Heritage, birthplace, age at migration, and education as life course mechanisms influencing cognitive aging among latinos

Latinos are the fastest-growing segment of older adults in the United States and are at high risk for cognitive impairment (CI). Although research on factors that affect the prevention, diagnosis, and care of Latinos with CI has been increasing, less explored are reconstitutive aspects of Latinidad (i.e., the intersection of heritage, birthplace, and age at migration) that function as life course mechanisms influencing cognitive health across the life course. Therefore, this study investigates how intersectional Latinidades influence self-reported cognitive impairment (SRCI), a precursor to CI. Data from the 2015-2019 American Community Survey were used to examine SRCI among Latinos aged 45+ from the 10 largest U.S. Latino heritage population groups originating from the following places: Colombia, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Peru, and Puerto Rico. A set of nested binary logistic regression models, stratified by gender, were estimated to model SRCI as a function of Latino heritage, birthplace, age at migration, and educational attainment. Our findings indicate that when solely considering Latino heritage, Puerto Ricans had the highest probabilities of SRCI at all ages, followed by Dominicans, Cubans, and Mexicans. When birthplace or nativity status is combined with Latino heritage, some Latino heritage groups displayed an immigrant advantage, which further widened with age. Additional consideration of age at migration revealed that the immigrant advantage does not extend to Latino immigrants who arrived in the United States at ages 50 or older, particularly for Cuban, Dominican, and Puerto Rican women. Last, we find that higher educational attainment is associated with lower probabilities of SRCI for many Latino groups. As the Latino population ages, comprehensive, multidisciplinary, and multilevel efforts are needed across disciplines along with authentic community-based and participant engagement to develop actionable and culturally appropriate health policies aimed at ameliorating the burden of CI.