Research on Family Relationship and Cognitive Function among Older Hispanic Americans: Empirical Evidence from the Health and Retirement Study

Abstract

The current study aimed to investigate the associations between family relationship and cognitive function among Hispanic older population. A cross-sectional analysis was conducted with a sample size of 1,580 individuals from the Health and Retirement Study in the United States (mean age = 65.65 (SD = 9.33)). Family relationship was measured in three dimensions: structural, functional, and appraisal support. The results of linear regression analysis indicated that diverse composition of family network (β = .070, p = .009) and receiving financial support from family members (β = .060, p = .018) were associated with better cognitive function. Moderation analyses demonstrated that these associations were greater for Hispanic women than men. Current findings highlight the importance of family relationship on cognitive function among Hispanic older population and suggest that researchers and policymakers should put emphasis on the structural and functional aspects of family relationship to improve their cognitive health.

Keywords

cognitive function family relationship older adults gender Hispanics

Introduction

Being the largest and the fastest growing ethnic minority in the United States, Hispanic Americans accounted for 18.4% of U.S. population in 2019 (U.S. Department of Health and Human Services, 2021). Accordingly, the number of older Hispanic Americans (aged 65 and above) is projected to increase to 19.9 million by 2060, making up more than 20% of U.S.’s older population (The Administration for Community Living, 2019), which emphasizes the increasing need to understand their health conditions and boost their well-being in the later life. In particular, cognitive function, a crucial component of healthy aging, need to be heavily weighted since it contributes to everyday functioning (Kelly et al., 2014), independence of older adults (Cigolle et al., 2007), and quality of life (Logsdon et al., 2002). In addition, poor cognitive function is a significant risk factor in dementia (Petersen et al., 2001), which yield high stress for patient, caregivers, and society (Kuiper et al., 2015). However, current studies yield a coherent result that older Hispanics tend to have poorer performance on cognitive tests compared to non-Hispanic whites (Díaz-Venegas et al., 2019) and that older Hispanic male are more likely to have a better cognitive function than older Hispanic female (Díaz-Venegas et al., 2016). Identifying the potential factors contributing to cognitive function is advantageous for policymakers and social workers to help maintain the cognitive health of older Hispanic Americans.

There is growing evidence that social relationships serve as an important contributor among older population by promoting social engagement, garnering social support (Kelly et al., 2017), and modifying health behaviors (Wu & Sheng, 2019). Among diverse social relationships, family is the main source of social support (Zamora-Macorra et al., 2017) and tends to be the major resource that Hispanics can rely on (Angel et al., 2004; Guo et al., 2015). Being a protector against external physical and emotional stressors of older Hispanic adults (Marin et al., 1987; Perreira et al., 2019), family promotes both physical and mental health outcomes (Katiria Perez & Cruess, 2014). As the acculturation and social changes distorting and reshaping Hispanics’ traditional family-oriented cultural preference and gender roles, the influence of family appears to become different, especially the influence on cognitive function which is greatly shaped by contextual and personal factors. However, few studies have considered the role of family on cognitive function focusing of Hispanic older adults in the United States. As such, the present study aims to examine the association between family relationship and cognitive function among Hispanic American older population, and further identify whether gender differences have moderating effects on the above association.

Guided by the classical social support theory (Antonucci, 1990), this study utilized three-dimension conceptualization of family relationship, which is composed of structural, functional, and appraisal supports to better reveal the complex family relationship. Operationalized as the structure of social network, the structural support refers to the number and types of relationships within the social network while functional support is usually conceptualized as various aspects of support resources available from one’s social network if needed (Lakey & Cohen, 2000). Generally, it could be divided into instrumental, financial as well as emotional support. Moreover, reflecting the satisfaction of received support, the appraisal support can be referred to the perceived support.

Structural support of family seems to be important to older Hispanics since they have a higher tendency to reside with more kids and adults in comparison with other ethnic/racial groups (Olsen et al., 2019) and have large family networks (Gallo et al., 2009). Research has indicated more family connections acting as higher cognitive stimulation were positively associated with cognitive function for Hispanics (Katz et al., 2020; Vásquez et al., 2019). In addition, the contact frequency with network members which is not included in the social support theory is also considered as one aspect of network structure by many researchers (Berkman et al., 2000). Previous studies highlighted the beneficial effects of contact with friends rather than family on cognitive function since it promotes active activity engagement (Sharifian et al., 2020). Nevertheless, it was not the case for Hispanic American older adults. Katz et al. (2020) have found higher contact frequency with family members but not with friends was associated with better executive function among older Hispanics. However, the effects on general cognitive function remains unclear.

