Cognitive Limitations Among Middle Eastern and North African Immigrants

Abstract

Objectives: To estimate and compare the prevalence of cognitive limitations among Middle Eastern and North African (MENA) immigrants compared to US- and foreign-born non-Hispanic Whites from Europe (including Russia/former USSR) and examine differences after controlling for risk factors. Methods: Cross-sectional data using linked 2000-2017 National Health Interview Survey and 2001–2018 Medical Expenditure Panel Survey data (ages >=65 years, n = 24,827) were analyzed. Results: The prevalence of cognitive limitations was 17.3% among MENA immigrants compared to 9.6% and 13.6% among US- and foreign-born non-Hispanic Whites from Europe. MENA immigrants had higher odds (OR = 1.88; 95% CI = 1.06–3.34) of reporting a cognitive limitation than US-born non-Hispanic Whites after controlling for age, sex, education, hearing loss, hypertension, depression, social isolation, and diabetes. Discussion: To further examine cognitive health among the MENA aging population, policy changes are needed to identify this group that is often absent from research because of their federal classification as non-Hispanic Whites.

Suspected undiagnosed ADRD among Middle Eastern and North African Americans

“…Household and medical condition MEPS les were merged with NHIS person les. More information has been reported previously (10).…”

“…With most older adults having other comorbid chronic conditions that need to be addressed during primary care visits (38), there may be limited opportunities for early detection and screening for ADRD while addressing other health concerns (39). Existing literature has identi ed a wide range (5.5%-60%) of prevalence estimates for depressive symptoms among MENA individuals using community-based convenience samples (40)(41)(42), electronic health record data (43,44), and nationally representative samples (10,45). For example, using linked NHIS and MEPS data, Kindratt and colleagues reported that 38.2% of MENA adults ages 65 and older had depressive symptoms (10).…”

“…Responses from White adults born in Europe and Russia/former USSR countries were combined (hereafter, referred to as Europe). Responses from White adults born in the Middle East and Africa were combined based on previous research (10). By including foreign-born White Africans, our study aligns with 2015 US Census content testing for race and ethnicity (6, 19) currently proposed for the 2030 Census (20).…”

“…Covariates were selected based on risk factors for cognitive limitations and diagnosis of ADRD identi ed in previous studies (10,21). Demographic variables examined were age (continuous, ages 65+) and sex (1 = male, 2 = female).…”

“…Few studies, therefore, have examined the national prevalence of ADRD among MENA adults, regardless of diagnosis. Two studies found that MENA adults were more likely to report cognitive limitations, a potential indicator of ADRD, when compared to US-born Whites (10,11). Other research demonstrated foreign-born MENA adults had higher estimates of cognitive limitations compared to US-born MENA adults (12).…”