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Abstract Background Mastery may shape the way individuals cope with life challenges and influence cognitive function in later life. Mastery grows out of traumatic experience and could change over the life course. This study examined the within-person and between-person associations of mastery and cognitive function, and if these associations were moderated by age in the United States. Method Data were derived from three time points (2006–2008, 2010–2012, and 2014–2016) of the Health and Retirement Study, with 14,461 adults (aged 51 or above). Cognitive function was measured through a 27-point Telephone Interview Cognitive Screen (TICS). Mastery was measured by a modified Pearlin Mastery Scale. Multilevel modeling was employed to analyze the data. Results Both within-person ( $$\beta$$ β =0.124, SE = 0.023, p

Abstract Animals employ different strategies to establish mating boundaries between closely related species, with sex pheromones often playing a crucial role in identifying conspecific mates. Many of these pheromones have carbon-carbon double bonds, making them vulnerable to oxidation by certain atmospheric oxidant pollutants, including ozone. Here, we investigate whether increased ozone compromises species boundaries in drosophilid flies. We show that short-term exposure to increased levels of ozone degrades pheromones of Drosophila melanogaster, D. simulans, D. mauritiana, as well as D. sechellia, and induces hybridization between some of these species. As many of the resulting hybrids are sterile, this could result in local population declines. However, hybridization between D. simulans and D. mauritiana as well as D. simulans and D. sechellia results in fertile hybrids, of which some female hybrids are even more attractive to the males of the parental species. Our experimental findings indicate that ozone pollution could potentially induce breakdown of species boundaries in insects.

Objective: To describe whether or not there are gender differences in lower urinary tract symptoms (LUTS) prevalence and risk factors in community-dwelling older Chinese Americans. Methods: We performed a secondary analysis of a prospective cross-sectional population-based survey of Chinese Americans aged 60 years and older between January 2011 and December 2013 in English, Mandarin, Cantonese, Taishanese, or Teochew. A clinical review of systems was used to assess LUTS, which included urinary frequency, urgency, burning and/or pain, blood in urine, and urinary incontinence. Results: Of the total 3157 people queried, 42% were men and 58% were women. More men reported LUTS compared to women (32.9% vs. 28.6%, p=0.01). In a multivariable analysis, female gender (adjusted odds ratio [aOR] 0.60, 95% confidence interval [CI] 0.49–0.73), being married (aOR 0.79, 95% CI 0.65–0.97), and smoking (aOR 0.66, 95% CI 0.49–0.88) were found to be protective, while traditional Chinese medicine use (aOR 1.51, 95% CI 1.28–1.78), heart disease (aOR 1.54, 95% CI 1.24–1.91), and anxiety (aOR 1.69, 95% CI 1.25–2.28) were most strongly associated with increased odds of LUTS. When examining genders separately, being married was found to be protective only in women. Meanwhile, unique factors found in men were hypertension, heart disease, and practice of Tai Chi. Conclusion: In this large population-based study, LUTS were more prevalent in older Chinese American men than women. We also found gender-specific factors that influenced the odds of reporting LUTS; however, traditional Chinese medicine use was the only factor that was shared by both genders. Future longitudinal investigations are needed to elucidate these underlying mechanisms to provide evidence-based and culture-specific guidelines for this rapidly growing population.

Abstract Low enrollment in U.S. biomedical research by non-White adults has historically been attributed to mistrust, but few studies have simultaneously examined dimensions of trust in three or more racial/ethnic groups. Leveraging the racial/ethnic diversity of New Jersey, we prospectively recruited 293 adults (72% women, 38% older than 54 years of age) between October 2020 and February 2022 to complete two anonymous surveys in English or one of the common languages (e.g., Spanish, Mandarin Chinese). The first consisted of 12 Likert-scale questions related to trust in biomedical researchers (according to safety, equity, transparency), and the second assessed willingness to consider participation in eight common research activities (health-related survey, blood collection, genetic analysis, medication study, etc). Participants self-reported as Hispanic (n = 102), Black (n = 49), Chinese (n = 48), other Asian (n = 53), or White (n = 41) race/ethnicity. Factor analysis showed three aspects related to trust in researchers: researchers as fiduciaries for research participants, racial/ethnic equity in research, and transparency. Importantly, we observed differences in the relationship between mistrust and willingness to participate. Whereas Chinese respondents’ low trust in researchers mediated their low interest in research involving more than health-related surveys, Hispanic respondents’ low trust in research equity did not deter high willingness to participate in research involving blood and genetic analysis. We caution that a generic association between trust and research participation should not be broadly assumed, and biomedical researchers should prospectively assess this relationship within each minoritized group to avoid hasty generalization.

Abstract Background Suicide is a large and growing public health problem. Little is known about the attributes of suicidal ideation (SI) in the contexts of immigration. This qualitative study aims to explore immigration- and acculturation-related attributes of SI among older immigrants. Methods A qualitative semi-structured interview design. Interview were conducted with 57 older Chinese immigrants in Chicago with self-reported SI in the past month. Results In addition to attributes of SI which have been well documented in the literature, we identified immigration- and acculturation-related attributes, including linguistic and cultural barriers of being integrated to the receiving communities, acculturation gaps in intergenerational support, and uselessness. Conclusions Findings of the study highlight the intersectionality of race, culture, and aging regarding SI, which are essential to improve recognition and understanding of SI among immigrant populations.

