Is Acculturation Associated with the Cognitive Performance of Older Hispanics?

J Alzheimers Dis. 2022;85(2):535-544. doi: 10.3233/JAD-210502.


Background: Hispanics in the United States are disproportionately affected by Alzheimer's disease and related dementias. Little is known about the impact of acculturation on cognitive performance.

Objective: This study examined the association between acculturation and cognitive performance among older Hispanics.

Methods: We analyzed cross-sectional data of 616 Hispanic participants in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 [average age = 67.15 years, %Female = 51.46, %less than high-school graduate = 52.60]. Cognitive performance was measured by two neuropsychological tests: Animal Fluency Test (AFT) and Digit Symbol Substitution Test (DSST). We used two single-item proxy measures to quantify acculturation: nativity status (non-US-born residing < 15 years in the US (low acculturation), non-US-born residing ≥15 years in the US, and US-born (high acculturation)); and language acculturation (only/mostly Spanish (low acculturation), Spanish and English, only/mostly English (high acculturation)). We used adjusted linear regression to evaluate associations between acculturation and cognitive performance.

Results: Results indicated poorer cognitive performance among the low-acculturated groups for both nativity and linguistic measures. Participants who were non-US-born living ≥15 years (p = 0.02) and speaking only/mostly Spanish or Spanish and English (p = 0.01 and 0.006 respectively) had significantly lower AFT scores compared to US-born and only/mostly English-speaking groups. Participants who were non-US-born living < 15 years (p < 0.0001) or non-US-born living ≥15 years (p < 0.0001) and speaking only/mostly Spanish (p = 0.0008) scored lower on the DSST than the US-born and only/mostly English-speaking participants.

Conclusion: In summary, low acculturation is associated with poorer cognitive performance among older Hispanics. Acculturation might be an important attribute to help understand cognitive decline and dementias among Hispanics.

Keywords: Acculturation; Hispanic Americans; cognitive performance; dementia.

MeSH terms

  • Acculturation*
  • Aged
  • Cognition*
  • Cross-Sectional Studies
  • Female
  • Hispanic or Latino / psychology*
  • Humans
  • Language*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Nutrition Surveys
  • United States