication: The findings suggest that most U.S. Chinese older adults who experienced EM did not seek formal help. Higher levels of contact with social networks could increase seeking help from formal sources. However, future research is needed to explore why informal supporters did not facilitate seeking help from formal sources in Chinese EM victims.

PHYSICAL FUNCTION, DEPRESSION, AND COGNITIVE FUNCTION OF OLDER CHINESE AMERICANS: CROSS-LAGGED MODEL

Abstract Introduction Understanding the complex interactions of physical function, depression, and cognitive function is crucial for understanding healthy aging. However, few studies have empirically tested these relationships. This study examined the directional relationships of physical function, depression, and cognitive function among older Chinese Americans. Methods This study included a subsample of participants (n=2,811) from the Population Study of Chinese Elderly in Chicago who completed the baseline survey during 2011-2013 (W1) and at least one of the three follow-up surveys conducted in 2013-2015 (W2), 2015- 2017 (W3), and 2017-2019 (W4). Physical function, depression, and cognitive function were measured by a battery of physical mobility, the 9-item Patient Health Questionnaire, and cognitive performance tests (executive function, memory, and cognitive impairments). A random intercept cross-lagged panel model was performed to examine the bidirectional relationships among physical function, depression, and cognitive function. Results The cross-lagged panel model showed that higher levels of depression at W1 were associated with poorer physical function at W2. In turn, poorer physical function at W2 was related to higher levels of depression at W3. Higher levels of depression (W2) were linked to poorer physical function at W3. Poorer physical function at W2 was associated with poorer cognitive function at W3. Finally, poorer cognitive function at W3 was associated with poorer physical function and higher levels of depression at W4. Discussion Our results support a bidirectional relationship between physical function and depression. Also, as individuals age, cognitive function plays a key role in predicting physical function and psychological well-being.

Residential Segregation, Perceived Neighborhood Environment, and All-Cause Mortality Among Community-Dwelling Older Chinese Americans.

Residential segregation profoundly affects mental and physical health. However, impacts of residential segregation and other neighborhood characteristics on health among older Asian Americans are not fully understood. This study aimed to close this gap by examining effects of residential segregation, perceived neighborhood cohesion, and neighborhood disorder on all-cause mortality among older Chinese immigrants, as well as testing whether the association between residential segregation and mortality would be mediated by perceived neighborhood cohesion and neighborhood disorder. Data were drawn from a subsample of 3,094 older Chinese Americans aged 60 and older (mean age = 72.8 years) from the Population Study of Chinese Elderly in Chicago. Residential segregation was derived using 2010-2014 American Community Survey data. Participants completed surveys on perceived neighborhood cohesion and neighborhood disorder between 2011 and 2013. All-cause mortality was tracked until December 2021. Residential segregation was associated with elevated all-cause mortality risk; this association, however, was no longer statistically significant after controlling for sociodemographic, behavioral, and health covariates. Perceived neighborhood cohesion, but not neighborhood disorder, was significantly associated with decreased mortality risks. There were no indirect effects of residential segregation on all-cause mortality through perceived neighborhood cohesion or neighborhood disorder. These effects were consistent across male and female participants. These results suggest the importance of neighborhood social environment, specifically perceptions of neighborhood cohesion, in influencing mortality risk among older Chinese immigrants. The findings also indicate the need to conduct further research to examine the health impact of residential segregation among this population.

Factors of Dental Care Utilization in Foreign-Born Older Chinese Americans

Good oral health is essential for healthy aging. Regular dental care utilization is instrumental to good oral health. Older immigrants tend to experience poorer oral health and less dental care use as compared with their native-born counterparts in the host country. Older immigrants are particularly vulnerable to interrupted or lost social ties and acculturation challenges after immigration to a new country. This study examined whether and to what extent social relations, acculturation, and perceived oral health needs are associated with dental care utilization in foreign-born older Chinese Americans. Data came from the Population Study of Chinese Elderly in Chicago, which were collected between 2017 and 2019 (N = 3,000). Dental care utilization was dichotomized into “yes” versus “no” in the past 2 y. Social relations were measured by positive and negative relations with spouse, family, and friends. Acculturation was measured by length of stay, behavioral acculturation, and residence in Chinatown. Perceived oral health needs were measured by the presence of problems related to teeth, gums, or bleeding. As guided by the Andersen model, separate logistic regression models were used to investigate factors of dental care utilization. An overall 23.1% reported dental care utilization. Individuals with no negative relations with spouse, family, and friends were 31%, 36%, and 38% less likely to visit a dentist, respectively. Individuals with higher levels of behavioral acculturation were 4% more likely to visit a dentist; individuals living in Chinatown were 45% less likely; and individuals with perceived oral health needs were 2.5 times more likely. Findings illustrate the importance of understanding social relations, immigration-related factors, and perceived oral health needs in dental care utilization in older immigrants.

