Education,Acculturation,and Network Diversity as Promoters of Cognitive Function: A Study of Older Chinese,Korean,and Vietnamese Americans in Southern California

Abstract

Objectives

This study examined the role of education, acculturation, and network characteristics (size and diversity) in the cognitive function of older Chinese, Korean, and Vietnamese Americans.

Methods

Data were drawn from 158 participants aged 60 or older in the DREAMS study—a study on Asian Americans’ sleep and health conducted in Southern California.

Results

Multivariate models of cognitive function showed significant effects of education (B [SE] = 0.28 [0.07], p < .001), acculturation (B [SE] = 0.17 [0.06], p < .01), and network diversity (B [SE] = 0.26 [0.12], p < .05).

Conclusions

Our findings support the role of education as a general cognitive reserve factor and acculturation as an immigrant-specific one. We also observed cognitive health benefits associated with diverse social networks, underscoring the importance of fostering opportunities for varied social interactions.

Keywords

network diversity bridging social capital cognitive function older immigrants

Introduction

About 14% of the older population in the United States is comprised of immigrants, and this proportion is projected to nearly double by 2060 (Mizoguchi et al., 2019). Despite the fact that approximately 30% of the current older immigrant population in the U.S. is of Asian origin, this group has received limited attention (Đoàn et al., 2019; Hanna & Batalova, 2021). The aging of these immigrant populations implies an increased risk of dementia and cognitive impairment, highlighting the importance of understanding the sociocultural context of their brain aging and cognitive health (Jang et al., 2020; Nguyen et al., 2024; Xu et al., 2017). Given the disadvantaged characteristics and life circumstances often experienced by older Asian immigrants (e.g., language barriers, low socioeconomic status, and limited access to resources and services), it is imperative to identify sociocultural factors linked to their cognitive reserve and functioning.

Education is a key contributor to cognitive reserve and a strong predictor of late-life cognition (Andel et al., 2006; Lee et al., 2003; Stern, 2002). It not only supports cognitive development in early life but also provides cognitive health benefits throughout the lifespan by enhancing social mobility and promoting healthy lifestyles. Individuals with more years of formal education are more likely to be exposed to cognitively stimulating environments and activities, which help them develop neural networks and better compensate for cognitive decline later in life (Andel et al., 2006; Lee et al., 2003; Stern, 2002). These cognitive health benefits of higher education have been consistently observed across diverse older populations (Meng & D’arcy, 2012; Nobel et al., 2021).

On the other hand, acculturation serves as a form of cognitive reserve unique to immigrants (Martinez-Miller et al., 2020; Mendoza et al., 2022; Xu et al., 2017). Cultural and linguistic familiarity acquired in the host country is closely associated with better health outcomes among older immigrants, particularly those who are foreign-born, with supporting evidence extending to cognitive health domains (e.g., Choi et al., 2020; Lamar et al., 2021; Tang et al., 2023). Stress from low acculturation can lead to physiological responses (e.g., overexposure to stress hormones, heightened allostatic load, and impaired neural networks), which ultimately undermines cognitive function (Hill et al., 2012; Martinez-Miller et al., 2020; Mendoza et al., 2022). The close linkage between acculturation and education is also noteworthy, as immigrants with higher levels of education are typically better equipped for migration and possess the skills necessary for successful sociocultural adaptation to the host country (Choi et al., 2020; Lamar et al., 2021; Tang et al., 2023).

Another source of cognitive reserve, particularly relevant to older immigrants, is social network. As a critical source of support, the size of one’s social network is positively associated with overall health and well-being. Networks of friends, in particular, are suggested to be beneficial for cognitive health (Crooks et al., 2008). Furthermore, emerging literature demonstrates that diversity within social networks is linked to enhanced cognitive capacity and brain structure in older individuals (Ali et al., 2018; Ellwardt et al., 2015; Perry et al., 2022). The exchange of novel information, knowledge, and coping strategies in diverse social relationships can stimulate mental capacity, thereby fostering cognitive resilience and reducing the risk of dementia (Cornwell, 2011; Jang et al., 2022; Perry et al., 2022). For immigrants, socializing with individuals from diverse cultural, linguistic, and socioeconomic backgrounds broadens access to resources and support systems, helping them navigate new environments and maintain their health and well-being (Jang et al., 2022). As bonding social connections (i.e., ties within homogeneous groups) and bridging social connections (i.e., ties across diverse individuals and groups) constitute the social capital of communities (Kawachi et al., 2008), it is important to examine how network size and diversity serve as determinants of cognitive health.

Acknowledging the ethnic, cultural, and linguistic diversity among Asian immigrant groups (Đoàn et al., 2019; Hanna & Batalova, 2021), we focused on Chinese, Korean, and Vietnamese immigrants as our target population. These three groups are among the six largest Asian subgroups in the U.S.—along with Asian Indian, Filipino, and Japanese—and a significant proportion of their members have limited English proficiency (Hanna & Batalova, 2021). Southern California, which has the largest Asian population in the country (Budiman & Ruiz, 2021), provides a particularly relevant context for this focus. Importantly, each of these groups also exhibits considerable within-group variation in immigration histories and sociodemographic characteristics (Budiman & Ruiz, 2021; Hanna & Batalova, 2021).

