Immigration, Racialization and Asian American Older Adults' Cognitive Difficulties.

The sociohistorical experiences of Asian American older adults (AAOA) vary, but limited research has examined how immigration status operates as social determinants. This study builds on an existing framework to examine the relationship among social determinants and the differential effects of immigration status on cognitive difficulties among AAOA. Using 5-year estimate data from the 2019 American Community Survey, the study sample consisted of AAOA aged 65 years and older identifying as Chinese, Filipino, Indian, Japanese, Korean or Vietnamese (N=100,584). AAOA were categorized as noncitizens, naturalized, or US-born for their immigration status. Participants who indicated having difficulty concentrating, remembering, or making decisions were categorized as having cognitive difficulties. Chinese were the most prevalent ethnic group (30%). Over 70% were naturalized citizens. About 8% endorsed having cognitive difficulties. According to bivariate analyses, there were considerable differences in AAOA's characteristics (e.g., age, gender, marital status, medical insurance, employment status) by their immigration status. The results from the logistic regressions showed the immigration status was independently associated with poor cognitive difficulties. By AAOA's immigration status, unique protective and risk factors were presented for cognitive difficulties. The differential pattern of cognitive difficulties among AAOA reveals a fuller picture of variations within AAOA by the immigration status. The results imply that more research is needed to develop culturally-sensitive practices that account for the racialized differences by AAOA's immigration status. Further research into the interplay between structural determinants is necessary to formulate practice and policy interventions to address better successful aging for AAOA.

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