What Increases the Likelihood of Dementia Among Asian Americans? Analysis of Nativity and Life Course Factors.

OBJECTIVES: The Alzheimer's Association has reported a 746% increase in dementia-related deaths in Asian American populations between 2000 and 2018, the most significant rise compared to all other racial groups. Asian Americans face a unique myriad of obstacles and factors contributing to significant health disparities, including those in dementia. Our aim is to compare determinants and outcomes of dementia between US-born and foreign-born Asian Americans. METHODS: Data from the 2019-2022 National Health Interview Survey was analyzed to examine the relationship between nativity and dementia. Other life course risk factors and outcomes of having dementia were also included in the analysis. The study sample included 16,331 US-born and 126,978 foreign-born Asian Americans. RESULTS: Foreign-born Asian Americans were found to have a higher proportion of dementia compared to US-born Asian Americans (1.1%>0.4%, p = 0.0140). Risk factors that were found to significantly explain the relationship between nativity and dementia included age > 65, ever being married, having some college education, and having Medicaid coverage. Foreign-born Asian Americans with dementia are more likely to suffer from depression (p < 0.001) and experience/have difficulty in social involvement (p < 0.001) compared to US-born Asian Americans with dementia. CONCLUSION: Our findings reaffirm that nativity contributes to the heterogeneous risk and outcomes of dementia in Asian Americans and the likelihood of having dementia is further impacted by life course factors. Interventions to support Asian American immigrants are needed to reduce the burden of dementia. More studies that identify nativity variations are also recommended to address health disparities that disproportionately affect older immigrants.