Immigration timing modifies the association between medication non-adherence and cognitive function in older adults

Area of Science:

• Gerontology
• Cognitive Neuroscience
• Public Health

Background:

• Aging immigrant populations face dementia risks, often undetected by traditional methods due to cultural/linguistic barriers.
• Unintentional medication non-adherence (MNA) is a potential early, noninvasive marker for cognitive decline.
• The influence of immigration timing on the MNA-cognition relationship is understudied.

Purpose of the Study:

• To investigate unintentional medication non-adherence (MNA) as a marker of cognitive decline in older adults.
• To examine how immigration status and timing modify the association between MNA and cognitive function.
• To assess the protective role of education in the MNA-cognition relationship.

Main Methods:

• Analysis of 10,854 participants aged ≥65 from the Health and Retirement Study (2012-2016).
• Assessment of cognitive function using standardized latent cognitive scores.
• Stratification of immigrants by age at arrival and regression analysis of MNA, immigration, and education interactions.

Main Results:

• Unintentional MNA, immigrant status, and older age at immigration correlated with lower cognitive scores.
• Immigration status, timing, and education significantly moderated the MNA-cognition association.
• The impact of unintentional MNA on cognition varied across ethnicity-immigration subgroups, influenced by immigration timing and education.

Conclusions:

• Unintentional MNA serves as a sensitive indicator of cognitive decline, particularly for immigrants who arrived in middle-late adulthood.
• Integrating medication adherence and immigration history into clinical assessments can enhance early detection of cognitive decline.
• Targeted interventions can be developed for diverse older adult populations based on these findings.