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Published on: May 10, 2019
Language, Immigration, Race and Cognitive Health: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study
Elisa Lee1, Rachel A Whitmer1, Paola Gilsanz2
1Department of Public Health Sciences, University of California Davis, Davis, CA, USA.
Journal of Racial and Ethnic Health Disparities
|June 11, 2026
Summary
The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study highlights the diverse racial, ethnic, and linguistic backgrounds of older Americans. Cognitive impairment was most prevalent in U.S.-born Black and non-U.S.-born Latino participants, underscoring the need for inclusive dementia research.
Area of Science:
- Gerontology
- Epidemiology
- Cognitive Neurology
Background:
- Large cohort studies on dementia often lack diverse representation.
- Understanding health disparities requires examining complex racial, ethnic, and linguistic histories.
- Operationalizing identity is crucial for accurately describing health inequities in aging populations.
Purpose of the Study:
- To describe the demographic complexity of a United States-based cohort of older adults.
- To analyze racial/ethnic, immigration, and linguistic diversity within the cohort.
- To identify patterns of cognitive impairment across diverse subgroups.
Main Methods:
- The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study enrolled 1,892 participants aged 65+.
- Self-reported race/ethnicity, immigration status, and languages spoken were collected via questionnaire.
- Cognitive status was assessed using NIH Toolbox screening and neurological exams for suspected impairment.
Main Results:
- The cohort comprised diverse racial/ethnic groups (Asian, Black, Latino, White, Native American) and varying immigration statuses (US-born/non-US-born).
- Language diversity included monolingual (46%), bilingual (31%), and unascertained (23%) participants.
- Cognitive impairment was most prevalent in U.S.-born Black and non-U.S.-born Latino participants, with variations in health behaviors across demographics.
Conclusions:
- Recruiting diverse populations is essential for dementia research.
- Acknowledging cultural and linguistic diversity is critical for understanding dementia risk in older adults.
- Future studies must reflect the heterogeneity of the aging population to address health disparities effectively.
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