Among the types of functional support, it is suggested that emotional support have a stronger association with cognitive function than insumental and financial supports (Kelly et al., 2017) because receiving instrumental and financial support may not have similar effects on displaying emotional connetion and changing lifestyle behaviors as receiving emotional support (Pillemer & Holtzer, 2016). In line with the previous studies on general population, Zahodne et al. (2018) have found negative associations between working memory and general emotional support among older Hispanics (n = 153) and nonsignificant association with general instrumental support. Although little is known about the impacts of financial support on cognitive function of older Hispanics, research on the African Americas who are also in similar unfavorable socioeconomic situation has revealed that financial support significantly predicted better executive functioning (Sims et al., 2011). Thus, we suppose the financial support of family might also benefit the cognitive function of Hispanic older adults by providing them more access to healthcare services and supports that help boost health behaviors and lessen their stress caused by their disadvantaged socioeconomic position.

With regard to apprasial support, substancial evidence indicated that perceived supports have noticiable influence on cognitive function by reducing stress and lowering levels of stress hormones, particularly in stressful situations (Costa-Cordella et al., 2021; Kuiper et al., 2016). In contrast, the study of Brown et al. (2009) denoted that general perceived support was irrelevant to the cognitive function among older Hispanic adults (n= 273 ), infering that without mutual exchange of resourses, passive reception of perceived emotional support may not have association with cognitive function. Due to its small sample size, future studies that utilize nationally represented sample need to be conducted to confirm this result.

Particularly, the association between family relationship and cognitive function could vary by gender. Although Hispanics exhibit a high level of Familismo, a core value of Hispanic culture, which contains a strong identification and attachment of individuals with their families and strong feelings of loyalty, reciprocity, and solidarity among members of the same family (Sabogal et al., 1987), within which both men and women display a distinct role and undertake different responsibilities. Hispanic women are expected to provide physical and emotional support to the family members and are responsible for maintaining family harmony and networks, serving as key figures in the family (Castillo et al., 2010). Hispanic men are responsible for keeping family order and disciplines as well as providing material support (Rocha-Sánchez & Díaz-Loving, 2005). Similar with other ethnic groups, Hispanic women are predisposed to embrace larger social networks and utilize various coping strategies by means of their network systems (Cano et al., 2018), while Hispanic men tend to be principally reliant on their spouse for support (Castillo et al., 2010). Therefore, the differences in family roles may also result in diverse effects on cognitive function. However, current studies failed to extend the association between gender differences in family relationships and cognitive function.

As supported by previous studies, the impacts of different dimensions of family relationship on cognitive function are heterogeneous across ethnic groups. However, existent sparse racial comparison studies did not reach conclusive results due to incomprehensive measurement of family relationship, unrepresentative sample of Hispanic population, lack of theoretical framework, and might have neglected of the moderator effect of gender whose role in family is peculiar according to cultural norm expectations. As such, the present study extends the previous research by examining the association between family relationship and cognitive function among Hispanic older adults living in the United States by using a nationally representative sample from Health and Retirement Study, and further investigating the moderator role of gender in the above relationships.

Method

Participants

Data was extracted from Health and Retirement Study (HRS) sponsored by the National Institute on Aging, which contains a large longitudinal, nationally representative survey of older Americans (aged 51 and older) and their spouses while embodies the race and ethnic diversity (Juster & Suzman, 1995) and is carried out by the University of Michigan. Starting from 2006, a random one-half of the sample that was selected to enhanced face-to-face interview was asked to complete a self-report psychosocial survey (also called leave-behind [LB] questionnaire) and every two surveys constitute data for a complete sample. In this study, data were derived from the subsample of Hispanic respondents completing both the Core and LB questionnaire in 2014 and 2016, which contain the latest complete psychosocial survey data. Due to the core interview is conducted every 2 years, we used the core interview data in 2016. For those who completed the LB questionnaire in 2014 but did not accomplish the core interview in 2016, we used the core interview data in 2014 as substitution. In total, 1,761 Hispanic respondents completed both LB questionnaire and core interview. The final sample consisted of 1,580 respondents after excluding those who were younger than 51 (n = 115), those who lived in the nursing home (n = 2) and those who were represented by a proxy (both core and LB questionnaire) (n = 64).

Measures

Cognitive function

For current analyses, we make use of an abbreviated version of the Telephone Interview for Cognitive Status (TICS). The total score ranged between 0 and 27, a composition of the scores of: 10 word immediate and delayed recall tests to assess memory (0-20 points), a serial sevens subtraction test for working memory (0-5 points), and counting backwards to measure mental processing speed (0-2 points), following the method proposed by Langa and Weir (Crimmins et al., 2011). Higher scores represent better cognitive performance.

Family Relationship

Structural Support

The structural support is assessed with two indices: composition of family network and the number living in the household. For the composition of family network, respondents were asked three questions respectively: do you have a husband, wife, or partner with whom you live? do you have any living children? do you have any other immediate family? (Yes = 1; No = 0). The total scores range from 0 to 3, higher scores indicate more diverse composition of family network. The number living in the household was conducted by one question: how many members live in the household.

Since many studies have attached great importance to contacts with social network (Kelly et al., 2017), we further added the contact frequency with family members as an additional variable which is not included in the social support theory and was placed in the final model. Respondents were asked to indicate the frequency with which they met up, spoke on the phone, and wrote or emailed children or other family members respectively. The scores of each question range from 1 (three or more times a week) to 6 (less than once a year or never) and then the coding was reversed. An average score of three questions was later calculated with a range between 1 and 6 (Vásquez et al., 2019). The mean scores of contact frequency of two dimensions were used.

