Introduction: Affiliate stigma may cause depressive symptoms among Asian American dementia caregivers, yet few studies have examined the underlying mechanisms or cross-ethnic differences.
Methods: We analyzed data from 338 older dementia caregivers (176 Chinese Americans, 162 Korean Americans; mean age 68.8 years) who completed measures of affiliate stigma, social isolation, loneliness, and depressive symptoms.
Results: Higher stigma was associated with more severe depressive symptoms (p < 0.001). Mediation analyses suggest this effect is partly explained by increased social isolation (12.8% mediated) and, especially, greater loneliness (44.4% mediated) among highly stigmatized caregivers. The stigma-depression relationship was stronger for Korean than for Chinese American caregivers (p for interaction < 0.01).
Discussion: These findings identify affiliate stigma as an important risk factor for dementia caregivers' depressive symptoms, operating through both objective and emotional forms of social disconnection. Culturally sensitive efforts to reduce caregivers' stigma and social disconnection may improve mental health outcomes in Asian American communities.
Keywords: Asian Americans; affiliate stigma; dementia; depressive symptoms; family caregiver; immigrants; informal caregiving; mediation and moderation analysis older adults; social connection.
© 2026 The Author(s). Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals LLC on behalf of Alzheimer's Association.