BackgroundMultiple studies have reported that hearing and vision impairment are linked to cognitive decline. Yet little is known about factors that may influence the association between sensory impairment and cognitive decline. This study examined if loneliness mediates or moderates the impact of sensory impairment on cognitive decline as individuals age.MethodsThis was a longitudinal study using data from the Health and Retirement Study (HRS) and The Aging, Demographics, and Memory Study (ADAMS) (N = 243). We used one timepoint of hearing and vision (ADAMS 2006–2008), one timepoint of loneliness (HRS 2006–2008), and five waves of cognition (HRS 2006–2014). Hearing impairment was defined by an inability to hear pure-tone stimuli of 25 dB at frequencies between 0.5 and 4.0 kHz in either ear. Visual impairment was defined as having corrected binocular vision worse than 20/40. Longitudinal parallel-process (LPP) analysis was conducted at a significance level of α = 0.05 (one-tailed).ResultsLoneliness moderated but did not mediate the association between visual impairment and the rate of cognitive decline (standardized β =−0.108, p < 0.05). No moderation or mediation effect of loneliness was found for the association between hearing impairment and cognitive decline. Both vision and hearing impairment were significantly associated with increased severity of loneliness.ConclusionVisual impairment combined with an elevated level of loneliness may produce a more synergistic, deleterious impact on older adults’ cognitive function than visual impairment alone. This study highlights the importance of promoting a healthy social and psychological status for older adults with sensory impairment.

Abstract Background Genetic disposition is considered critical for identifying subjects at high risk for disease development. Investigating disease-causing and high and low expressed genes can support finding the root causes of uncertainties in patient care. However, independent and timely high-throughput next-generation sequencing data analysis is still a challenge for non-computational biologists and geneticists. Results In this manuscript, we present a findable, accessible, interactive, and reusable (FAIR) bioinformatics platform, i.e., GVViZ (visualizing genes with disease-causing variants). GVViZ is a user-friendly, cross-platform, and database application for RNA-seq-driven variable and complex gene-disease data annotation and expression analysis with a dynamic heat map visualization. GVViZ has the potential to find patterns across millions of features and extract actionable information, which can support the early detection of complex disorders and the development of new therapies for personalized patient care. The execution of GVViZ is based on a set of simple instructions that users without a computational background can follow to design and perform customized data analysis. It can assimilate patients’ transcriptomics data with the public, proprietary, and our in-house developed gene-disease databases to query, easily explore, and access information on gene annotation and classified disease phenotypes with greater visibility and customization. To test its performance and understand the clinical and scientific impact of GVViZ, we present GVViZ analysis for different chronic diseases and conditions, including Alzheimer’s disease, arthritis, asthma, diabetes mellitus, heart failure, hypertension, obesity, osteoporosis, and multiple cancer disorders. The results are visualized using GVViZ and can be exported as image (PNF/TIFF) and text (CSV) files that include gene names, Ensembl (ENSG) IDs, quantified abundances, expressed transcript lengths, and annotated oncology and non-oncology diseases. Conclusions We emphasize that automated and interactive visualization should be an indispensable component of modern RNA-seq analysis, which is currently not the case. However, experts in clinics and researchers in life sciences can use GVViZ to visualize and interpret the transcriptomics data, making it a powerful tool to study the dynamics of gene expression and regulation. Furthermore, with successful deployment in clinical settings, GVViZ has the potential to enable high-throughput correlations between patient diagnoses based on clinical and transcriptomics data.

This qualitative study explored perceptions of research among a rapidly growing underserved population within a suburban community, a setting that has yet to be sufficiently explored using a community-based research (CBR) approach. We recruited community members from community health care agencies in DuPage County, Illinois, and 79 participants were enrolled in the study. Community researchers conducted nine focus groups comprised of agency clients and eight stakeholder interviews to collect community perspectives regarding the meaning of research and its community impact, current and desired channels of research information, and research motives, discrimination, and funding. Findings revealed four major themes: community members 1) often associate research with medical research or community engagement; 2) rely most heavily on the internet for research information; 3) perceive financial barriers, rather than racial or ethnic barriers, as a significant obstacle to receiving the benefits of research; and 4) trust research conducted by academic institutions.

Abstract We are entering the era of personalized medicine in which an individual's genetic makeup will eventually determine how a doctor can tailor his or her therapy. Therefore, it is becoming critical to understand the genetic basis of common diseases, for example, which genes predispose and rare genetic variants contribute to diseases, and so on. Our study focuses on helping researchers, medical practitioners, and pharmacists in having a broad view of genetic variants that may be implicated in the likelihood of developing certain diseases. Our focus here is to create a comprehensive database with mobile access to all available, authentic and actionable genes, SNPs, and classified diseases and drugs collected from different clinical and genomics databases worldwide, including Ensembl, GenCode, ClinVar, GeneCards, DISEASES, HGMD, OMIM, GTR, CNVD, Novoseek, Swiss‐Prot, LncRNADisease, Orphanet, GWAS Catalog, SwissVar, COSMIC, WHO, and FDA. We present a new cutting‐edge gene‐SNP‐disease‐drug mobile database with a smart phone application, integrating information about classified diseases and related genes, germline and somatic mutations, and drugs. Its database includes over 59 000 protein‐coding and noncoding genes; over 67 000 germline SNPs and over a million somatic mutations reported for over 19 000 protein‐coding genes located in over 1000 regions, published with over 3000 articles in over 415 journals available at the PUBMED; over 80 000 ICDs; over 123 000 NDCs; and over 100 000 classified gene‐SNP‐disease associations. We present an application that can provide new insights into the information about genetic basis of human complex diseases and contribute to assimilating genomic with phenotypic data for the availability of gene‐based designer drugs, precise targeting of molecular fingerprints for tumor, appropriate drug therapy, predicting individual susceptibility to disease, diagnosis, and treatment of rare illnesses are all a few of the many transformations expected in the decade to come.

Background: To further understand social determinants of oral health, this study examined the relationship between psychological sense of community (PSoC) and oral health problems and investigated whether the relationship would vary by family reunification status among foreign-born older Chinese Americans. Methods: Data came from the Population-Based Study of Chinese Elderly in Chicago (PINE) collected between 2011 and 2013. The PINE study is considered representative of the aging Chinese population in the greater Chicago area. The working sample included 2,981 foreign-born, community-dwelling Chinese Americans aged 60 or older. Stepwise logistic regressions with interaction terms were conducted. Results: Stronger PSoC was associated with a 3% lower likelihood of reporting oral health problems (OR= 0.97; CI= 0.96, 0.98). The strength of the relationship between PSoC and oral health problems varied by family reunification status (OR= 1.06; CI= 1.02, 1.09). For individual components of PSoC, stronger influence was associated with a 16% lower likelihood of reporting oral health problems (OR= 0.84; CI= 0.81, 0.87). Only the relationship between needs fulfillment and oral health problems varied by family reunification status (OR= 1.21; CI= 1.08, 1.36). Conclusions: Interventions need to consider community belonging and reasons for immigration to promote oral health in this growing population.