Functional Support

The functional support was sorted into emotional support, instrumental support, and financial support according to the social support theory proposed by Antonucci (1990). Given that HRS does not include the questions related to the emotional support and instrumental support from family, we selected the perspective of financial support to represent the function support of family relationships using a binary measure for whether the respondent received money in recent two years from kids or relatives.

Appraisal Support

The appraisal support is accessed with perceived support (both negative and positive). For each relationship category (spouse, kids, and other family members), there are three positively worded items and four negatively worded items. Each item was measured using a 4-point Likert scale ranging from 1 (a lot) to 4 (not at all) and then the values were reversed. Indexes of positive and negative support for each relationship were created and categorized by averaging the scores within each dimension (Ge et al., 2017; Smith et al., 2017). Both perceived positive and negative family support were calculated using the average scores of above three dimensions, the total score ranges from 1 to 4. Cronbach’s alpha of positive support of spouse, kids, and other family members were .82, .83, .86 respectively and the Cronbach’s alpha of negative support for each domain were .79, .78, .81 respectively (Smith et al., 2017).

Covariates

Selected covariates include age, gender (male = 0, female = 1), education attainment (assessed by the years of schooling), household assets (calculated using log value), chronic comorbid health conditions, physical function (Activities of daily living [ADLs]; the respondents were asked whether had difficulty in bathing, eating, dressing, walking across a room, and getting in/out of bed respectively; yes = 1, no = 0; a sum score of five questions ranges between 0 and 5) (Martinez et al., 2014) and perceived negative friend support (calculated using the similar method of the perceived negative support from family; range from 0 to 4; Cronbach’s alpha was .84 [Smith et al., 2017]). For chronic comorbid health conditions, we used the count of eight self-reported chronic diseases based on the history of diagnoses including high blood pressure, diabetes, cancer, lung disease, arthritis, stroke, heart disease, and psychiatric problems. The total scores range from 0 to 8 (Fong, 2019).

Data Analysis

All statistical analyses were performed using Stata 16.0. First, a series of linear-regression analyses were used to examine the association between the family relationships and the cognitive function after adjustment for covariates. We first included (1) covariates and then sequentially inserted, (2) structural support (the number living in the household, composition of family network), (3) appraisal support (perceived positive family support, perceived negative family support), (4) functional support (financial support from family members), and at last (5) contact frequency with family members. Multicollinearity test results indicated estimates of variance inflation factors were all less than 2, which reported no evidence of multicollinearity (Ziegel & Myers, 1991). In the second step, a moderation test was conducted examining the interactions of each variable with gender on cognitive function.

Results

Demographic Characteristics

Table 1 presents the respondents’ characteristics. Most of the respondents were female (58.80%), have some secondary and more education (75.06%), normal cognitive function (69.81%), and no ADL disabilities (79.56%). The average age was 65.65 (SD = 9.33). In addition, respondents tended to have more than two members living in the household and more than two different components of family composition. Both men and women perceived similar level of positive and negative family support and had similar percentage of receiving financial support from family members. In particular, women contacted more frequently with family members (3.81) than men (3.46).

Table 1.

Participant Characteristics.

N (%)	Women (N = 929)		Men (N = 651)		Overall (N = 1,580)
N (%)	N (%)	Mean (SD)	N (%)	Mean (SD)	N (%)	Mean (SD)
Age		65.53 (9.39)		65.82 (9.23)		65.65 (9.33)
51–64	507 (54.57)		352 (54.07)		859 (54.37)
65–74	230 (24.76)		154 (23.66)		384 (24.30)
75–84	157 (16.90)		121 (18.59)		278 (17.59)
85+	35 (3.77)		24 (3.68)		59 (3.73)
Education attainment		10.23 (4.37)		10.35 (4.29)		10.28 (4.33)
No formal education	31 (3.35)		17 (2.63)		48 (3.05)
Some primary (1–6 years)	203 (21.95)		141 (21.79)		344 (21.88)
Some secondary or more (7+ years)	691 (74.70)		489 (75.58)		1,180 (75.06)
Household assets (USD)		217,791.7 (671,263.5)		188,141.4 (427,766.2)		205,575.0 (583,403.5)
Cognitive function		13.67 (4.65)		13.63 (4.09)		13.65 (4.43)
Demented (0–6)	64 (6.89)		33 (5.07)		97 (6.14)
CIND (7–11)	223 (24.00)		157 (24.12)		380 (24.05)
Normal (12–27)	642 (69.11)		461 (70.81)		1,103 (69.81)
No ADL disabilities	720 (77.50)		537 (82.49)		1,257 (79.56)
Number of chronic diseases		2.21 (1.56)		2.05 (1.50)		2.14 (1.53)
Perceived negative friend support		1.48 (0.57)		1.51 (0.58)		1.50 (0.58)
Number living in the household		2.78 (1.62)		3.06 (1.62)		2.89 (1.62)
Composition of family network		2.21 (0.80)		2.37 (0.79)		2.27 (0.80)
Perceived positive family support		3.20 (0.65)		3.20 (0.64)		3.20 (0.65)
Perceived negative family support		1.82 (0.62)		1.79 (0.59)		1.81 (0.61)
Received money from family members	114 (12.39)		67 (10.45)		181 (11.60)
Contact frequency with family members		3.81 (0.99)		3.46 (1.04)		3.67 (1.02)

Note. ADL = activities of daily living; CIND = cognitive impairment.

