Cognitive performance among diverse Asian American subgroups: exploring the role of nativity, language, and education

Research often aggregates Asian American, Native Hawaiian, and Pacific Islander (AANHPI) individuals into one group, obscuring possible differences in factors related to cognition. This study included 875 individuals self-identified as AANHPI from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) and LifeAfter90 studies. Executive function (EF) and verbal episodic memory (VM) were repeatedly measured. Analysis of covariance compared baseline differences while linear mixed-effects models examined cognitive trajectories. We tested moderation by nativity, first language, and education. The average±SD age of participants was 82 ± 9.6 years (47% Chinese, 17% Filipino, 21% Japanese, 15% NHPI/Other). Filipino participants had the lowest baseline EF compared to other subgroups. Relative to Chinese participants, Filipino and Japanese participants had faster EF declines. Nativity and education moderated associations; US-born participants had higher baseline EF but faster decline, and participants with ≥college education had faster EF decline. First language did not moderate associations. Results highlight potential heterogeneity in cognition across AANHPI ethnic subgroups. Differences may be moderated by nativity and education.