Estonian Institute for Population Studies, School of Governance, Law and Society, Tallinn University, Tallinn, Estonia.
Estonian Interuniversity Population Research Centre, Tallinn, Harju County, Estonia.
Front Public Health. 2023 Jul 12;11:1058578. doi: 10.3389/fpubh.2023.1058578. eCollection 2023.
In migration and health research, the healthy migrant effect has been a common finding, but it usually pertains to specific contexts only. Existing findings are inconsistent and inconclusive regarding the cognitive functioning of the (aging) foreign-origin population relative to the populations of their host and sending countries. Moreover, this comparison is an understudied design setting.
We analyze the outcomes and associations of cognitive functioning outcomes of the non-institutionalized middle-aged and older population, comparing the Russian-origin population in Estonia with Estonians in Estonia and Russians in Russia in a cross-sectional design. We aim to estimate the (long-term) effects of migration on cognitive functioning in later life, contextualizing the findings in previous research on the healthy migrant effect.
We use data from face-to-face interviews conducted within the SHARE Estonia (2010-2011) and SAGE Russia (2007-2010) surveys. Respondents aged 50+ living in urban areas were grouped by self-identified ethnicity, including 2,365 Estonians, 1,373 Russians in Estonia, and 2,339 Russians in Russia (total = 6,077). Cognitive functioning was measured using a 25-percentile cut-off threshold for the results of two cognition outcomes - immediate recall and verbal fluency - and the odds of impairment were estimated using binary logistic regression.
Russian men and women living in Estonia have significantly higher odds of impairment in immediate recall than Estonian men and women, though they do not differ from Russians in Russia in the final adjusted models. The differences between all groups are non-significant if age at migration is considered. There are no significant differences between the groups in verbal fluency.
Contrary to the commonly found healthy migrant effect, the middle-aged and older foreign-origin population in Estonia fares initially worse than the native population in the immediate recall outcome, but does not differ from their sending country population, possibly due to Russia's higher mortality rate and therefore the selective survival of healthier people. Different results depending on the cognitive functioning outcome suggest that migration may affect temporary memory more than crystallized knowledge. However, there are no differences between the groups if defined based on age at migration, which suggests that the age profile differences explain most of the groups' differences in cognitive functioning.
在移民与健康研究中，“健康移民效应”是一个常见的发现，但它通常仅适用于特定的背景。现有的研究结果对于（老年）外国出生人口的认知功能与他们的母国和原籍国人口相比并不一致和确定。此外，这种比较是一种研究不足的设计环境。
我们分析了非制度化的中年和老年人群的认知功能结果的结果和关联，在横断面设计中比较了爱沙尼亚的俄罗斯裔人口与爱沙尼亚的爱沙尼亚人和俄罗斯的俄罗斯人。我们的目的是估计移民对晚年认知功能的（长期）影响，将这些发现置于对健康移民效应的先前研究中。
我们使用了在 SHARE 爱沙尼亚（2010-2011 年）和 SAGE 俄罗斯（2007-2010 年）调查中进行的面对面访谈的数据。居住在城市地区的 50 岁以上的受访者按自我认同的族裔分组，包括 2365 名爱沙尼亚人、1373 名爱沙尼亚的俄罗斯人和 2339 名俄罗斯的俄罗斯人（总计 6077 人）。认知功能使用两种认知结果的 25%截断阈值进行测量 - 即时回忆和言语流畅性 - 使用二元逻辑回归估计损伤的几率。
居住在爱沙尼亚的俄罗斯男性和女性在即时回忆方面的损伤几率明显高于爱沙尼亚男性和女性，但在最终调整模型中他们与俄罗斯的俄罗斯人没有差异。如果考虑移民年龄，所有群体之间没有显著差异。在言语流畅性方面，各组之间没有显著差异。
与普遍发现的健康移民效应相反，爱沙尼亚的中年和老年外国出生人口在即时回忆结果方面的表现最初比本地人口差，但与他们的原籍国人口没有差异，这可能是由于俄罗斯的死亡率较高，因此选择性地生存了更健康的人。根据认知功能结果的不同结果表明，移民可能会对临时记忆产生更大的影响，而不是对结晶知识产生影响。但是，如果根据移民年龄定义组，则组之间没有差异，这表明年龄分布差异解释了群体在认知功能方面的大部分差异。