Regression Model of Family Relationship

Results of Linear regression indicated that age, gender, education attainment, physical function, chronic comorbid health conditions, and household assets were significantly associated with cognitive function. Regarding family relationship, in the aspect of structural support, composition of family network was significantly associated with cognitive function (β = .070, t = 2.63, p = .009), while the association between the number living in the household and cognitive function was statically nonsignificant. In addition, the association between appraisal of family support and cognitive function was not significant. In terms of function support, financial support was significantly associated with cognitive function (β = .060, t = 2.38, p = .018). The final model explained 22.74% of the variation in cognitive function of Hispanic older adults (Table 2 displays these results).

Table 2.

Linear Regression Analyses for the Relationship of Family and Cognitive Function.

Variable	Model 1	Model 2	Model 3	Model 4	Model 5
Variable	β (SE)	β (SE)	β (SE)	β (SE)	β (SE)
Age	−.173 (0.013)***	−.164 (0.013)***	−.167 (0.014)***	−.169 (0.014)***	−.171 (0.014)***
Gender	.025 (0.220)	.035 (0.225)	.037 (0.226)	.036 (0.228)	.034 (0.233)
Education attainment	.279 (0.027)***	.285 (0.028)***	.290 (0.029)***	.290 (0.029)***	.287 (0.030)***
Household assets	.126 (0.374)***	.116 (0.380)***	.115 (0.383) ***	.119 (0.384)***	.121 (0.385)***
Activities of daily living (ADLs)	−.110 (0.116)***	−.107 (0.118)***	−.105 (0.119)***	−.105 (0.119)***	−.105 (0.119)***
Number of chronic diseases	−.082 (0.077)**	−.081 (0.078)**	−.076 (0.079)**	−.075 (0.080)**	−.069 (0.080)*
Perceived negative friend support	.013 (0.191)	.019 (0.197)	.036 (0.226)	.033 (0.228)	.022 (0.232)
Number living in the household		.012 (0.073)	.013 (0.074)	.011 (0.074)	.009 (0.074)
Composition of family network		.074 (0.149)**	.070 (0.153)**	.068 (0.154)**	.070 (0.156)**
Perceived positive family support			.035 (0.203)	.029 (0.204)	.032 (0.223)
Perceived negative family support			−.019 (0.240)	−.019 (0.024)	−.008 (0.245)
Financial support				.058 (0.344)*	.060 (0.345)*
Contact frequency with family members					.010 (0.125)

Note. Standardized coefficients were reported in this table.

p < .05. **p < .01. ***p < .001.

Moderation Effect of Gender on Family Relationship and Cognitive Function

Table 3 presented the moderator effects of gender on the association between family relationship and cognitive function among Hispanic older adults. The moderation test further indicated that the associations between composition of family network and cognitive function (β = .120, t = 2.03, p = .043), and that between financial support and cognitive function (β = .074, t = 2.82, p = .005) were stronger among women as compared with men. Additionally, gender did not moderate the relationships between appraisal support (both perceived positive and negative family support) and the number living in the household and cognitive function.

Table 3.

Linear Regression Analyses for the Interactions of Variables with Gender and Cognitive Function.

Variable	Model 1	Model 2	Model 3	Model 4
Variable	β (SE)	β (SE)	β (SE)	β (SE)
Age	−.164 (0.013)***	−.165 (0.014)***	−.167 (0.014)***	−.168 (0.014)***
Gender	−.104 (0.507)	−.104 (1.220)	−.200 (1.221)	−.280 (1.288)
Education attainment	.283 (0.028)***	.284 (0.028)***	.286 (0.029)***	.282 (0.029)***
Household assets	.119 (0.380)***	.118 (0.384)***	.124 (0.385)***	.126 (0.385)***
Activities of daily living (ADLs)	−.108 (0.118)***	−.106 (0.119)***	−.103 (0.119)***	−.102 (0.119)***
Number of chronic diseases	−.080 (0.078)**	−.076 (0.079)**	−.076 (0.080)**	−.070 (0.080)*
Perceived negative friend support	.017 (0.197)	.026 (0.211)	.023 (0.213)	.012 (0.216)
Number living in the household × Gender	.037 (0.096)	.039 (.097)	.033 (.097)	.030 (.098)
Composition of family network × Gender	.118 (0.195)*	.118 (.203)*	.116 (.204)*	.120 (.207)*
Perceived positive family support × Gender		.117 (0.262)	.102 (0.263)	.121 (0.284)
Perceived negative family support × Gender		−.017 (0.291)	−.015 (0.291)	.011 (0.297)
Financial support × Gender			.072 (0.426)**	.073 (0.429)**
Contact frequency with family members × Gender				.039 (0.162)

Note. Standardized coefficients were reported in this table.

p < .05. **p < .01. ***p < .001.

