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Objectives: Studies on the interdependence of couples’ health behaviors and subsequent cognitive outcomes remain limited. Methods: Longitudinal data from the China Health and Retirement Longitudinal Study (2011–2018) were used ( N = 1869 heterosexual couples). Latent class analysis identified the dyadic pattern of health behaviors in 2011 (i.e., alcohol consumption, smoking, and physical inactivity). Stratified Cox models examined the association of latent classes with risk of developing memory-related disorders in 2013–2018. Results: Three classes were identified: class 1 (21.25%, only husband smoke, and both active), class 2 (47.55%, both inactive, neither drink nor smoke), and class 3 (31.20%, both drink and smoke, and both active). Couples’ sedentary lifestyle was associated with an increased risk of memory-related disorders among both husbands and wives. Conclusion: Couples were moderately concordant in their physical activity but weakly in smoking and drinking. Couple-based interventions, especially promoting physical activity, may reduce cognitive aging among middle-aged and older Chinese couples.

Background Studies have suggested older spouse caregivers experience burden-related adverse health outcomes compared to non-caregivers. However, potential causal inferences remain unclear. This study examined the effect of caregiving on insomnia symptoms of spouse caregivers over time, compared to non-caregiver samples matched by propensity score (PS). Methods Longitudinal data from the Health and Retirement Study from 2006 to 2018 were used. Caregivers (Nf403) were respondents (aged 50+) who assisted their heterosexual spouses in performing (instrumental) activities of daily living at baseline. PS-matching was used to match non-caregivers based on sociodemographic, household, and health-related characteristics. Symptoms of insomnia were evaluated every four years for both groups. The link between caregiver status and number/severity of insomnia symptoms over time was assessed using a Poisson mixed-effects model. Results The propensity-matched sample achieved a satisfactory covariate balance. There was no statistically significant difference between caregivers and non-caregivers in the number of insomnia symptoms at baseline (β_caregiver=0.092, 95% CI = -0.017, 0.201). However, caregivers reported a slower increase in insomnia symptoms compared to non-caregivers (β_caregiver×time = -0.012, 95% CI = -0.021, -0.003). Results were cross-validated in modelling the severity of insomnia symptoms. Conclusion There is weak evidence that a spouse’s role as a caregiver may be beneficial for his/her sleep health over time. The negative effects of caring on older individuals’ sleep may vary depending on the caregiving context. The potential health benefits of informal spousal caring and their underlying mechanisms warrant further investigations.

Background This study investigates types of parent-child relationships and associated health outcomes among older adults of U.S. and China. Method: Cross-sectional data from Health and Retirement Study in the U.S. and Health and Retirement Longitudinal Study in China were used (N_(U.S.)=3918, N_China=4058). Relationship indicators included co-residence, living nearby, having weekly contacts, receiving assistance with daily activities, providing grandchild care, and having financial transfer from/to children. Latent class and regression analyses were conducted. Results Four classes were identified for older Americans, including (1) distant and uninvolved (6.58%); (2) geographically proximate with frequent contacts and downward support (47.04%); (3) co-resident with frequent contacts and upward support (13.1%); and (4) geographically proximate with frequent contacts (33.28%). By contrast, three classes were identified among older Chinese, including (1) co-resident with frequent contacts and upward support (37.46%); (2) coresident/interdependent (25.65%); (3) geographically proximate with frequent contacts and upward financial support (36.89%). For both countries, providing downward support was associated with fewer functional limitations and better cognitive function. Receiving instrumental support from children was associated with more depressive symptoms and functional limitations, and poorer cognitive function among Chinese older adults only. Conclusions Cultural contrasts were evident in parent-adult child relationship types and their associations with health outcomes. Overall, child-parent relationships in China tend to be more tight-knit than that of the U.S. Receiving financial support from children and co-residence are unique features of child-parent relationships in China. Cultural differences in child-parent relationships call for culturally-relevant strategies to address needs of older adults from various cultures.