In the present study, we examined self-rated health as a mediator between physical health conditions (chronic diseases and functional disability) and depressive symptoms in older Chinese and Korean Americans. Using harmonized data (N = 5,063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we tested direct and indirect effect models. In both groups, chronic diseases and functional disability were closely associated with negative ratings of health and symptoms of depression. Analyses with the PROCESS macro showed that the effect of chronic diseases and functional disability on depressive symptoms was mediated by self-rated health in both groups; the indirect effect was greater in the Korean American sample than in the Chinese American sample. These findings contribute to the understanding of the psychological mechanisms that underlie the mind-body connection and highlight the potential importance of subjective health assessment as a useful tool for health promotion.

Purpose: Healthcare utilization and health-seeking behaviors of Chinese American immigrant women may be influenced by longstanding cultural perspectives of family roles and relationships. An understanding of Chinese immigrant women's perceptions of family social support in health and how these beliefs manifest in healthcare utilization and help-seeking behaviors is critical to the development of culturally appropriate health interventions. Focusing on a sample of Chinese women in Chicago's Chinatown, this qualitative study seeks to describe women's attitudes and beliefs about spouse and adult children's involvement in women's health and healthcare. Methods: We conducted six focus groups among 56 Chinese-speaking adult women in Chicago's Chinatown between July and August 2014. Focus groups were transcribed, coded, and analyzed for emergent themes. Results: Women reported that their adult children supported their health and healthcare utilization by helping them overcome language and transportation barriers, making and supporting decisions, and providing informational and instrumental support related to diet and nutrition. Women viewed these supports with mixed expectations of filial piety, alongside preferences to limit dependency and help-seeking because of concern and emotional distress regarding burdening adult children. Women's expectations of the spouse involvement in their healthcare were low and were shaped by avoidance of family conflict. Conclusion: Findings inform opportunities for the development of culturally appropriate interventions to enhance Chinese immigrant women's health and healthcare. These include patient navigation/community health worker programs to promote self-management of healthcare and family-centered strategies for enhancing family social support structures and reducing family conflict.

Background: As health care reform continues within the United States, navigators may play increasingly diverse and vital roles across the health care continuum. The growing interest in patient navigation programs for underserved populations calls for detailed descriptions of intervention components to facilitate implementation and dissemination efforts. Methods: In Chicago’s Chinatown, Chinese immigrant women face language, cultural, and access barriers in obtaining breast and cervical cancer screening and follow-up. These barriers spurred the research partnership between Northwestern University, the Chinese American Service League, Mercy Hospital & Medical Center, and Rush University Medical Center to formalize the Chinatown Patient Navigation Collaborative for adapting and implementing previously developed patient navigation models. Results: In this report, we describe the adaptation of patient navigation to build the Chinatown Patient Navigation Collaborative’s community-based patient navigation program for breast and cervical cancer. We offer insights into the roles of community patient navigators in safety net hospital and underserved Chinese immigrant communities, and describe implications for patient navigation initiatives to maximize community benefits by improving access to health care for vulnerable populations. Conclusions: Our adaptation and implementation of a patient navigation intervention in Chicago’s Chinatown illustrates promising approaches for future navigator research.

This cross-sectional study aims to examine the associations between engagement in cognitive, social, and religious activity and cognitive function (i.e., global cognition, cognitive performance, episodic memory, working memory, and executive function) and to explore the moderation effect of acculturation on the associations. Data were drawn from the Population-Based Study of Chinese Elderly (PINE) Wave I. Multivariate regression analyses showed that participation in more cognitive and social activities were associated with better cognitive function indicated by all five measures. Also, more frequent attendance in religious services is related to better working memory only. Compared with those more acculturated peers, the less acculturated community-dwelling Chinese older adults benefited more from high levels of activity engagement, especially in global cognition, cognitive performance, and episodic memory. Findings illustrate the importance of increasing older adults’ exposure to cognitively stimulating and socially integrated activities or environments, which may help to preserve the cognitive function of older adults.

This study examined the relationships of psychological sense of community (PSOC) with self-rated health and depressive symptoms among older Chinese Americans. The sample was taken from the Population Study of Chinese Elderly in Chicago (PINE), a population-based survey of 3,159 community-dwelling seniors. PSOC was measured through the Sense of Community Index (SCI). Factor analysis indicated a four-dimensional structure within the SCI; however, the SCI lacked dimensional consistency and items that composed four underlying factors were different than the proposed ones. After controlling for sociodemographics, binary and multinomial logistic regression analyses showed that a higher level of PSOC was related to a lower likelihood of self-reporting poor or fair health and of developing more depressive symptoms. The identified factors of influence and emotional connection were also significantly related to self-rated health and depressive symptoms. Future research need aim at improving the conceptualization process of the PSOC and cultural relevance in minority populations.

Objective: Loneliness has been associated with cognitive functioning in the general older adult population. Previous studies further indicate that loneliness has a strong association with depressive symptoms and the two constructs can reinforce each other to diminish well-being. However, such relationships have not been examined in U.S. Chinese older adults. This study attempts to bridge this knowledge gap. Method: Data were drawn from a population-based study of 3,159 U.S. Chinese older adults in the Greater Chicago area. Stepwise multivariate regression analyses were conducted to examine the relationship between loneliness, depressive symptoms, and global cognitive functioning. Results: Loneliness was associated with poor global cognitive functioning in U.S. Chinese older adults, though the relationship became nonsignificant after adjustment for depressive symptoms. The interaction term between loneliness and cognitive functioning was statistically significant ( p < .01). The findings further highlight the importance of age, education, number of children, number of people in household, and length of residence in the U.S. in cognitive functioning among U.S. Chinese older adults. Discussion: The study findings indicate that loneliness and depressive symptoms act together to influence cognitive functioning in U.S. Chinese older adults. Research and clinical implications of the findings are discussed.