Examining sociocultural factors in widowhood and cognitive function among older Chinese immigrants: findings from the PINE study

Objectives: Although there is growing evidence on widowhood and cognitive function, existing studies have shown mixed results. Little is known about protective factors that may contribute to resilience, thereby ameliorate the adverse effect of widowhood on cognition among older Asian immigrants. This study explored potential moderators (i.e. social support, acculturation, leisure activities) in the association between widowhood and cognitive function among older Chinese immigrants. Method: The study sample included 2,515 adults aged 60 or older who completed two waves (2011–2013 and 2013–2015) of the Population Study of Chinese Elderly in Chicago. Cognitive function was indexed by global cognitive function and episodic memory. Linear regression analyses were conducted with interaction terms. Results: Our results show that social support moderated the relationship between widowhood and global cognitive function, and acculturation moderated the relationship between widowhood and episodic memory. The adverse effect of widowhood on cognitive function was more pronounced at lower levels of social support and acculturation. Conclusion: Our findings indicate buffering roles of social support and acculturation in cognitive health among older Chinese immigrants who experience widowhood. Providing supportive programs and interventions to increase social support and acculturation is suggested to promote cognitive function in this population.

Social Support and Unmet Needs for Personal Assistance Among Community-Dwelling U.S. Chinese Older Adults: Does the Source of Support Matter?

ABSTRACT This study examines the relationship between social support sources and unmet needs among U.S. Chinese older adults. Data were from the Population Study of Chinese Elderly in Chicago. Unmet needs were assessed by indexes of activities of daily living (ADL) and instrumental activities of daily living (IADL). Three specific sources of social support (spouse, family members, and friends) were included. Multivariable logistic regression models were conducted. Approximately 17% of the 3,157 respondents reported having unmet ADL/IADL needs. U.S. Chinese older adults with less overall social support were more likely to have unmet ADL needs (odds ratio [OR]=0.91, 95% CI=0.83-0.99) and IADL needs (OR=0.84, 95% CI=0.81-0.88). Family and friend support were associated with a lower likelihood of having unmet ADL needs. Support from spouse, family, and friends was associated with a lower likelihood of having unmet IADL needs. The findings highlight the importance of informal social support in addressing unmet needs .

Residential Segregation and Depressive Symptoms in Older Chinese Immigrants: The Mediating Role of Social Processes.

Older Chinese immigrants are at risk for depression due to acculturative stress and language barriers. Residential segregation with respect to language use plays an important role in the mental health of historically marginalized populations. Previous research provided mixed evidence about the segregation effect among older Latino and Asian immigrants. Guided by a model of social processes, we examined the direct and indirect effects of residential segregation on depressive symptoms via multiple mechanisms of acculturation, discrimination, social network, social support, social strain, and social engagement. Four waves of depressive symptoms were assessed in the Population Study of Chinese Elderly (2011-19, N = 1,970), and linked to the 2010-14 American Community Survey estimates of neighborhood context. Residential segregation was measured by the Index of Concentrations at the Extremes which simultaneously assesses Chinese and English language use within a given census tract. Latent growth curve models with adjusted cluster robust standard errors were estimated after controlling for individual-level factors. Residents of segregated Chinese-speaking neighborhoods had fewer baseline depressive symptoms but a slower rate of symptom reduction than those living in neighborhoods segregated with English-only speakers. Racial discrimination, social strain, and social engagement partially mediated the association between segregation and baseline depressive symptoms; social strain and social engagement partially mediated the association with long-term reduction in depressive symptoms. This study demonstrates the importance of residential segregation and social processes in shaping mental well-being among older Chinese immigrants and suggests potential mechanisms to alleviate mental health risks.

