BACKGROUND

• Studies on the effects of social risk (neighborhood deprivation and everyday discrimination experiences - EDE) and resilience factors (social support and neighborhood cohesion) in relation to cognitive performance are limited, particularly among Asian Americans.
• We examined these associations among older ethnic Chinese, Korean, and Vietnamese Americans in California

 

METHODS

• Cross-sectional study of Asian Americans in California; recruited from May 2024-March 2026
• Participants completed a survey that included demographic questions and self-reported social support, neighborhood cohesion, and discrimination experiences.
• Cognition was evaluated using CASI-I, CASI-II, and 3MS and modeled as a standardized Z-score within each test.
• EDEs modeled as none, low, high; social support and neighborhood cohesion modeled as continuous variables.
• Neighborhood deprivation estimated at the census block level and modeled in quintiles.
• Linear regression estimating changes in standard deviation (SD) and 95% confidence intervals (CI) per unit change in the risk and resilience factors, adjusting for age, gender, income, cultural group, diabetes, hypertension, body mass index, and smoking.

 

RESULTS

•  Average age (SD) of participants was 74.3 (5.5), 61% female, 47.2% Vietnamese, 37.5% ethnic Chinese, and 15.5% Korean.

•  Mean (SD; range) cognitive scores were 86.4 (8.2; 44.0-99.0), 93.5 (7.9; 45.4-100.0), and 86.8 (8.1; 62.0 - 98.0) for CASI-I, CASI-II, and 3MS, respectively.

•  Neighborhood deprivation was associated with cognitive score: compared to those living in the least deprived neighborhoods, those in the most deprived neighborhoods had a 0.438-SD (95% CI 0.086 – 0.789; p-trend = 0.02) lower cognitive score

•  High EDEs were associated with higher cognitive scores: compared to those with no experiences of discrimination, those who experienced high discrimination had a 0.33 -SD (95% CI 0.08 - 0.58) higher cognitive score.

•  Education attenuated the effect to 0.25 (95% CI 0.02 - 0.48).

•  Social support and neighborhood cohesion were not associated with cognitive scores.

 

DISCUSSION

• The association with neighborhood deprivation is consistent with a significant body of literature linking neighborhood-level disadvantage to worse cognitive outcomes.
• The positive association between discrimination and standardized cognitive score was contrary to initial hypotheses, and contrary to findings among other minority groups
• The observed association may reflect that Asians who experience higher levels of perceived discrimination use coping strategies, which may improve cognition. Future studies should evaluate this mechanism.
• Higher cognition may shape how discrimination is being perceived and reported; a limitation of this cross-sectional study design.
• Other potential limitations include selection bias and survivor bias.