Longitudinal Associations of US Acculturation With Cognitive Performance, Cognitive Impairment, and Dementia

Am J Epidemiol. 2020 Nov 2;189(11):1292-1305. doi: 10.1093/aje/kwaa088.


US Latinos, a growing, aging population, are disproportionately burdened by cognitive decline and dementia. Identification of modifiable risk factors is needed for interventions aimed at reducing risk. Broad sociocultural context may illuminate complex etiology among culturally diverse Latinos. Among 1,418 older (≥60 years), low-socioeconomic position (SEP) Latinos (predominantly of Mexican descent) in Sacramento, California, we examined whether US acculturation was associated with cognitive performance, cognitive decline, and dementia/ cognitive impairment without dementia over a 10-year period and whether education modified the associations (Sacramento Area Latino Study on Aging, 1998-2008). Analyses used linear mixed models, competing-risk regression, and inverse probability of censoring weights for attrition. Participants with high US acculturation had better cognitive performance (0.21 fewer cognitive errors at grand-mean-centered age 70 years) than those with low acculturation after adjustment for sociodemographic factors, practice effects, and survey language. Results may have been driven by cultural language use rather than identity factors (e.g., ethnic identity, interactions). Rate of cognitive decline and risk of dementia/cognitive impairment without dementia did not differ by acculturation, regardless of education (β = 0.00 (standard error, 0.00) and hazard ratio = 0.81 (95% confidence interval: 0.49, 1.35), respectively). High US acculturation was associated with better cognitive performance among these older, low-SEP Latinos. Acculturation may benefit cognition when SEP is low. Future studies should incorporate extended longitudinal assessments among more diverse groups.

Keywords: Hispanic Americans; acculturation; cognition; cognitive dysfunction; dementia; education; social determinants of health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acculturation*
  • Aged
  • Aging / ethnology*
  • Aging / psychology
  • California / epidemiology
  • Cognition
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / ethnology*
  • Dementia / epidemiology
  • Dementia / ethnology*
  • Educational Status
  • Female
  • Hispanic or Latino / psychology*
  • Humans
  • Income
  • Independent Living / psychology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Socioeconomic Factors