Despite the well-documented health interdependence in the spousal context, empirical evidence on how psychological wellbeing of one’s partner might affect one’s cognitive function remains limited. Using dyadic data, the objective of this study is to examine trajectories of depressive symptoms and associated cognitive function outcomes among U.S. older married couples. Longitudinal Health and Retirement Study data (2004-2016) were used (N=6,289 heterosexual couples). Latent class growth analysis characterized depressive symptom trajectories for wives and husbands, separately. Structural equation models examined the actor and partner effects of depressive symptom trajectories on cognitive function in 2016 after adjusting for covariates. Four distinct depressive symptom trajectories were identified, including persistently low (wives: 73.61%; husbands: 79.59%), increasing (wives: 8.60%; husbands: 8.27%), decreasing (wives: 12.80%; husbands: 8.32%), and persistently high (wives: 4.99%; husbands: 3.81%). Compared to the low trajectory, increasing and high depressive symptom trajectories were associated with poorer cognitive function for wives and husbands (β_(wife,increasing,actor)=-0.92,95%CI=-1.30,-0.54; β_(wife,high,actor)=-0.71,95%CI=-1.19,-0.23; β_(husband,increasing,actor)=-0.81,95%CI=-1.16,-0.45; β_(husband,high,actor)=-1.20,95%CI=-1.78,-0.63). Notable gender discrepancies in partner effects were observed. Specifically, wife’s depressive symptom trajectories were not associated with husband’s cognitive function (P>0.05). However, husband’s decreasing depressive symptom trajectory was linked to wife’s better cognitive function. One’s own depressive symptom trajectories predicts his/her own cognitive function. Specifically, older adults with increasing and persistently high depressive symptoms over time may experience poorer cognitive function, and thereby warrant additional policy and clinical attention. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses’ cognitive function. Future studies need to validate such gender differences.

This study examined the gap between need and provision of community services in China and its association with older adults' life satisfaction over time. Longitudinal data from the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014 were used (3 waves, N = 16,199). Respondents reported if they needed nine types of community service and if their community provided such service. Growth curve models analyzed whether individual- and/or province-level characteristics predicted the initial level and/or changes of life satisfaction over time. Results indicated the presence of major unmet service needs in China. Available community services were mismatched with older adults' perceived needs. Unmet service needs were associated with decreased life satisfaction at baseline. However, unmet service needs were not associated with changes in life satisfaction over time. Study findings highlighted the urgent need to optimize service design in accordance with older adults' needs, which ultimately could promote older adults' well-being.

The retinoid-interferon-induced mortality-19 (GRIM-19) gene has been identified as a negative regulator associated with tumor development. The current study created a model of an orthotopically implanted hepatocarcinoma tumor to verify the inhibitory effect of GRIM-19 in vivo. After treatment with GRIM-19 carried by attenuated Salmonella, transplanted tumors were measured with an Imaging System. The expression of GRIM-19, Stat3/p-Stat3, cyclinD1, CDK4, PCNA, Bax/Bcl-2, cleaved caspase-9/3, VEGF, and MMP-2/9 was determined using immunohistochemistry and Western blot analysis. The cell cycle was assessed using flow cytometry (FCM). Apoptosis was determined using FCM and a TUNEL assay. Results indicated that GRIM-19 overexpression resulted in inhibition of peritoneal metastasis, induction of cell cycle arrest, and apoptosis in vivo. In addition, the expression of Stat3/p-Stat3 was down-regulated by GRIM-19. These results suggest that GRIM-19 overexpression could suppress the growth of orthotopically implanted hepatocarcinoma tumors by reversing the regulation of the Stat3 signaling pathway. This approach could potentially be a powerful treatment for hepatocarcinoma.

OBJECTIVES: This study aims to investigate the relationship between quantity, quality, and composition of social networks and depressive symptoms among U.S. Chinese older adults. METHODS: Data were derived from the Population Study of Chinese Elderly (PINE) (N = 3,157), a study of Chinese older adults aged 60 and above in Chicago. We assessed quantitative (network size and volume of contact), qualitative (emotional closeness), and composition (proportion kin, proportion female and proportion coresident) aspects of social networks. Depressive symptoms were measured by the Patient Health Questionnaire-9. Negative binomial and logistic regressions were conducted. RESULTS: Older adults who had three to five network members with strong ties, a medium level of contact, and a high level of emotional closeness were less likely to experience depression than their counterparts. Quantitative and qualitative dimensions of social networks have stronger protective effects than the composition dimension. CONCLUSIONS: U.S. Chinese older immigrants with different levels of social network characteristics have different risks of depression, suggesting targeted subpopulation assessments to facilitate the delivery of more appropriate and effective treatment to those most in need. CLINICAL IMPLICATIONS: Health-care professionals and social service agencies are suggested to develop intervention programs to promote mental health through increasing strong ties and improving the quality of social networks for U.S. Chinese older immigrants.