Discussion

To the best of authors’ knowledge, this study is the first study focusing on the impacts of family relationship on the cognitive function of Hispanic older population in the United States, thus providing implications for both policy-making and practice-conducting. The results of this study revealed that more diverse composition of family network and financial support from family members were positively associated with cognitive function among Hispanic older adults but not the number living in the household nor the perceived support (both positive and negative). Importantly, the above association was higher among Hispanic older women than men.

In the structural dimension of family relationship, more diverse composition of family network was associated with better cognitive function of older Hispanics while the number of co-living members showed nonsignificant effects. With much emphasis on extended family, large family network, and quantity of co-living family members tend to be considered as the Hispanic sociocultural customs (Olsen et al., 2019) and have aroused much social attention. Interestingly, the diversity of family support resources seemed to be more important to the cognitive function, although interactions with those living with them are inclined to serve as the most predominant support resources (Shanas, 1979). This finding shed light on the different influences of structural dimension of family relationship and provides new impetus for studying cognitive health within Hispanic cultural background. Consistent with previous studies, women benefited more from the diverse composition of family network than men by more actively involving in reciprocated relationships (Chatters et al., 1985), which highlighted the salient impacts of different family roles performed on the cognitive function of Hispanic women and broadened our understanding of the impacts of varying family norms.

Moreover, financial support helps boost better cognitive function since it facilitate the stress-buffering effects on the vulnerable Hispanic older people. Although the financial support they received might be quite limited (Henly et al., 2005), it might serve as backup helping them tide over an economic hardship or crisis. Material aid could also improve the unfavorable living and health conditions by equipping them with more access to health care and other necessary services, and thus eliminates stress and encourages better cognitive function. With more financial support, women can use more resources and strategies to maintain and enlarge their social network which is different from men who tend to have a family-centered social network as they age. Therefore, women have more opportunities to participate in cognitive stimulating activities to promote their cognitive function.

Consistent with the study of Brown et al. (2009), we found no significant associations between both perceived negative and positive family supports and cognitive function and the moderator effect of gender was not revealed in these associations. This might partly due to the indirect effect of perceived family support on cognitive function by lessening depression among older Hispanic population (Kuiper et al., 2016). Moreover, Simpatía (interpersonal harmony) and Respecto (valuing of elder community members) (Ruiz et al., 2016), another two Hispanic cultural values, encourage family members to provide supports and showing respect for older generations. Thus, the perceived supports might not show cognitive stimulating effects on Hispanic older adults since they act as passive recipients. In addition, women and men were influenced distinctively by different types of perceived family support. Perceived support from children might have a salient impact on women while perceived support from spouse on men (Liao & Scholes, 2017). Therefore, the average perceived family support in this study might not reflect the exact nature of the mechanisms of perceived family supports among the Hispanic older population. Further research is needed to be done to investigate how different aspects of appraisal support influence older Hispanics.

Contrary to expectations, the average contact frequency with family members did not significantly associate with general cognitive function in this study, which was contrary to the previous studies’ results that social interactions were cognitively and emotionally processed by the brain and thus could bring direct stimulatory effects on the cognitive function (Seeman et al., 2001). This may due to similar reasons that different family members’ interactions might bring diverse outcomes. Moreover, the used data collected the information of interactions with family members who did not live with the respondents, therefore, future work should examine respectively the interactions with those living together and with those living apart on cognitive function.

The current study had several limitations. Since Hispanics older people in our study is a general racial conception, the effects of family relationships might be different in heterogeneous Hispanic subgroups which mainly consist of Hispanics of Mexican, Puerto Ricans, Cubans, and others. In addition, constrained by the data, our study excluded measures of emotional and instrumental support, and the financial support from family members also implicitly included the support from friends. Future studies need to comprehensively examine the effects of family relationship on cognitive function. Also, the average perceived support from family members and average contact frequency might not reflect the mechanisms of appraisal dimension of family relationships and of interactions within family. Lastly, this study used cross-sectional analysis and therefore causality or direction of influence cannot be tested.

Using a reliable nationally representative sample of the United States and following the classical theoretical framework proposed by Antonucci (1990), this study has important implications for the interventions of cognitive function among the aging Hispanic population. Helping professionals (e.g., nurses and social workers) need to put emphasis on encouraging positive familial connections as well as community-based activities with local residents among Hispanic older adults to help perform their functions in the family and extend their social networks, and thus help them increase social participation, embrace diverse social supports and promote beneficial health outcomes. When cognitive decline is detected, a cooperation between clinicians and helping professionals is recommended. By enhancing comprehensive understanding of their social and familial circumstances, a more rational and appropriate therapeutic treatment must be elaborated for the older Hispanics. Our results also call for policy-makers to take cultural preference into consideration when analyzing risk factors in poor cognitive performance of Hispanic older population with the intention of formulating health and social programs to maintain and boost their cognitive function.

