Lamar Melissa, Glover Crystal M, Capuano Ana W, Wilson Robert S, Fleischman Debra A, Bennett David A, Marquez David X
Rush Alzheimer's Disease Center Rush University Medical Center Chicago Illinois USA.
Department of Psychiatry and Behavioral Sciences Rush University Medical Center Chicago Illinois USA.
Alzheimers Dement (N Y). 2023 Apr 10;9(2):e12380. doi: 10.1002/trc2.12380. eCollection 2023 Apr-Jun.
Acculturation-related characteristics, that is, factors directly connected to culture and familial relationships, are associated with engaged research participation within Latino communities. Despite this, little empirical data exists on whether acculturation changes over time in older Latinos, which has potential implications for Alzheimer's disease and related dementias (ADRD) research study design including longer duration clinical trial implementation.
Self-identified Latinos ( = 222; mean age = 71, 76% female) participating in one of three ongoing longitudinal community-based cohort studies of aging who reported their nativity outside of the United States/District of Columbia (US/DC) contributed, on average, 4.0 ± 1.2 years of annually collected data. This included acculturation-related characteristics of total, language-, and social-based scores from the Short Acculturation Scale for Hispanics (SASH) and total and domain-specific scores from an abbreviated Sabogal Familism questionnaire. We used ordinal mixed effects models and linear mixed effects models (as appropriate) to assess change in acculturation metrics after adjusting for age, sex, education, income, and duration of time in the US/DC.
Although none of the SASH metrics changed over time (-values ≥ 0.25), all Familism metrics declined over time (-values ≤ 0.044). Additionally, select participant-based characteristics including years of education were significantly (and differentially) associated with level of, but not change in, acculturation-related outcomes.
Results suggest that specific acculturation-related factors (i.e., familism) change over time in older Latinos, and participant-based characteristics associated with baseline levels of (but not change in) acculturation more generally. Thus, acculturation-related characteristics are not all static, trait-like qualities but rather a multi-faceted, and at times evolving, construct. Considering this dynamic phenotyping is important when contextualizing older Latinos' lived experience, and when designing, adapting, and conducting ADRD clinical trials and other health-related interventions.
与文化适应相关的特征，即与文化和家庭关系直接相关的因素，与拉丁裔社区积极参与研究有关。尽管如此，关于老年拉丁裔的文化适应是否会随时间变化，实证数据很少，这对阿尔茨海默病及相关痴呆症（ADRD）的研究设计，包括长期临床试验的实施，可能具有重要意义。
自我认定为拉丁裔的人群（n = 222；平均年龄 = 71岁，76%为女性）参与了三项正在进行的基于社区的纵向衰老队列研究之一，他们报告自己出生在美国/哥伦比亚特区（US/DC）以外的地区，平均提供了4.0 ± 1.2年的年度收集数据。这包括来自西班牙裔简短文化适应量表（SASH）的总体、语言和社会基础分数的与文化适应相关的特征，以及来自缩写的萨博加尔家族主义问卷的总体和特定领域分数。我们使用有序混合效应模型和线性混合效应模型（视情况而定），在调整年龄、性别、教育程度、收入和在美国/哥伦比亚特区的时间长度后，评估文化适应指标的变化。
尽管SASH的所有指标都没有随时间变化（p值≥0.25），但所有家族主义指标都随时间下降（ｐ值≤0.044）。此外，包括受教育年限在内的特定基于参与者的特征与文化适应相关结果的水平显著（且有差异）相关，但与变化无关。
结果表明，在老年拉丁裔中，特定的与文化适应相关的因素（即家族主义）会随时间变化，而基于参与者的特征更普遍地与文化适应的基线水平（而非变化）相关。因此，与文化适应相关的特征并非都是静态的、类似特质的品质，而是一个多方面的、有时会演变的概念。在将老年拉丁裔的生活经历背景化时，以及在设计、调整和开展ADRD临床试验及其他与健康相关的干预措施时，考虑这种动态表型很重要。
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