End-of-life (EOL) care awareness and practice remain particularly low among older Chinese Americans. More empirical evidence regarding EOL is needed to develop culturally-relevant interventions to promote EOL engagement in this minority population. Using population-specific data, this study investigates preferences and associated sociodemographic and health determinants related to EOL among older Chinese Americans. Data were from the Population-based Study of Chinese Elderly in Chicago (collected 2017-2019, N=3,124). Linear and logistic regressions were conducted. Of the sample, 46.1% considered EOL care planning as important or somewhat import. Nearly 22% had EOL discussions with families. The most preferred EOL locations were home (43.7%), hospital (35.5%), nursing home (10.1%), and hospice (4.3%). Overall, 47.1% perceived EOL care as family decisions, 39.6% regarded EOL care as personal decisions, 7.5% preferred children to make EOL decisions, and 3.3% preferred a spouse to make EOL decisions. Chinese older adults who were female (B=0.10, p

Discrimination has been more prevalent since the pandemic. Black Lives Matter (BLM) movement flourished in the summer of 2020 as protests against police brutality and racial injustice. However, the extent to which individuals’ discrimination experiences and associated mental health outcomes change amid a global pandemic and a dramatic societal movement in American society remains unknown. This study examines the dynamic relationship of racism and/or Covid-19-related discrimination with changes in mental health in the context of BLM and Covid-19. Data were from U.S. adults (age ≥18) who completed the online Understanding Coronavirus in America survey in June and September of 2020 (n=3,502). Respondents were asked to attribute their discrimination experience to 8 main reasons: (1) Covid-19; (2) national origin/race/skin color; (3) gender/sexual orientation; (4) age; (5) physical feature; (6) education/income; (7) health condition; and (8) religion/other. Quasi-Poisson regression models examined the associations between discrimination and anxiety/depression/stress. Results indicated about 33% of respondents reported discrimination in June compared to 21% in September. Racism was significantly associated with more anxiety/depression/stress in June, but not in September or in the longitudinal trend. Covid-19-related discrimination was associated with elevated levels of anxiety/depression/stress in September and in the longitudinal trend, but not in June 2020. We concluded that individuals’ discrimination experiences are shaped by societal contexts. Specifically, racism was the dominant discrimination attribution in June 2020 when BLM was at its peak. However, Covid-19 discrimination overtook racism as the primary attribution and showed a significant relationship with poorer mental health over time.

Chinese culture places a high value on saving face and not bringing shame to the family. This study aimed to examine the associations between face-saving and help-seeking among U.S. Chinese older adults who experienced elder mistreatment (EM). Data were retrieved from the PINE study. Regression analyses were performed. Most EM victims sought help from informal sources only (48.21%), followed by no help (26.79%), informal plus formal help (19.64%), and formal help only (5.36%). For EM screening, face-saving was associated with informal help-seeking intentions (p < .05). For EM subtypes, face-saving was associated with overall help-seeking intentions for financial exploitation (p < .05), but not on physical mistreatment, psychological mistreatment, and caregiver neglect. Face-saving was not associated with help-seeking behaviors. Study findings underscore the significance of a unique cultural value in understanding EM help-seeking intentions among Chinese older adults. Cultural constructs should be considered in future EM research in diverse populations.