In summary, cognitive function of older Hispanic Americans appears to benefit from diverse composition of family network and financial support from family and these associations are particularly greater for women than men. Policies and practices should be made to encourage Hispanic families to establish connections and provide supports to maintain cognitive function of older adults to improve their quality of life. Future longitudinal studies should use more accurate measurements to examine the family relationship on cognitive function comprehensively among Hispanic older adults.

Footnotes

Acknowledgements

This analysis is based on the 2014 and 2016 waves of the Health and Retirement Survey (HRS). HRS is funded by the National Institute on Aging (NIAU01AG009740) and collected by the University of Michigan. We are grateful to the HRS research team and field team for collecting the data and making the data publicly accessible.

Author Contributions

Chunhui Xiao contributed to statistical analysis, original draft preparation and writing, and revision. Shan Mao contributed to statistical analysis, paper writing, and revision. Siming Jia contributed to data analysis, paper writing, and revision. Nan Lu contributed to supervision, study design, paper revision, and editing.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The current research was supported by fund for building world-class universities (disciplines) of Renmin University of China.

Ethics approval

Ethics approval of HRS has been obtained from the Institutional Review Board of the University of Michigan.

ORCID iD

Shan Mao

Author Biographies

Chunhui Xiao is a bachelor of the Department of Spanish Language and Literature, School of Foreign Languages, Renmin University of China.

Shan Mao is a Master of Social Work (MSW) of the Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China.

Siming Jia is a PhD candidate of the School of Sociology and Population Studies, Renmin University of China.

Nan Lu, PhD, is an associate professor of the Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China.

References

Angel

J. L.

Angel

R. J.

Aranda

M. P.

Miles

T. P.

(2004). Can the family still cope? Social support and health as determinants of nursing home use in the older Mexican-origin population. Journal of Aging and Health, 16(3), 338–354. https://doi.org/10.1177/0898264304264203

Antonucci

T. C.

(1990). Social support and social relationships. In Binstock

R. H.

George

L. K.

(Ed.), Handbook of aging and the social sciences (3rd ed., pp. 205–226). Academic Press.

Berkman

L. F.

Glass

Brissette

Seeman

T. E.

(2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51(6), 843–857. https://doi.org/10.1016/s0277-9536(00)00065-4

Brown

S. C.

Mason

C. A.

Spokane

A. R.

Cruza-Guet

M. C.

Lopez

Szapocznik

(2009). The relationship of neighborhood climate to perceived social support and mental health in older Hispanic immigrants in Miami, Florida. Journal of Aging and Health, 21(3), 431–459. https://doi.org/10.1177/0898264308328976

Cano

M. Á.

Sánchez

Rojas

Ramírez-Ortiz

Polo

K. L.

Romano

De La Rosa

(2018). Alcohol use severity among adult hispanic immigrants: Examining the roles of family cohesion, social support, and gender. Substance Use & Misuse, 53(4), 668–676. https://doi.org/10.1080/10826084.2017.1356333

Castillo

L. G.

Perez

F. V.

Castillo

Ghosheh

M. R.

(2010). Construction and initial validation of the Marianismo Beliefs Scale. Counselling Psychology Quarterly, 23(2), 163–175. https://doi.org/10.1080/10826084.2017.1356333

Chatters

L. M.

Taylor

R. J.

Jackson

J. S.

(1985). Size and composition of the informal helper networks of elderly Blacks. Journal of Gerontology, 40(5), 605–614. https://doi.org/10.1093/geronj/40.5.605

Cigolle

C. T.

Langa

K. M.

Kabeto

M. U.

Tian

Blaum

C. S.

(2007). Geriatric conditions and disability: The Health and Retirement Study. Annals of Internal Medicine, 147(3), 156–164. https://doi.org/10.7326/0003-4819-147-3-200708070-00004

Costa-Cordella

Arevalo-Romero

Parada

F. J.

Rossi

(2021). Social support and cognition: A systematic review. Frontiers in Psychology, 12, 452. https://doi.org/10.3389/fpsyg.2021.637060

10.

Crimmins

E. M.

Kim

J. K.

Langa

K. M.

Weir

D. R.

(2011). Assessment of cognition using surveys and neuropsychological assessment: The Health and Retirement Study and the Aging, Demographics, and Memory Study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66(Suppl_1), i162–i171. https://doi.org/10.1093/geronb/gbr048

11.

Díaz-Venegas

Downer

Langa

K. M.

Wong

(2016). Racial and ethnic differences in cognitive function among older adults in the USA. International Journal of Geriatric Psychiatry, 31(9), 1004–1012. https://doi.org/10.1002/gps.4410

12.