IMMIGRATION EXPERIENCES AND COGNITIVE TRAJECTORIES AMONG OLDER CHINESE IMMIGRANTS

Abstract Some studies have documented cognitive health among older immigrants in the United States; however, little is known about how the life-course immigration experiences were associated with cognitive trajectories among older Chinese immigrants. This study filled the research gap by identifying the patterns of cognitive change trajectory among older Chinese immigrants and examining the associations of immigration experiences (that is, age at migration, reasons for migration, acculturation, perceived discrimination, and preferred dialects) with cognitive trajectories. The sample comprised 2,075 participants from the Population Study of Chinese Elderly (PINE), who completed a battery of cognitive tests at four time points (2011-2019). Latent class growth analysis and multinomial logistic regression were utilized. Three latent classes of cognitive trajectories were identified: the low functioning with the fastest decline (LCF, 12%), the moderate functioning with a medium decline rate (MCF, 39%), and the high functioning with the slowest decline (HCF, 48%). Perceiving more discrimination reduced, while speaking Taishanese increased the odds of being in the LCF and MCF. High acculturation only distinguished MCF from HCF after controlling for the known factors of cognition such as age, education, and social engagement. This study identifies a group of older Chinese immigrants who are especially vulnerable to cognitive impairment, and indicates that the immigration-related risks for cognitive decline, such as late-life migration and lower acculturation, could be buffered by education in early life and social engagement post immigration. Practice and policy efforts are needed to increase socioeconomic and cultural opportunities for social integration among older immigrants.

SOCIAL NETWORKS AND HELP-SEEKING AMONG US CHINESE OLDER ADULTS REPORTED ELDER MISTREATMENT

Abstract Purpose Older immigrant adults are reported to be more tolerant of abusive situations and less likely to seek help. This study aimed to examine the associations between social networks and help-seeking among U.S. Chinese older adults reported elder mistreatment (EM). Methods Data were from the Population Study of Chinese Elderly in Chicago (PINE). Social networks were assessed with network size, volume of contact, emotional closeness, proportion kin, proportion female, and proportion coresident. Informal/formal help-seeking (intentions and actual behaviors) were measured. Descriptive statistics and regression analyses were performed. Results A total of 450 participants reported EM. Participants had a mean age of 72.73 ± 8.03 years old (range 60-97). Participants had a mean of 3.29 (SD ± 1.31) network members, a mean of 3.24 (SD ± 0.67) emotional closeness, and average contacts of 6.62 (SD ± 1.10) times per year with network members. Smaller network size (p = .00) and less emotional closeness (p = .03) were associated with an increase in intentions of seeking help from formal sources. Compared to not seeking help, smaller network size (p = .04) and more emotional closes (p = .03) were associated with a higher likelihood to seek help from informal sources among U.S. Chinese older adults who reported any EM. Conclusion/implication: This study highlights the dynamic nature of social networks of help-seeking among this underserved population. Culturally tailored interventions are suggested to promote help-seeking through increasing strong ties and improving the quality of social networks for U.S. Chinese older immigrants with EM.

SOCIAL SUPPORT, SOCIAL STRAIN, AND DENTAL CARE UTILIZATION AMONG OLDER CHINESE AMERICANS

Abstract Regular dental care utilization is instrumental to good oral health. This study aimed to examine how positive and negative aspects of social relationships jointly exert influences towards dental care use among foreign-born older Chinese Americans. Data came from the Population Study of Chinese Elderly in Chicago collected between 2017 and 2019 (n = 3,000). Dental care utilization was dichotomized into “no dental visit” versus “any dental visit” in the past two years (including dental visit overseas). Social support and strain were measured by the Health and Retirement Study’s scale from spouse, other family members, and friends (1= having any support/no strain). In stepwise logistic regression, accounting for chronic conditions, oral health problems, and sociodemographics, spousal support remained to be significantly associated with a lower likelihood of having any dental visit. Findings illustrate the importance of understanding how different aspects of social relationships might play a role in dental care use.

NEIGHBORHOOD COHESION, LIVING ALONE, AND ALL-CAUSE MORTALITY IN COMMUNITY-DWELLING OLDER CHINESE AMERICANS

Abstract This study aimed to examine whether neighborhood cohesion would mitigate the adverse effect of living alone on all-cause mortality in community-dwelling older Chinese Americans. Data were drawn from the Population Study of Chinese Elderly (PINE, N = 3,157, 59-105 years, 58% female), a longitudinal study started in 2011. Mortality was tracked through December 2021 (N = 642 deceased). Cox regression indicated that neighborhood cohesion moderated the association between living alone and all-cause mortality (HR = 0.74, 95%CI [0.57, 0.97]), showing that among participants living alone (N = 678), those with high neighborhood cohesion had a 41% lower mortality risk than their counterparts with low neighorhood cohesion. In contrast, among participants living with others, those with high and low neighborhood cohesion had a similar mortality risk. These findings highlight that strong neighborhood cohesion may protect against the increased risk of premature mortality associated with living alone in older Chinese Americans.