Research about Asian Americans and Asian health equity issues have significant gaps, in part, due to lack of funding and support for minority investigators and examinations of health in this population. This special issue is designed to further our understanding of Asian health equity, especially within the context of global Chinese populations to examine how sociocultural contexts impact aging and health. Through the findings reported in this special issue, we call for increased funding and support to minority research scholars to conduct research toward improving Asian health equity, with an emphasis on nuanced cultural contexts of this population.

Using data from the Population Study of Chinese Elderly in Chicago (PINE) conducted from 2011 to 2013, this study aims to examine the role of acculturation in engagement in cognitive, social, and religious activities among older Chinese Americans. Activity engagement and acculturation levels were relatively low in the study sample. Multivariate regression analyses showed that high levels of acculturation in general, and particularly media use (e.g., TV and radio) and ethnic social relations (i.e., preferred ethnicity of those with whom one interacts) were associated with more engagement in cognitive and social activities, respectively. High levels of acculturation in general and ethnic social relation in particular increased the likelihood of engaging in religious activities. Language use was not related to engagement in any activity, probably because only 2% of the PINE participants preferred to speak English. Findings indicate that acculturation can promote activity engagement probably through media use and social relations, whereby older adults may acquire information about opportunities for various activities. Active participation with life may improve older adults’ well-being and help address the widening health disparities among minority older populations in American society.

Older adults disproportionately experience musculoskeletal symptoms, which are associated with morbidity and mortality. Traditional Chinese medicine (TCM) is an important part of Chinese culture and for millennia have been used to maintain health. This article aims to examine the association between musculoskeletal symptoms and different subtypes of TCM usage. Data were collected through the Population Study of Chinese Elderly in Chicago (PINE) study, a community-engaged, epidemiological study of a U.S. Chinese population. Review of systems was used to measure musculoskeletal symptoms. TCM use was measured by using a 5-point scale. Logistic regression analyses were conducted to control for potential confounding factors. Of 3,157 Chinese, older adults aged 60 and older, the mean age was 72.8 ( SD = 8.3) and 58.9% were female. Older adults with any musculoskeletal symptoms had greater utilization of overall TCM use (odds ratio [OR] = 2.10, 95% confidence interval [CI] = [1.76, 2.52]), especially massage therapy (OR = 3.41, 95% CI = [2.51, 4.63]), herbal (OR = 2.68, 95% CI = [2.28, 3.14]), and acupuncture (OR = 2.49, 95% CI = [1.87, 3.32]). However, there was no statistically significant association between the presence of musculoskeletal symptoms and Tai-Chi (OR = 1.18, 95% CI = [0.93, 1.50]). This study demonstrated that musculoskeletal symptoms among Chinese older adults were strongly associated with the use of TCM. Future research is needed to examine the effectiveness of TCM in treating musculoskeletal symptoms.

The experience of loneliness is prevalent and detrimental. Personality may influence individual perceptions of loneliness, but the relationship has not been adequately examined among minority aging populations. In a representative sample of 3,157 Chinese older adults in Chicago, we examined the associations between two personality traits and loneliness. Independent variables were neuroticism and conscientiousness, and dependent variable was perceived loneliness. Logistic regressions were used to adjust for confounding factors. Both traits were significantly associated with loneliness. One unit increase in neuroticism was associated with a 1.15 times higher likelihood of feeling lonely (odds ratio [OR]: 1.15, 1.12-1.18), whereas a unit increase in conscientiousness was associated with 3% decrease in risk of loneliness (OR: 0.97, 0.96-0.99). Compared with a low level of neuroticism, individuals with middle and high levels were 1.51 and 3.59 times more likely to feel lonely (OR: 1.51, 1.17-1.95; OR: 3.59, 2.84-4.54). Participants with high conscientiousness had a 24% decreased risk of loneliness relative to those with a low level (OR: 0.76, 0.60-0.96). This study provides evidence supporting the close relationships between personality and loneliness among U.S. Chinese older adults. Rigorously designed longitudinal studies are needed to clarify different trajectories of loneliness over time and its associated factors.

Objective: To examine U.S. Chinese older women and the association between their cancer screening behaviors and self-reported cancers with Traditional Chinese Medicine (TCM) use across sociodemographic characteristics. Method: Through the Population Study of Chinese Elderly in Chicago (PINE), 1,830 Chinese older women self-reported history of cancer screening, presence of women’s cancers, and TCM use according to type. Analyses were performed using multivariate regression models. Results: Chinese older women who underwent breast cancer screening are more likely to use herbal TCM (rate ratio [RR] = 1.15, 95% confidence interval [CI] = [1.03, 1.29]), acupuncture (RR = 1.62, CI = [1.21, 2.15]), massage therapy (RR = 2.05, CI = [1.46, 2.88]), and tai chi (RR = 1.86, CI = [1.28, 2.69]). Those who had cervical cancer screening are more likely to use herbal TCM (RR = 1.32, CI = [1.17, 1.48]), acupuncture (RR = 1.66, CI = [1.27, 2.18]), massage therapy (RR = 1.61, CI = [1.17, 2.21]), tai chi (RR = 1.69, CI = [1.19, 2.40]), and other forms of TCM (RR = 1.36, CI = [1.04, 1.79]). Those with cervical cancer are less likely to use herbal TCM (RR = 0.42, CI = [0.19, 0.93]). Conclusion: Contrary to previous studies, our results suggest that U.S. Chinese older women who have engaged in cancer screening use TCM while those with self-reported cancer did not use TCM at a higher rate. This warrants further research on TCM utilization to identify reasons of use in this population and encourage patient-centered care.