This paper aims to describe study design of the unique dyadic older Chinese American-adult children dataset, and present sample characteristics of the dyads. A total of 807 older parents were matched with their adult children (characteristics of matched versus not matched participants will be compared). On average, adult children were 48 years old, had 12 years of education, lived with 3 persons in household, had 2 children, and lived in U.S. for 17 years. Approximately 65% of the adult children sample were female, 82% married, 93% preferred to speak Chinese dialects, and over 97% foreign-born immigrants. On the other hand, older parents were 74 years old, had 7 years of education, lived with 3 persons in household, had 3 children, and lived in U.S. for 17 years on average. About 60% of the older parent sample were female, 73% married, over 99% foreign-born immigrants who preferred to speak Chinese dialects.

Using data from 544 older parents-adult children Chinese American dyads, this study aims to understand the association between older parents’ physical function and their adult children’s perceived caregiving burden. Parents’ physical function was assessed by the Katz Index of Activities of Daily Living (ADL) and the Lawton Instrumental ADL (IADL), with higher scores indicating more functional limitations. Adult children’s caregiving burden was assessed in five dimensions, including time dependence, developmental, physical, social, and emotion burden. Logistic regression was used to examine the association. More ADL limitations were associated with a higher likelihood of developmental burden (OR:1.14 (1.06-1.23)) and physical burden (OR:1.14 (1.06-1.23)) burden. More IADL limitations was associated with a higher likelihood of time dependence burden (OR:1.08 (1.03-1.12)), developmental burden (OR:1.06 (1.03-1.09)), and physical burden (OR:1.08 (1.04-1.12)). Parents’ physical function was not related to children’s social and emotional burdens. Practice and research implications will be discussed.

Western culture emphasizes independence in the child-parent relationship while Chinese culture values interdependence between adult children and older parents. This study compared the association of child-parent relationships with older adults’ multidimensional health over time in the U.S. and China. Two waves of data (2012-2015) from HRS and CHARLS were used (n=6,641, aged ≥65). Linear regression models were estimated. Results showed that, compared to Chinese older adults, fewer older Americans co-resided with or lived nearby their children, had less weekly contact, and fewer financial transfers from/to their children. Most child-parent relationship variables were nonsignificant predictors of older Americans’ health. However, a closer child-parent relationship was linked to fewer depressive symptoms and better cognition among older Chinese. Co-residence was associated with poorer health among Chinese parents. The associations of child-parent relationships with older adults’ health exhibited cross-cultural differences. A cultural perspective is recommended in understanding how family relations affect older adults’ health.

Advance Directive (AD) allows older adults to communicate preferred care at the end of life. Numerous studies reported that ethnic minorities were less likely to complete AD then non-Hispanic Whites. However, determinants of AD completion among older Chinese Americans remain unknown. The present study aims to address this knowledge gap. Data came from a survey of 439 Chinese Americans aged from 51 to 103 living in two metropolitan areas in 2018. Participants’ average year was 75 (SD=9.37). About 63% were women and 93% were born outside the US. Approximately 14% of participants completed an AD. Guided by the Andersen’s Service Use Model, we used logistic regression to examine determinants of AD completion. Results show that older age (OR = 1.06, p < 0.01), being employed (OR = 2.63, p < 0.05), acculturation (OR = 2.09, p < 0.001), having US citizenship (OR = 3.57, p < 0.01), and expectation of intergenerational support (OR = 1.84, p < 0.05), were positively associated with AD completion. Physical and mental health needs were not significantly associated with AD completion. This is among the first studies focusing on AD completion among Chinese Americans, one of the fastest growing older minority populations in the US. Findings highlight the influence of socioeconomic and cultural factors on AD completion and illustrates the importance of developing culturally sensitive interventions to promote end-of-life care decision-making among older Chinese Americans.