Díaz-Venegas

Downer

Langa

K. M.

Wong

(2019). Cognitive functioning of U.S. adults by race and hispanic origin. In Vega

Angel

Gutiérrez Robledo

Markides

(Eds.), Contextualizing health and aging in the Americas (pp. 85–107). Springer. https://doi.org/10.1007/978-3-030-00584-9_5

13.

Fong

J. H.

(2019). Disability incidence and functional decline among older adults with major chronic diseases. BMC Geriatrics, 19(1), 1–9. https://doi.org/10.1186/s12877-019-1348-z

14.

Gallo

L. C.

Penedo

F. J.

Espinosa de los Monteros

Arguelles

(2009). Resiliency in the face of disadvantage: Do Hispanic cultural characteristics protect health outcomes? Journal of Personality, 77(6), 1707–1746. https://doi.org/10.1111/j.1467-6494.2009.00598.x

15.

Bailey

D. E.

Jr. Dong

(2017). Social support, social strain, and cognitive function among community-dwelling US Chinese older adults. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 72(Suppl_1), S16–S21. https://doi.org/10.1093/gerona/glw221

16.

Guo

Liu

Sun

(2015). Family relations, social connections, and mental health among Latino and Asian older adults. Research on Aging, 37(2), 123–147. https://doi.org/10.1177/0164027514523298

17.

Henly

J. R.

Danziger

S. K.

Offer

(2005). The contribution of social support to the material well-being of low-income families. Journal of Marriage and Family, 67(1), 122–140. https://doi.org/10.1111/j.0022-2445.2005.00010.x

18.

Juster

F. T.

Suzman

(1995). An overview of the Health and Retirement Study. Journal of Human Resources, 30, S7–S56. https://doi.org/10.2307/146277

19.

Katiria Perez

Cruess

(2014). The impact of familism on physical and mental health among Hispanics in the United States. Health Psychology Review, 8(1), 95–127. https://doi.org/10.1080/17437199.2011.569936

20.

Katz

Turney

Lee

J. H.

Amini

Ajrouch

K. J.

Antonucci

T. C.

(2020). Race/ethnic differences in social resources as cognitive risk and protective factors. Research in Human Development, 17(1), 57–77. https://doi.org/10.1080/15427609.2020.1743809

21.

Kelly

M. E.

Duff

Kelly

Power

J. E. M.

Brennan

Lawlor

B. A.

Loughrey

D. G.

(2017). The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: A systematic review. Systematic Reviews, 6(1), 1–18. https://doi.org/10.1186/s13643-017-0632-2

22.

Kelly

M. E.

Loughrey

Lawlor

B. A.

Robertson

I. H.

Walsh

Brennan

(2014). The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: A systematic review and meta-analysis. Ageing Research Reviews, 15, 28–43. https://doi.org/10.1016/j.arr.2014.02.004

23.

Kuiper

J. S.

Zuidersma

Voshaar

R. C. O.

Zuidema

S. U.

van den Heuvel

E. R.

Stolk

R. P.

Smidt

(2015). Social relationships and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies. Ageing Research Reviews, 22, 39–57. https://doi.org/10.1016/j.arr.2015.04.006

24.

Kuiper

J. S.

Zuidersma

Zuidema

S. U.

Burgerhof

J. G.

Stolk

R. P.

Oude Voshaar

R. C.

Smidt

(2016). Social relationships and cognitive decline: A systematic review and meta-analysis of longitudinal cohort studies. International Journal of Epidemiology, 45(4), 1169–1206. https://doi.org/10.1093/ije/dyw089

25.

Lakey

Cohen

(2000). Social support theory and measurement. In Cohen

Underwood

L. G.

Gottlieb

B. H.

(Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 29–52). Oxford University Press. https://doi.org/10.1093/med:psych/9780195126709.003.0002

26.

Liao

Scholes

(2017). Association of social support and cognitive aging modified by sex and relationship type: A prospective investigation in the English longitudinal study of ageing. American Journal of Epidemiology, 186(7), 787–795. https://doi.org/10.1093/aje/kwx142

27.

Logsdon

R. G.

Gibbons

L. E.

McCurry

S. M.

Teri

(2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64(3), 510–519. https://doi.org/10.1097/00006842-200205000-00016

28.

Marin

Sabogal

Marin

B. V.

Otero-Sabogal

Perez-Stable

E. J.

(1987). Development of a short acculturation scale for Hispanics. Hispanic Journal of Behavioral Sciences, 9(2), 183–205. https://doi.org/10.1177/07399863870092005

29.

Martinez

C. H.

Richardson

C. R.

Han

M. K.

Cigolle

C. T.

(2014). Chronic obstructive pulmonary disease, cognitive impairment, and development of disability: The health and retirement study. Annals of the American Thoracic Society, 11(9), 1362–1370. https://doi.org/10.1513/AnnalsATS.201405-187OC

30.

Olsen

Roy

S. B.

Tseng

H.-K.

(2019). The Hispanic health paradox for older Americans: An empirical note. International Journal of Health Economics and Management, 19(1), 33–51. https://doi.org/10.1007/s10754-018-9241-4

31.