Among older Chinese adults in the United States, depression is a common health problem. Using data from the first population-based survey of older Chinese Americans ( N = 2,929) and applying negative binomial and ordinary least squares regression models, this study examines the relationship between social engagement (including cognitive activity and social activity) and sense of loneliness and hopelessness. Findings reveal that social engagement is significantly and negatively related to both loneliness and hopelessness after controlling for sociodemographic characteristics and health status. In addition, it is found that different aspects of social engagement present differential associations with sense of loneliness and hopelessness: Social activity is significantly associated with lower rate ratios of loneliness, whereas cognitive activity is significantly related to reduced levels of hopelessness. Our findings address the importance of engaging in cognitively stimulating and socially integrating activities in promoting psychological well-being for U.S. Chinese older adults.

Objective: Andersen’s Behavioral Model of Health Services Utilization was used as a framework to examine the influence of acculturation and health literacy on cancer screening behaviors among older Chinese Americans living in the greater Chicago area. Method: Data were obtained from the Population Study of Chinese Elderly in Chicago ( N = 3,157; mean age = 72.8 years). Logistic regression analyses were conducted to examine the impact of acculturation and health literacy on lifetime cancer screening utilizations and adherence to cancer screening guideline established by American Cancer Society (ACS) after controlling for predisposing, enabling, and need factors of Andersen’s behavioral model. Results: Lifetime rates of ever had cancer screening were low among older Chinese Americans living in the greater Chicago area. The majority of study participants were not adherent to ACS early detection cancer screening guidelines. Results from multivariate analyses showed that higher health literacy (odds ratio range = 1.39-1.72) and acculturation (odds ratio range = 1.28-2.06) levels were associated with an increased likelihood of lifetime and current cancer screening among older Chinese Americans. Discussion: The findings of this study highlight the importance of working to improve health literacy and developing effective interventions to increase cancer screening among older Chinese Americans.

Objective: The primary purposes of the present study are (a) to investigate the stress–cognition relationship among U.S. Chinese older adults and (b) to examine the moderating role of health status on the stress–cognition relationship. Method: Data were drawn from the Population Study of Chinese Elderly in Chicago (PINE), which investigated 3,157 Chinese adults over 60 years old living in Chicago. Participants reported health status and completed the Chinese Perceived Stress Scale. Cognitive functions were measured by the East Boston Memory Test, the Digit Span Backward, the Symbol Digit Modalities Test, and Chinese Mini-Mental State Examination. Results: Controlling for age, sex, education, and income, perceived stress was negatively associated with cognitive functions, whereas health status was positively associated with cognitive functions. In addition, older adults’ health status interacted with stress such that the negative relationships between perceived stress and cognitive functions were more pronounced for those who had poor health than for those who had good health. Conclusion: Findings suggest that physical health is a critical factor moderating the relationship between perceived stress and cognitive functions among U.S. Chinese older adults. Longitudinal research is needed to examine the complex relationships among stress, health, and cognitive functions of U.S. Chinese older adults.

Objectives: This study aims to examine the association between social engagement and cancer screening utilization among a Chinese American older population. Method: Data were drawn from the Population Study of Chinese Elderly (PINE). In total, 3,157 Chinese older adults enrolled in this study. Cancer screening utilization was assessed by asking whether participants had utilized cancer screenings. Social engagement was measured with 16 questions. Results: After controlling for potential confounders, a higher level of social engagement was associated with increased utilization in blood stool test (OR 1.03, [1.02, 1.05]), colonoscopy (OR 1.02, [1.01, 1.03]), mammography (OR 1.06, [1.05, 1.08]), Pap test (OR 1.04, [1.03, 1.06]), and prostate specific antigen (PSA) test (OR 1.03, [1.01, 1.05]). Compared with those with low levels of social engagement, older adults with high levels of social engagement were more likely to have utilized a blood stool test (OR 1.85, [1.46, 2.35]), a colonoscopy (OR 1.37, [1.09, 1.72]), a mammography (OR 3.05, [2.25, 4.14]), and a Pap test (OR 1.99, [1.49, 2.66]), but not more likely to have utilized a PSA test (OR 1.40, [0.97, 2.03]). Conclusion: This study underscores the association between active social engagement and increased utilization of cancer screening among a Chinese American older population. Improving social engagement could be helpful in promoting cancer screening utilization.

Background: The aim of this study was to understand the associations between acculturation and oral health among older Chinese immigrants in the United States. Method: We used data from the PINE study, which included the foreign-born older Chinese immigrants ( N = 3,128). We measured acculturation by measuring participants’ length of stay and behavioral acculturation. Participants’ tooth and gum symptoms were the outcome variables. Results: Longer stay in the United States was significantly associated with fewer gum symptoms but not with tooth symptoms. Behavioral acculturation was not significantly associated with either tooth or gum symptoms. The middle tertile of behavioral acculturation, compared with its upper and lower tertiles, deemed to be a more significant risk factor of tooth/gum symptoms. In addition, older immigrants with more social interactions with the Americans were more likely to have tooth symptoms. Discussion: In the future, we will conduct a study using longitudinal data to help us better understand the relationship between acculturation and oral health in Chinese American population.

Objective: This study aims to examine the association between neighborhood disorder with self-neglect among a community-dwelling Chinese American older population. Method: Data were extracted from the Population Study of Chinese Elderly (PINE), a cross-sectional study of 3,157 participants living in the greater Chicago area. Self-neglect was assessed with systematic observations of participants’ personal and home environment. Neighborhood disorder was measured through eight questions. Logistic regression was used to examine the association between neighborhood disorder and self-neglect. Results: After adjusting for potential confounding factors, every one point higher in neighborhood disorder score was significantly associated with greater risk for overall self-neglect (odds ratio [OR] = 1.13, [1.11, 1.16]), mild self-neglect (OR = 1.14, [1.11, 1.17]), and moderate/severe self-neglect (OR = 1.12, [1.09, 1.16]). Regarding the phenotypes of self-neglect, every one point higher in neighborhood disorder score was significantly associated with greater risk for hoarding (OR = 1.17, [1.14, 1.20]), personal hygiene (OR = 1.15, [1.12, 1.19]), house in need of repair (OR = 1.12, [1.10, 1.15]), unsanitary conditions (OR = 1.12, [1.09, 1.15]), and inadequate utilities (OR = 1.10, [1.05, 1.15]). Discussion: This study underscores the significant association between disordered neighborhood and greater risk of self-neglect among Chinese American older adults. Improving neighborhood disorder problems could benefit for elder self-neglect prevention.