Preventive healthcare utilization is an important aspect of medical practice that facilitates the identification of chronic diseases at an early stage and increases options for treatment. Cognitive function plays an important role in individuals’ utilization of preventive care services. However, our understanding of the relationship between cognitive function and preventive care utilization is limited, particularly in older minority aging populations. The study aims to assess the association between cognitive function and preventive healthcare utilization among U.S. Chinese older adults. Data were obtained from the Population Study of Chinese Elderly in Chicago (PINE). Five instruments were used to measure global cognition, including the Mini-Mental State Examination, East Boston Memory Test Immediate Recall and Delayed Recall, Digit Span Backwards, and Symbol Digit Modalities Test. Preventive care services included immunization (i.e. flu, pneumonia, and hepatitis B vaccines) and cancer screenings (i.e. colorectal, breast, cervical, and prostate). Multivariable regression analyses were used. The findings showed that higher level of global cognition was associated with higher utilization of pneumonia vaccination (OR=1.32, 95% CI= 1.14-1.52), hepatitis B vaccination (OR=1.24, 95% CI= 1.05-1.47), colon exam (OR=1.23, 95% CI= 1.07-1.41), mammogram (OR=1.46, 95% CI= 1.22-1.73), breast exam (OR=1.23, 95% CI= 1.04-1.46), and cervical exam (OR=1.38, 95% CI= 1.15-1.65). Future longitudinal studies are needed to elucidate potential mechanisms underlying the relationship between cognitive function and preventive care utilization among U.S. Chinese older adults. Study findings underscore the need to understand preventive care utilization patterns among U.S. Chinese older adults with low cognitive function.

Depressive symptoms are prevalent in the aging population and can negatively impact the health and well-being of older adults. Personality traits may interact with depressive symptoms, but there is currently limited knowledge regarding this relationship in minority aging research. This study aims to explore the associations between two personality traits, neuroticism and conscientiousness, and depressive symptoms in 3,157 U.S. Chinese older adults. Data were obtained from the Population Study of Chinese Elderly in Chicago (PINE) collected between 2011 and 2013. Neuroticism and conscientiousness were measured by the NEO Five-factor Inventory. Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). 45.3% of the participants reported at least one depressive symptom. Controlling for potential confounders, logistic regression analyses showed that both traits were significantly associated with depressive symptoms. One unit increase in neuroticism was associated with 19% increased odds of having any depressive symptoms (odds ratio [OR]=1.19, 95% confidence interval [CI]=1.17-1.22). One unit increase in conscientiousness was associated with 5% decreased odds of having any depressive symptoms (OR=0.95, 95% [CI]=0.94-0.96). Results validate the significant association between both traits and depressive symptoms among U.S. Chinese older adults, adding to the psychological and cultural profiles of those who have experienced mental distress. More in-depth examination using culturally-tailored measurements for personality traits is encouraged in minority aging studies. The NEO inventory was developed from Western populations and hence might not adequately represent personality traits valued by non-Western cultures.

Discrimination has been consistently documented to relate to adverse health outcomes. However, most existing research focused on a single discrimination attribution (e.g. ageism). Few studies considered multifaceted discrimination attributions. Guided by an intersectionality framework, this study examined intersectional discrimination attributions and their associations with health outcomes. Older respondents (aged >50) from the Health and Retirement Study in 2014-2015 were included in the analysis (n=6,286). Their experiences and self-perceived reasons (age, gender, sexual orientation, race, national origin, religion, financial status, weight, physical appearance, disability, and others) for everyday discrimination were examined. Latent class analysis was employed to ascertain the profiles of subgroups characterized by their intersectional discrimination attributions. Regression models examined the correlates of the class memberships and the associations with health outcomes. Six classes were identified: class 1 (54.52% of the sample) had no/minimal discrimination experience; Class 2 (21.89%) experienced primarily ageism; class 3 (8.81%) reported discrimination based on age/gender/national origin/race; class 4 (7.99%) attributed discrimination to financial/other reasons; class 5 (5.87%) experienced discrimination based on age/weight/physical appearance/disability; and class 6 (0.92%) perceived discrimination from almost every aspect. Intersectional discrimination attributions were associated with poorer self-rated health, and greater levels of depressive symptoms and loneliness. The associations between intersectional discrimination and cognition were not statistically significant. This study found multiple marginalized identities co-occur and compound to contribute to perceived everyday discrimination among American older adults. Those experiencing discrimination due to multiple reasons warrant particular attention. Results underscore the utility of an intersectional approach in understanding discrimination in later life.

