Eleanor Hayes-Larson1, Joseph Fong1, Taylor M Mobley1, Paola Gilsanz2,3, Rachel A Whitmer4,5, Gilbert C Gee6, Ron Brookmeyer7, Elizabeth Rose Mayeda1. 1. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA. 2. Division of Research, Kaiser Permanente Northern California, Oakland, California, USA. 3. Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA. 4. Alzheimer's Disease Center, University of California, Davis, Sacramento, California, USA. 5. Department of Public Health Sciences, University of California, Davis, California, USA. 6. Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA. 7. Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, USA.
Abstract
INTRODUCTION: Literature shows lower dementia incidence in Asian American groups versus whites, varying by Asian ethnicity. One hypothesized driver is nativity differences (eg, healthy immigrant effect). METHODS: We followed a cohort of 6243 Chinese, 4879 Filipino, 3256 Japanese, and 141,158 white Kaiser Permanente Northern California members for incident dementia (2002 to 2020), estimating age-adjusted dementia incidence rates by ethnicity and nativity, and hazard ratios (HR) for nativity on dementia incidence using ethnicity-stratified age- and sex-adjusted Cox proportional hazards models. RESULTS: Dementia incidence appeared higher in foreign- versus US-born Filipinos (HR, 95% confidence interval: 1.39, 1.02 to 1.89); differences were small in Japanese (1.07, 0.88 to 1.30) and Chinese (1.07, 0.92 to 1.24). No nativity differences were observed among whites (1.00, 0.95 to 1.04). DISCUSSION: Nativity does not explain lower dementia incidence in Asian Americans versus whites, but may contribute to heterogeneity across Asian ethnicities. Future research should explore differential impacts of social and cardiometabolic factors.
INTRODUCTION: Literature shows lower dementia incidence in Asian American groups versus whites, varying by Asian ethnicity. One hypothesized driver is nativity differences (eg, healthy immigrant effect). METHODS: We followed a cohort of 6243 Chinese, 4879 Filipino, 3256 Japanese, and 141,158 white Kaiser Permanente Northern California members for incident dementia (2002 to 2020), estimating age-adjusted dementia incidence rates by ethnicity and nativity, and hazard ratios (HR) for nativity on dementia incidence using ethnicity-stratified age- and sex-adjusted Cox proportional hazards models. RESULTS: Dementia incidence appeared higher in foreign- versus US-born Filipinos (HR, 95% confidence interval: 1.39, 1.02 to 1.89); differences were small in Japanese (1.07, 0.88 to 1.30) and Chinese (1.07, 0.92 to 1.24). No nativity differences were observed among whites (1.00, 0.95 to 1.04). DISCUSSION: Nativity does not explain lower dementia incidence in Asian Americans versus whites, but may contribute to heterogeneity across Asian ethnicities. Future research should explore differential impacts of social and cardiometabolic factors.
Authors: A B Graves; L Rajaram; J D Bowen; W C McCormick; S M McCurry; E B Larson Journal: J Gerontol B Psychol Sci Soc Sci Date: 1999-05 Impact factor: 4.077
Authors: Elizabeth Rose Mayeda; M Maria Glymour; Charles P Quesenberry; Rachel A Whitmer Journal: Alzheimers Dement Date: 2016-02-11 Impact factor: 21.566
Authors: Elizabeth R Mayeda; M Maria Glymour; Charles P Quesenberry; Rachel A Whitmer Journal: Alzheimer Dis Assoc Disord Date: 2017 Jul-Sep Impact factor: 2.703
Authors: Paola Gilsanz; Maria M Corrada; Claudia H Kawas; Elizabeth Rose Mayeda; M Maria Glymour; Charles P Quesenberry; Catherine Lee; Rachel A Whitmer Journal: Alzheimers Dement Date: 2019-02-20 Impact factor: 21.566
Authors: R J Havlik; G Izmirlian; H Petrovitch; G W Ross; K Masaki; J D Curb; A M Saunders; D J Foley; D Brock; L J Launer; L White Journal: Neurology Date: 2000-04-11 Impact factor: 9.910
Authors: Dennis R Taaffe; Fumiko Irie; Kamal H Masaki; Robert D Abbott; Helen Petrovitch; G Webster Ross; Lon R White Journal: J Gerontol A Biol Sci Med Sci Date: 2008-05 Impact factor: 6.053
Authors: Oanh L Meyer; Chloe W Eng; Michelle J Ko; Michelle L Chan; Uyen Ngo; Paola Gilsanz; M Maria Glymour; Elizabeth Rose Mayeda; Dan M Mungas; Rachel A Whitmer Journal: Int Psychogeriatr Date: 2020-12-23 Impact factor: 7.191
Authors: Taylor M Mobley; Crystal Shaw; Eleanor Hayes-Larson; Joseph Fong; Paola Gilsanz; Gilbert C Gee; Ron Brookmeyer; Rachel A Whitmer; Joan A Casey; Elizabeth Rose Mayeda Journal: Alzheimers Dement Date: 2022-04-06 Impact factor: 16.655