Purpose: This study examined the association between social support and depressive symptoms among U.S. Chinese older adults. Methods: Data were from the Population Study of Chinese Elderly in Chicago (PINE) study. Independent variables were positive and negative perceived social support (PSS). Dependent variable was depressive symptoms. Multinomial logistic regression analyses were performed. Results: A total of participants were 3,157 Chinese older adults with the mean age of 72.8 years (range 60-105 years). After controlling for confounding factors, Chinese older adults with higher positive PSS were 12% (odds ratio [OR] = 0.88, 95% confidence interval [CI] = [0.85, 0.92]) and 18% (OR = 0.82, 95% CI = [0.79, 0.86]) less likely to report mild and moderate-severe depressive symptoms, respectively, compared to reporting minimal depressive symptoms; On the contrary, Chinese older adults with higher negative PSS were 34% (OR = 1.34, 95% CI = [1.24, 1.46]) and 38% (OR = 1.38, 95% CI = [1.26, 1.52]) more likely to report mild and moderate-severe depressive symptoms, respectively. Discussion: The study findings corroborate previous research that social support is significantly associated with depressive symptoms. Our findings reinforce the importance of developing strategies to utilize positive social support and limit negative support in practice for the depressed older adults. Further studies should be conducted to better understand the associations between different dimensions of social support and depression among U.S. Chinese older adults.

Background: Depressive symptoms are detrimental to the overall health and well-being of older adults. This study aimed to examine the association between filial piety and depressive symptoms among U.S. Chinese older adults. Method : Data were derived from the Population Study of Chinese Elderly in Chicago (PINE), a community-engaged, population-based epidemiological study of U.S. Chinese older adults aged 60 years and above in the Greater Chicago area. The Patient Health Questionnaire-9 (PHQ-9) was adopted to measure depressive symptoms. Six domains of filial piety were evaluated, involving respect, happiness, care, greeting, obedience, and financial support. Regression analyses were performed. Results: After adjusting for age, sex, education, annual personal income, marital status, living arrangement, number of children, years in the United States, years in the community and medical comorbidities, every one point lower in filial piety expectation score was associated with increased risk of depressive symptoms (RR [rate ratio] = .96, .95-.98). And every one point lower in filial piety receipt score was associated with increased risk of depressive symptoms (RR = .94, .93-.95). Discussion : This study provides insights to research on filial piety and depressive symptoms by examining expectation and perceived receipt of filial piety. Future studies are needed to investigate the association between filial discrepancy and depressive symptoms.

The Chinese older population in the U.S. is among the largest and fastest growing segment of the aging population; however, little is known regarding their health and well-being due to various research barriers. To fill in the critical void, the Population-based Study of Chinese Elderly in Chicago (the PINE study) was carried out as an epidemiological study of health and well-being amongst 3,157 community-dwelling Chinese older adults aged 60 years and older in the Greater Chicago Area. Based on the PINE study findings, this special issue is designed to examine the health status, medical conditions, and social and psychological well-being of Chinese American older adults. This editorial described the rationale of the study, methods and design, and preliminary findings. Important study implications for researchers and policy makers were also reported. In aggregate, coordinated family and community care, improved delivery of care, practice changes, and policy reform are necessary to work in concert to prepare for the diverse minority older adults who are in urgent need of the linguistically and culturally appropriate social services.

This study aimed to examine the prevalence and correlates of gambling participation and problems among community-dwelling Chinese older adults in the U.S. Based on a community-based participatory research approach, the study enrolled 3,159 Chinese older adults aged 60 years and above in the greater Chicago area. Among the participants, 58.9% were women and the average age was 72.8 years. Overall, 467 older adults had engaged in gambling in the past twelve months and 65 older adults had experienced any risk of problem gambling. Visiting a casino was the most commonly reported type of gambling, whereas betting on Mahjong had the highest frequency. Being male, lower educational levels, higher income levels, having more children, living in the U.S. for a longer period of time, living in the community for a longer period of time, better health status, lower quality of life, and improved health over the past year were significantly correlated with any gambling in the past year. Younger age, being male, and living with more people were significantly correlated with experiencing any risk of problem gambling in the past year. Future studies should be conducted to better examine the health effects of gambling and problem gambling among Chinese older adults.

Background: Neurological symptoms influence health and well-being among older adults. However, Chinese older adults are underrepresented in most studies on neurological symptoms. This study aims to examine the prevalence of neurological symptoms among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S Chinese older adults in the greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. Clinical review of system (ROS) was used to assess the presence of dizziness, syncope/fainting, fall, seizures, weakness, numbness, tingling, tremor, and stiffness. Results: Neurological symptoms were commonly experienced by U.S Chinese older adults (50.6%). Symptoms as dizziness (31.0%), numbness (19.0%), and falls (14.8%) were commonly reported. Participants were more likely to report any neurological symptom if they were older , less educated, low income, with poorer self-perceived health status, poorer quality of life, and worsened health change over last year. Conclusions: Neurological symptoms are common among Chinese older adults in the U.S. Future longitudinal research is needed to examine risk factors and health outcomes associated with neurological symptoms.