Resilience is defined as a personal quality that enables growth in knowledge, understanding and self-actualization in the face of adversity and life disruptions. Low levels of resilience can dispose older adults to higher risks for negative health outcomes in the aftermath of traumatic events. However, we have limited knowledge of resilience among minority aging populations. This study aims to examine the presence and levels of resilience and its sociodemographic correlates among U.S. Chinese older adults. Data were drawn from the Population Study of Chinese Elderly, an epidemiology study of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,036 Chinese older adults aged 60 and above participated in face-to-face interviews from 2015 to 2017. Spearman’s rank-order coefficient was utilized to test correlation. A 10-item validated Chinese version of the Connor-Davidson resilience scale was used to assess resilience. In our sample, 59.7% were female, and the average age was 75. The mean resilience score was 26.9, ranging from 1 to 40. U.S. Chinese older adults who were younger, male, married, had higher education and income, fewer children, better health status and quality of life, and improved health and have lived fewer years in the U.S. reported higher levels of resilience. Future longitudinal research is needed to investigate the protective effects of resilience among older Chinese Americans against mental and physical distress.

Family involvement is critical to end-of-life (EOL) care of older adults. Attitude toward family involvement in EOL care can be influenced by family relationship. Yet, mechanisms explaining such influence have not been examined among older Chinese Americans. This study aims to examine the association between family relationship and older Chinese Americans’ attitude toward family involvement in EOL care and explore pathways of this association. Potential mediators include self-efficacy, perceived benefits, and perceived barriers of discussing EOL care with family members. Data were collected from 276 Chinese Americans aged 55+ in two metropolitan areas in 2018. Participants’ average age was 74 years (SD=9.6). Approximately 64% of the sample were female. Most participants (57%) held positive attitudes toward family involvement in EOL care. Using the Structural Equation Modeling method, we found that family relationship had a significant positive total effect on positive attitude toward family involvement in EOL care (z=5.57, p

A healthy diet is essential to various health outcomes that are common among minority aging populations. To explore frequencies and correlates of food consumption among U.S. Chinese older adults, this study used data from the Population-based Study of Chinese Elderly (PINE) collected in Chicago during 2015-2017 (N=3053). Food consumption frequencies of five food groups (vegetables, fruits, grains, protein foods, and dairy) were assessed by a validated 48-item food frequency questionnaire. All responses of consumption frequency were transformed to “times per day” and weighted by reported portion size. The average frequencies of vegetables, grains, and protein foods intake among the U.S. Chinese older adults were 2.02 (SD±1.32), 1.32 (SD±0.70), and 1.58 (SD±0.90) times/day, respectively. Fruits and dairy consumption frequencies were much lower: 0.76 (SD±0.70) and 0.48 (SD±0.53) times/day. In addition, higher levels of education were correlated with higher consumption of all five food groups. Being female was positively correlated with frequencies of fruits and dairy intake. In contrast, poorer life quality and having more children were correlated with less intake of all five food groups. Older age, preference to speak Cantonese/Taishanese compared to Mandarin/English, and poorer health status were also correlated with lower consumption frequencies of fruit and dairy. The study provides important dietary data of U.S. Chinese older adults and sheds light on significant socioeconomic correlates of food consumption. More in-depth investigations are needed to clarify the sociocultural determinants of dietary behavior and how they relate to different health outcomes among the U.S. Chinese population.

Chinese older adults are particularly vulnerable to social isolation due to various barriers they face in developing/maintaining social networks (i.e. limited English proficiency and transportation barriers) in the U.S. However, the prevalence of social isolation and its potential health consequences in this rapidly growing minority aging population remain poorly understood. To address this knowledge gap, the current study examines the prevalence of social isolation, and the relationship between social isolation and cognitive function among U.S. Chinese older adults. Data were obtained from the Population-based Study of Chinese Elderly in Chicago collected between 2011 and 2013 (N=3,157). A four-item index (including living alone, not married, lack of confidant, and low participation in social activities) was constructed to assess social isolation (range: 0 to 4, a score of ≥2 was used to identify individuals who were most isolated). Cognitive function was measured by five validated instruments (range: -2.8 to 2.0). Nearly 22% of the sample were socially isolated. Multivariable linear regression analysis showed that social isolation accounted for 44% of variance in global cognitive functioning. Chinese older adults with greater levels of social isolation had poorer overall cognitive function (B= -0.05, SE=0.01, p=0.001). Study findings highlight the importance of addressing social isolation in cognitive aging among older Chinese Americans. Culturally tailored interventions facilitating the development of supportive social networks/ support have the potential to mitigate cognitive decline in this population. Future longitudinal studies need to elucidate potential mechanisms underlying the relationship between social isolation and cognitive function. Practice implications will be discussed.

