ArticleBMJ public health2026
Immigrant generational status, late-life social support and mental well-being, and cognitive change in the Kaiser Healthy Aging and Life Experiences cohort.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Little is known about the protective effects of social support and mental well-being for late-life cognition among different immigrant generations. Methods: Kaiser Healthy Aging and Diverse Life Experiences participants were categorised as 1st-generation arriving age <18 years (n=73), first-generation arriving ≥18 years (n=282), 2nd-generation (n=279) or ≥3rd-generation (n=174). Social support (emotional, instrumental), loneliness and depressive symptoms were assessed at baseline. Verbal episodic memory (VEM) and executive function (EF) were assessed up to four times (max. years=6.6). Linear mixed-effects models examined associations of social support, loneliness and depression with EF and VEM, adjusting for covariates overall and in race/ethnic-stratified models. Interactions by immigrant generation were tested. Results: First-generation immigrants arriving <18 years old had the lowest instrumental support (mean (SD)=-0.18 (1.0)) and the highest loneliness (mean (SD)=0.25 (0.93)) and depressive symptom (mean (SD)=-0.04 (0.80)) scores. Instrumental (β=0.05 (95% CI 0.003 to 0.10)) support and emotional support (β=0.06 (95% CI 0.01 to 0.11)) were positively associated with baseline EF. Loneliness (β=-0.08 (95% CI -0.13 to -0.03)) and depressive symptoms (β=-0.09 (95% CI -0.15 to -0.04)) were negatively associated with baseline EF. For associations with VEM, instrumental support (β=0.02 (95% CI -0.04 to 0.07)) and emotional support (β=0.03 (95% CI -0.03 to 0.09)) were not significantly associated. Loneliness (β=-0.07 (95% CI -0.13 to -0.02)) was negatively associated and depression (β=-0.04 (95% CI -0.11 to 0.03)) trended negatively with VEM. All associations with cognitive change were null. In race/ethnic stratified models, associations were more pronounced for Latino participants, whereas associations for Asian participants were generally weaker and non-significant. Conclusions: Social support and mental well-being may be most pertinent for late-life EF among older Latinos, as associations were generally stronger among Latino adults and closer to null among Asian adults. These findings reiterate the importance of considering both immigrant generation and race/ethnicity in evaluations of late-life cognition risk and resilience factors.
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