Grandparent caregiving responsibilities influence feelings of burden in many older adults. Though grandparenting is traditionally seen as a rewarding experience for Chinese older adults, some research has pointed to the possibility of grandparenting burden in Chinese older adults in the U.S. However, there is a paucity of research concerning prevalence of grandparenting burden in Chinese older adults. This study aims to provide an overall estimate on grandparenting burden and examine its correlations with socio-demographic characteristics, self-reported health data, and time spent caring for grandchildren. Data was collected through the Population Study of Chinese Elderly in Chicago (PINE) study. This community-based participatory research study surveyed a total of 3,159 Chinese older adults aged 60 and above, 2,146 of whom have grandchildren. We used four questions on a Likert-scale to determine levels of grandparenting burden. Our study found 22% of our participants who are grandparents experience grandparenting burden. Younger age (r = 0.12), living with four or more people (r = 0.09), lower overall health status (r = 0.09), lower quality of life (r = 0.09), and more time spent caring for grandchildren (r = 0.37) were correlated with grandparenting burden. Our findings show that grandparenting is not a necessarily rewarding experience for Chinese older adults, and that certain subsets of the population are more likely to experience grandparenting burden. Future longitudinal research should be conducted to determine causality as well the psychological, physical, and social effects of grandparenting burden.

This study examined the socio-demographic and health related characteristics of elder mistreatment (EM) in a community-dwelling older Chinese population. Methods: Guided by a community-based participatory research approach, the PINE study conducted in-person interviews with 3,159 U.S. Chinese older adults aged 60 years and older in the Greater Chicago area from 2011–2013. Participants answered questions regarding psychological, physical and sexual mistreatment, caregiver neglect, and financial exploitation. Definitional approaches for EM subtypes were constructed from least restrictive to most restrictive. Results: The sociodemographic and health-related characteristics associated with EM differed by type of mistreatment and by the operational definition used. Living with fewer people, having been born in countries other than China, poorer health status, and lower quality of life were significantly correlated with physical mistreatment. Only higher education was positively and significantly associated with sexual mistreatment and only poorer health status was consistently correlated with psychological mistreatment among all definitions. Male gender, higher educational levels, higher income, fewer children, and having been in the U.S. for fewer years were significantly correlated with financial exploitation. As for caregiver neglect, older age, having more children, having been in the U.S. for more years, poorer health status, lower quality of life, and worsening health over the past year were consistently correlated with caregiver neglect with different definitions. Conclusions: Prevention and intervention programs on EM should be geared towards specific types of mistreatment. Studies on EM should conduct a thorough analysis to justify the operational definition used.

Musculoskeletal disorders affect many older adults and are a major public health concern due to rising prevalence. However, there is a paucity of research regarding the prevalence of musculoskeletal symptoms in minority older adults, especially in older Chinese adults in the U.S. This study aims to provide an overall estimate on the prevalence of musculoskeletal symptoms among Chinese older adults in the U.S. and examine the correlations between sociodemographic characteristics, self-reported health measures, and musculoskeletal symptoms. Data was collected through the Population Study of Chinese Elderly in Chicago (PINE) study. This community-based participatory research study surveyed a total of 3,159 Chinese older adults aged 60 and above. Review of Systems (ROS) was used to assess individual perceptions of musculoskeletal symptoms. We found 67% of participants experience musculoskeletal symptoms. Muscle or joint pain (55.3%) and back pain (34.5%) were the most prevalent types of symptoms. Being female (r = 0.18), having lower education (r = 0.15), living fewer years in the community (r = 0.05), having a lower overall health status (r = 0.22), and having a lower quality of life (r = 0.08) were all significantly correlated with reporting musculoskeletal symptoms. Our findings show that musculoskeletal symptoms are a common health concern among Chinese older adults, and that certain subsets of the population, related to sociodemographic factors, are more likely to experience these symptoms. Future longitudinal studies should be conducted to determine causality as well as changes in musculoskeletal symptoms burden.

Objectives: Personality traits are important indicators of health and well-being. Neuroticism and conscientiousness in particular, are closely associated with morbidity and mortality in old age. However, little is known regarding the levels of these two key personality traits among U.S. Chinese older adults. This report aimed to examine the levels of personality traits among this population. Methods: Data were from the PINE study, a population-based study of U.S. Chinese older adults aged 60 and above. We measured neuroticism and conscientiousness using modified NEO personality inventory. Results: Of the 3,159 community-dwelling Chinese older adults, 58.9% were female, and mean age was 72.8 years. Compared to neuroticism, conscientiousness trait was endorsed higher among Chinese older adults in our sample. Each conscientiousness item had at least 67.8% of participant endorsement, in comparison to the lowest endorsement rate of 14.3% in the neuroticism measure. Younger age (r-neuroticism = -0.06, r-conscientiousness = -0.14) and fewer children (r-neuroticism = -0.06, r-conscientiousness = -0.06) were correlated with both traits. Female gender (r = 0.11), poorer health status (r = -0.26), poorer quality of life (r = -0.23) and worsened health over the past year (r = -0.15) were correlated with higher levels of neuroticism. In contrast, male gender (r = -0.05), better health status (r = 0.20), higher quality of life (r = 0.17) and improved health over the past year (r = 0.07) were correlated with higher levels of conscientiousness. Education level (r = 0.15) was positively correlated with higher levels of conscientiousness, but not with neuroticism; whereas income level (r = -0.04) was negatively correlated with neuroticism but not with conscientiousness. Conclusion: U.S. Chinese older adults generally possess higher agreement level on conscientiousness traits than neuroticism. Future analysis should be conducted to explore the complex associations between different personality traits among Chinese aging population, Our study also calls for further in-depth studies to understand adverse health outcomes associated with specific personality traits among minority older adults.

Background: Perceived stress is an important indicator of well-being. However, we have limited understanding of the experience of stress in minority aging populations. Methods: This study aims to identify the stress level among U.S. Chinese older adults. Results: Our findings indicated that 74% of PINE participants have experienced some level of daily stress. Of the 10-items in the stress scale, the prevalence of individual items ranged from 11.4% to 31.8%. Higher levels of perceived stress were more likely to present among older adults with an older age, female gender, lower education and income level, and poorer health status and quality of life. Participants with zero years of education showed the highest level of perceived stress, with a mean score of 12.2. Conclusions: This study indicates that Chinese older adults in the U.S are experiencing stress in their daily lives. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with perceived stress in Chinese older adults.