Background/Purpose: Older immigrants are at risk of experiencing marginalization and social exclusion. Traditional Chinese culture values could deeply influence the older Chinese immigrants’ perceptions regarding mistreatment and motivating them to seek help. This study aimed to examine the associations between perceived social support and informal/formal help-seeking intentions and behaviors among U.S. Chinese older adults experiencing elder mistreatment. Methods: Data derived from the Population Study of Chinese Elderly in Chicago (PINE). Independent variables were positive and negative perceived social support. Dependent variables were informal/formal help-seeking intentions and behaviors. Descriptive statistics and logistic regression analyses were performed. Results: A total of 423 participants experienced elder mistreatment (mean age: 72.4 ±7.88 years old). The most common informal help-seeking sources were adult children, followed by partner, and friends/neighbors/colleagues. The most common sources of formal help-seeking were community social services organizations and the legal criminal justice system. After controlling for covariates, positive perceived social support was associated with informal help-seeking intentions (OR=1.14, 95% CI: 1.05-1.24, p < .01) and behaviors (OR=1.12, 95% CI: 1.04-1.22, p < .01). However, the associations between perceived social support and formal help-seeking intentions and behaviors were not significant. Conclusions & Implications: Further research is needed to examine the mediating effects of cultural values on the relationship between perceived social support and help-seeking among mistreated older Chinese immigrants. In addition, additional studies are needed to identify impede or facilitate factors of informal/formal elder mistreatment help-seeking. Prevention and intervention programs should incorporate valuable cultural insight to improve help-seeking among this population.

Older Chinese Americans (≥65 years) have a distinct social support profile and greater health care service utilization than their Caucasian counterparts. To date, it is unknown if the unique social support profile in older Chinese Americans is related to their use of health service utilization. Using the Andersen Behavioral Model of health services use as the conceptual framework of this study, we examined the relationship of social support from spouse, family, and friends with hospitalizations and emergency department (ED) visits among older Chinese Americans, with a focus on potential moderation effects between social support and need factors of health service use (i.e., medical illnesses and physical function). This study utilized data from the Population Study of Chinese Elderly (07/2011-07/2013; N=3,157), the largest population-based study on psychosocial well-being of Chinese older adults in Western countries. In logistic regression analyses, main effects of social support were not related to hospitalization or ER visits, after adjusting for demographic, clinical, and functional covariates. Significant interaction between social support from spouse and the number of limitations in (instrumental) activities of daily living was related to lower risk of hospitalization (Odds Ratio [OR]=0.98 [0.96–0.99], p

For centuries, in traditional Chinese culture, filial piety are considered as the highest of all virtues. A previous cross-sectional study reported a significant relationship between filial discrepancy and psychological well-being among U.S. Chinese older adults. However, less is known regarding the longitudinal relationship between filial discrepancy and psychological wellbeing over time. This study aimed to examine the relationship between filial discrepancy and depressive symptoms using two-wave data. Depressive symptoms were measured by nine-item Patient Health Questionnaire. Change of depressive symptoms was calculated by wave 2 minus wave 1 scores. Negative binomial and linear regressions were performed. Filial expectation was associated with increase in depressive symptoms during two years (b = .03, SE = .01). Larger filial expectation than receipt was associated with larger increase in depressive symptoms (b = .04, SE = .01) and higher level of depressive symptoms after two years (RR, 1.02 [1.00, 1.03]). The result showed a positive association between filial discrepancy and depressive symptoms; intensified depressive symptoms that prolonged in the two years of research. Our findings suggested that early identification and intervention for Chinese older adults with filial discrepancy are necessary to help them maintain optimal psychological wellbeing in later life. Depressive symptoms have a wide range of intensity, can lead to a serious condition that requires immediate medical treatment which also interferes with daily life. Due to the cultural differences, findings suggested that Chinese older adults mainly have high filial expectations and low receipt; recognizing depressive symptoms may require extra attention.