ORAL HEALTH AND DENTAL CARE AMONG OLDER ADULTS IN DIVERSE POPULATIONS: ANALYSES OF LARGE COHORT DATA

Abstract Using large cohort surveys, this symposium includes five studies examining the linkages between oral health and systemic conditions, and social and behaviors factors affecting oral health and dental care utilization in older adults. The first study used the English Longitudinal Study of Ageing (ELSA) and analyzed the effect of changes in self-rated dental conditions on memory among adults age 51+. This study also examined the mediation effect of stroke on this relationship. Using the same data (ELSA), the second study examined the longitudinal relationships between cognitive function and changes in diabetes and oral health status. Results showed that participants with co-occurrence of diabetes and poor oral health had an accelerated decline in cognitive function over the study period. The third study was conducted among 8,744 adults age 51+ using data from the Health and Retirement Study over a 10-year period. The authors found that social isolation had a significant effect on dementia onset and that both dental visits and tooth status had a mediating effect on the association. The fourth study analyzed the Medical Expenditure Panel Survey from 2009-2016 and found that individuals with cognitive impairment had a significantly lower probability of annual dental visits. Using data from the Population Study of Chinese Elderly in Chicago collected between 2017-2019, the fifth study found that spousal support was significantly associated with a lower likelihood of having any dental visit. Findings illustrate the importance of understanding how different aspects of social relationships might play a role in dental care use.

COGNITIVE FUNCTION AND HELP-SEEKING AMONG US CHINESE OLDER ADULTS WITH ELDER MISTREATMENT

Abstract Purpose Elder mistreatment (EM) in immigrants with cognitive decline is an understudied public health problem. Cognitive function plays an important role in individuals’ ability to seek help. This study aimed to examine the associations between cognitive function and help-seeking among U.S. Chinese older adults reported EM. Methods Data were from the Population Study of Chinese Elderly in Chicago (PINE). Five instruments were used to measure cognitive function, including the Mini-Mental State Examination, East Boston Memory Test Immediate Recall and Delayed Recall, Digit Span Backwards, and Symbol Digit Modalities Test. Informal/formal help-seeking intentions and behaviors were measured. Descriptive statistics, linear regression, and logistic regression were performed. Results A total of 450 participants reported EM. Most victims sought help from informal sources (53.48%), followed by any sources (11.42%) and formal sources (3.34%). About one-third of participants did not seek any help. Higher episodic memory was associated with an increase in help-seeking intentions among Chinese older adults with financial mistreatment (p &amp;lt; .05) and poly-victimization (p &amp;lt; .01). Lower working memory was associated with an increase in help-seeking intentions among those with caregiver neglect (p &amp;lt; .001). Compared to not seeking help, higher executive function was associated with a higher likelihood to seek help from any sources among Chinese older adults with psychological mistreatment (p &amp;lt; .05). Conclusion/implication: This study highlights the associations between cognitive function and help-seeking among this underserved population. Culturally tailored interventions are suggested to promote help-seeking for different types of cognitive impairment among Chinese older adults with EM.

Neighborhood segregation, socioeconomic status, and cognitive function among older Chinese immigrants.

The fast-growing population of older Chinese immigrants and their segregated residences highlight the importance of understanding the role of neighborhood context in cognitive health. The segregation-cognition association is equivocal based on a limited number of studies among Hispanic and Asian Americans. To close the knowledge gap, this study examined the associations of neighborhood segregation and socioeconomic status (NSES) with cognitive functioning among older Chinese immigrants. Four waves of cognitive performance tests were conducted in the Population Study of Chinese Elderly in Chicago (2011-2019) and linked to the 2010 to 2014 American Community Survey estimates of neighborhood contexts. NSES was a summary z-score of six census variables of education, income/wealth, and occupation. Neighborhood segregation was measured by the Index of Concentrations at the Extremes (ICE), which simultaneously assesses Chinese and English language use within a given census tract. There were 170 census tracts in the present sample of 2044 participants. Latent growth curve models with adjusted cluster robust standard errors were estimated. On average, cognitive functioning declined over time (B=-0.07, p < 0.001). After adjusting for individual-level predictors, living in high-NSES neighborhoods was associated with slower cognitive decline (B=0.003, p=0.04). ICE was not associated with cognitive functioning, but boosted the protective effect of high NSES on cognitive decline (B=0.006, p=0.05). Neighborhood socioeconomic advantage was related to slower cognitive decline among older Chinese immigrants, especially among those living in neighborhoods with more English speakers or less segregation. This finding suggests complex associations between neighborhood context and cognitive health among Chinese immigrants.