Background: Self-mastery is an important psychological resource to cope with stressful situations. However, we have limited understanding of self-mastery among minority aging populations. Objective: This study aims to examine the presence and levels of self-mastery among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. A Chinese version of the Self-Mastery Scale was used to assess self-mastery. Results: Out of the 7-item Chinese Self-Mastery Scale, approximately 42.8% to 87.5% of Chinese older adults experienced some degree of self-mastery in their lives. Older adults with no formal education and the oldest-old aged 85 and over had the lowest level of self-mastery in our study. A higher mastery level was associated with being married, having fewer children, better self-reported health status, better quality of life, and positive health changes. Conclusion: Although self-mastery is commonly experienced among the Chinese aging population in the Greater Chicago area, specific subgroups are still vulnerable. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with self-mastery among Chinese older adults.

Background: Sense of community is a concept that has significant implications cross multiple disciplines, particularly in public health practice. However, there exists a knowledge gap in utilizing the sense of community in investigating the health of older immigrant populations. Objective: This study aimed to explore the perception of the sense of community among community-dwelling U.S. Chinese older adults. Methods: Data were from the PINE study, a population-based survey of U.S. Chinese older adults aged 60 years and above in the greater Chicago area. We administered the Sense of Community Index to measure the levels of sense of community. Socio-demographic information was also collected. Results: Our results suggest that Chinese older adults in this study sample reported a strong sense of community. In total, 86.7% of the participants reported satisfaction with the current neighborhood, and 78.4% expressed their desire to continue living in the community as long as possible. In addition, older age (r =0.11), having higher levels of income (r =0.08), being female (r =0.08), being unmarried (r =-0.06), living with fewer people (r =-0.22), having more children (r =0.11), having been in the U.S. for more years (r =0.12), longer residency in the community (r =0.15), higher overall health status (r =0.18), better quality of life (r =0.23), and improved health status in the past year (r =0.11) were significantly correlated with the higher levels of the sense of the community. Conclusions: The study investigation provided the basis for generating empirical knowledge for understanding the sense of community among U.S. Chinese older adults. Future research is needed to delineate the mechanisms underlying sense of community and health in the increasingly diverse aging population.

Background: This study aims to explore gender differences in depressive symptoms in U.S. Chinese older adults. Methods: Data were from the PINE study, a population-based study of U.S. Chinese older adults aged 60 years and above. The PHQ-9 was used to measure depressive symptoms. Results: Depressive symptoms were more prevalent in U.S. Chinese older women (59.2%) than in older men (48.5%). Older women were more likely to present somatic depressive symptoms and to develop moderate to severe depressive symptoms. Older age (r = 0.09, P < 0.001), lower income (r = 0.07, P < 0.01), poorer health status (r = 0.34, P < 0.001), inferior quality of life (r = 0.17, P < 0.001) and worsening health changes over the past year (r = 0.23, P < 0.001) were positively correlated with any depressive symptom in older women. Conclusions: This study emphasizes the need for developing tailored interventions for depressive symptoms in the subgroup of U.S. Chinese older adults. Further longitudinal studies should be conducted to better understand gender differences in risk factors and outcomes associated with depressive symptoms in U.S. Chinese older adults.

The strength of community-engaged research has been well documented in public health literature. It is recognised as a useful approach for eliminating health disparities by linking research and practice. While the framework of community-engaged research encompasses a broad range of research collaborations, community-based participatory research (CBPR) places most emphasis on involving the community as a full, equitable partner throughout the collaboration. Despite growing interest in and demand for community-university partnerships, less attention is given to the issue of partnership sustainability. The purpose of this article is to present the challenges faced in sustaining a community-university partnership when conducting a CBPR project with an elderly Chinese population in Chicago’s Chinatown. Lessons and strategies learned from the cultural and linguistic complexities of the Chinese community are also detailed. In addition, based on a well-accepted sustainability conceptual framework, we reflect on the initial stage, mid-term actions and long-term goals of developing partnership sustainability. Working with the Chinese community required trust and respect for its unique cultural values and diversity. The cultural, social and environmental contexts within which the partnership operated served as critical forces for long-term sustainability: a culturally sensitive approach is instrumental in sustaining community-university partnership. Also discussed are the significant implications for evidence-based, impact-driven partnerships to develop culturally appropriate strategies to meet the needs of diverse populations. Keywords Community-based participatory research, community health partnerships, health promotion, Chinese Americans, ageing

This qualitative study examines US Chinese older adults’ views on the perceived effectiveness, challenges, and cultural adaptations of elder abuse interventions to psychological distress in the Chinese community in Chicago. A community-based participatory research approach was implemented to partner with the Chinese community. A total of 37 community-dwelling Chinese older adults (age 60+) participated in focus group discussions. Data analysis was based on grounded theory framework. Our findings suggest that older adults perceived social support, empowerment, and community-based interventions design as most effective to promote psychological well-being of victims. The perceived preferences were similar between elder abuse victims and non-victims. Strategies to culturally adapt evidence-based interventions were proposed with respect to nurturing filial piety values, familial integrations, and increased independence. Research and educational outreach initiatives were also discussed. This study has wide policy and practice implications for designing and deploying interventions to reduce psychological distress with respect to elder abuse outcome. Cultural relevancy of health interventions is important in the context of the Chinese communities. Collective federal, state, and community efforts are needed to support the culturally appropriate design and implementation of interventions suitable for the needs of the Chinese older adults.

The objective of this study is to examine the cultural views of healthy aging, knowledge and barriers to services, and perception of health sciences research among community-dwelling Chinese older adults in Chicago's Chinatown. This qualitative study is guided by the Precede-Proceed conceptual model with community-based participatory research design. Data analysis is based on eight focus group interviews with Chinese older (age 60+) adults (n=78). We used a grounded theory framework to systematically guide the thematic structure of our data. Findings show participants described cultural conception of health in terms of physical function, psychological well-being, social support, and cognitive function. The availability, affordability, and cultural barriers towards health care services were major negative enabling factors that inhibit participants from fulfilling health needs. Perception and knowledge of health sciences research were also discussed. This study has implications for the delivery of culturally appropriate health care services to the Chinese aging population.