This study aims to examine the relationship between religiosity and depressive symptoms in a large cohort of community-dwelling U.S. Chinese older adults living in the Greater Chicago area, which has received relatively little research attention. Cross-sectional self-report data was obtained from the Population Study of Chinese Elderly in Chicago between 2011 and 2013 (N=3,157). Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). A score of 5 and above indicated the presence of clinically significant depressive symptoms. Logistic regression analyses were conducted to examine the association between religiosity and depressive symptoms. Out of 3,157 participants, 20.3% participants had a score of or above 5 on PHQ-9. 35.4% reported religiosity as being “important” (24.7%) and “very important” (10.7%); 16% reported attending organized religious services at least once a month (3.1% reported once a month; 12.3% reported once a week; 0.6% reported almost every day); 23% reported having religious services at home at least once a month (10.3% reported once a month; 3.2% reported once a week; 9.5% reported almost daily). Results showed that recognizing religiosity as important is significantly negatively associated with depressive symptoms (odds ratio [OR]=0.94, 95% confidence interval [CI]=0.89-0.99). However, no significant associations between depressive symptoms and religious activity attendance or religious service at home were observed. Findings suggest that senses of belonging and life meaning may help reduce depressive symptoms, rather than the religious activities per se. Future interventions could reduce depressive symptoms of U.S. Chinese older adults through religiosity.

The increasing diversity in U.S. aging population warrants improved understanding of risk factors of cognitive aging in minority populations. This study presents the prevalence of incident cognitive impairment (CI) among U.S. Chinese older adults; and the relationship between social engagement and incident CI. Data were obtained from the Population-based Study of Chinese Elderly in Chicago, a prospective cohort study of Chinese older adults. Baseline (collected between 2011 and 2013) and one subsequent wave of data (collected between 2013 and 2015) were used in analyses (N=2,713). Social engagement was measured by the frequency of participation in social and cognitive activities (range=0-65). Cognitive function was assessed by a battery of 5 validated instruments. Incidence of CI was defined as having a follow-up cognition score lower than 1.5 standard deviations below the mean baseline cognition score. Logistic regression analyses were conducted. Nearly 6% of the sample reported incident CI. Chinese older adults who are more socially-engaged had a lower likelihood of developing CI (odds ratio [OR] 0.94, 0.92-0.96). The relationship was consistent across cognitive domains, including episodic memory (OR 0.95, 0.92-0.97), working memory (OR 0.92, 0.88-0.95), and perceptual speed (OR 0.95, 0.92-0.98). Furthermore, older age (OR 1.12, 1.09-1.15), and lower education (OR 0.91, 0.87-0.96) were associated with incident CI. No significant association was observed between gender, income, marital status, household size, acculturation, medical morbidities, depressive symptoms, and incident CI. The findings highlight the importance of social engagement in cognitive aging. Discrepancies with prior literature and implications of these findings will be discussed.

Body composition has been proposed as an important modifiable risk factor of cognitive decline in multiple epidemiological studies. However, the relationship between body mass index (BMI) and cognitive function remains controversial and conflicting in diverse populations. This study aims to investigate the association between BMI and cognitive decline in U.S. Chinese older adults. Classifications of BMI are based on Asian criteria recommended by WHO (underweight: BMI

Among 2,038 older Chinese adults in the U.S., we examined the relationship between physical function (Short Performance Physical Battery [SPPB], [instrumental] activities of daily living [ADL/IADL] limitations) at baseline (2011-2013) and changes in cognitive function in the two-year follow-up (2013-2015). Cognitive function was measured by the East Boston Memory Test (EBMT), the Digit Span Backwards assessment (DSB), the Symbol Digit Modalities Test (SDMT), and the Mini-Mental State Examination (MMSE). During the two-year follow-up, 41.8%-50.88% of the participants decreased in cognitive function and 32.88%-44.8% increased. In linear regression that adjusted for baseline cognitive function, education, age, and other covariates, baseline SPPB and ADL/IADL limitations were significantly associated with changes in cognitive function in the two-year follow-up (SPPB: βEBMT=0.0149, p0.05; βSDMT=0.2742, p