Perreira

K. M.

Marchante

A. N.

Schwartz

S. J.

Isasi

C. R.

Carnethon

M. R.

Corliss

H. L.

Kaplan

R. C.

Santisteban

D. A.

Vidot

D. C.

Van Horn

(2019). Stress and resilience: Key correlates of mental health and substance use in the Hispanic community health study of Latino youth. Journal of Immigrant and Minority Health, 21(1), 4–13. https://doi.org/10.1007/s10903-018-0724-7

32.

Petersen

R. C.

Doody

Kurz

Mohs

R. C.

Morris

J. C.

Rabins

P. V.

Ritchie

Rossor

Thal

Winblad

(2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58(12), 1985–1992. https://doi.org/10.1001/archneur.58.12.1985

33.

Pillemer

S. C.

Holtzer

(2016). The differential relationships of dimensions of perceived social support with cognitive function among older adults. Aging & Mental Health, 20(7), 727–735. https://doi.org/10.1080/13607863.2015.1033683

34.

Rocha-Sánchez

T. E.

Díaz-Loving

(2005). Cultura de género: La brecha ideológica entre hombres y mujeres. Anales de Psicología/Annals of Psychology, 21(1), 42–49. https://revistas.um.es/analesps/article/view/27111

35.

Ruiz

J. M.

Hamann

H. A.

Mehl

M. R.

O’Connor

M.-F.

(2016). The Hispanic health paradox: From epidemiological phenomenon to contribution opportunities for psychological science. Group Processes & Intergroup Relations, 19(4), 462–476. https://doi.org/10.1177/1368430216638540

36.

Sabogal

Marín

Otero-Sabogal

Marín

B. V.

Perez-Stable

E. J.

(1987). Hispanic familism and acculturation: What changes and what doesn’t? Hispanic Journal of Behavioral Sciences, 9(4), 397–412. https://doi.org/10.1177/07399863870094003

37.

Seeman

T. E.

Lusignolo

T. M.

Albert

Berkman

(2001). Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychology, 20(4), 243–255. https://doi.org/10.1037/0278-6133.20.4.243

38.

Shanas

(1979). The family as a social support system in old age. The Gerontologist, 19(2), 169–174. https://doi.org/10.1093/geront/19.2.169

39.

Sharifian

Kraal

A. Z.

Zaheed

A. B.

Sol

Zahodne

L. B.

(2020). Longitudinal associations between contact frequency with friends and with family, activity engagement and cognitive functioning. Journal of the International Neuropsychological Society, 26(8), 815. https://doi.org/10.1017/S1355617720000259

40.

Sims

R. C.

Levy

S.-A.

Mwendwa

D. T.

Callender

C. O.

Campbell

A. L.

Jr. (2011). The influence of functional social support on executive functioning in middle-aged African Americans. Aging, Neuropsychology, and Cognition, 18(4), 414–431. https://doi.org/10.1080/13825585.2011.567325

41.

Smith

Ryan

Sonnega

Weir

(2017). Psychosocial and lifestyle questionnaire 2006–2016. Survey Research Center, Institute for Social Research. https://hrs.isr.umich.edu/sites/default/files/biblio/HRS%202006-2016%20SAQ%20Documentation_07.06.17_0.pdf

42.

The Administration for Community Living. (2019). Profile of Hispanic Americans age 65 and over. U.S. Department of Health and Human Services. https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2018HA_OAProfile.pdf

43.

U.S. Department of Health and Human Services. (2021). Profile: Hispanic/Latino Americans. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=64

44.

Vásquez

P. M.

Tarraf

Doza

Marquine

M. J.

Perreira

K. M.

Schneiderman

Zeng

Cai

Isasi

C. R.

Daviglus

M. L.

(2019). The cross-sectional association of cognitive stimulation factors and cognitive function among Latino adults in Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 5, 533–541. https://doi.org/10.1016/j.trci.2019.07.006

45.

Sheng

(2019). Social support network, social support, self-efficacy, health-promoting behavior and healthy aging among older adults: A pathway analysis. Archives of Gerontology and Geriatrics, 85, 103934. https://doi.org/10.1016/j.archger.2019.103934

46.

Zahodne

L. B.

Watson

C. W.-M.

Seehra

Martinez

M. N.

(2018). Positive psychosocial factors and cognition in ethnically diverse older adults. Journal of the International Neuropsychological Society, 24(3), 294–304. https://doi.org/10.1017/S1355617717000935

47.

Zamora-Macorra

de Castro

E. F. A.

Ávila-Funes

J. A.

Manrique-Espinoza

B. S.

López-Ridaura

Sosa-Ortiz

A. L.

Shields

P. L.

Del Campo

D. S. M.

(2017). The association between social support and cognitive function in Mexican adults aged 50 and older. Archives of Gerontology and Geriatrics, 68, 113–118. https://doi.org/10.1016/j.archger.2016.10.005

48.

Ziegel

Myers

(1991). Classical and modern regression with applications. Technometrics, 33, 248. https://doi.org/10.2307/1269070