The aim of the present study is to examine the role of education, acculturation, and network characteristics (size and diversity) in the cognitive function of older Chinese, Korean, and Vietnamese immigrants living in Southern California. Based on the above review, we hypothesize that more years of education, higher levels of acculturation, and greater size and diversity in social networks will be associated with better cognitive function. Identifying sociocultural determinants could inform intervention strategies to protect and promote the cognitive health of older Asian immigrants.

Methods

Data

Data were drawn from the DREAMS study, which examines the effects of stressors and sleep on cardiometabolic health of Asian Americans residing in Southern California (Los Angeles County and Orange County). The parent study included 779 participants aged 30 or older (256 Chinese, 256 Koreans, and 267 Vietnamese) surveyed between July 2022 and August 2024. Inclusion criteria for the DREAMS study were (1) self-identified Chinese, Korean, or Vietnamese Americans; (2) 30 years or older; (3) willing to give written consent to participate in the study; and (4) planning to stay in the US at least next 3 years. Exclusion criteria for the DREAMS study were as follows: (1) current physician-diagnosed major psychiatric diseases (e.g., bipolar disorder, schizophrenia, and major depressive disorders); and (2) participants with infants younger than 1 year old. The subset selected for the present investigation included 158 individuals aged 60 or older: Chinese (n = 52), Koreans (n = 54), and Vietnamese (n = 52). The survey was self-administered, and the questionnaires were available in English, Chinese, Korean, and Vietnamese. Cognitive assessments were conducted in person by trained bilingual research assistants. The study was approved by the Institutional Review Boards of the University of California, Irvine.

Measures

Cognitive Function

We used the Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005) to assess global cognitive function. The MoCA is a 10-minute screening tool that includes 30 items evaluating memory, visuospatial ability, executive functions, attention, language, and orientation to time and place. Total MoCA scores range from 0 to 30, with scores of 26 or higher traditionally indicating normal cognition (Nasreddine et al., 2005). The MoCA has been translated into Chinese, Korean, and Vietnamese, and has demonstrated promising validity in these language versions (Do et al., 2022; Lee et al., 2008; Lu et al., 2011). While the applicability of the original cut-off score remains debated (Do et al., 2022; Lee et al., 2008; Lu et al., 2011), the MoCA is a valuable tool for cognitive screening among Chinese, Korean, and Vietnamese populations.

Cognitive Reserve

Education, acculturation, and network characteristics (size and diversity) were the main independent variables considered in the study. Educational attainment was measured by the total number of years of formal schooling.

Acculturation was measured using an adapted version of the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale (Hoffstetter et al., 2007). The scale comprised 10 items assessing language use, friendship preferences, music and food choices, and cultural identity. Responses were recorded on a five-point Likert scale, with total scores ranging from 0 to 40; higher scores indicated greater acculturation to the host country. The scale has been validated among diverse Asian American groups, including Chinese, Korean, and Vietnamese populations (e.g., Chen et al., 2012). Internal consistency of the scale in the current sample was high (α = .85).

Network size was measured by the total number of close friends reported in an open-ended format. Network diversity was assessed using three items selected from the Bridging Social Capital Questionnaire (Villalonga-Olives et al., 2016). Participants indicated how often they socialized with individuals from a different country of origin, a different racial or ethnic background, and a different educational level than their own, using a four-point Likert scale ranging from 0 (never) to 3 (very often). Total scores could range from 0 to 9, with higher scores reflecting greater diversity in participants’ social networks. Internal consistency of the scale in the current sample was acceptable (α = .76).

Covariates

A set of sociodemographic variables were controlled for the analysis, including age (in years), sex (male = 0, female = 1), ethnicity (Chinese = 0, Korean = 1, Vietnamese = 2), and marital status (not married = 0, married = 1). Chronic medical conditions were also controlled, and they were assessed using a 26-item checklist of common diseases and conditions among older adults (e.g., high cholesterol, hypertension, diabetes, arthritis, and cancer). A summation of positive responses, ranging from 0 to 26, was used in the analysis.

Analytic Strategy

Descriptive statistics and bivariate correlations were examined to identify the overall characteristics of the sample and the underlying associations among study variables. After conducting diagnostic assessments, linear regression models were used to examine the effects of cognitive reserve factors (education, acculturation, and network characteristics) on cognitive function. The analyses were conducted after adjusting for the covariates known to be associated with cognitive function, including sociodemographic and health-related characteristics (age, sex, ethnicity, marital status, and chronic medical conditions) (e.g., Lamar et al., 2021; Tang et al., 2023; Xu et al., 2017). Given the small sample size, each set of cognitive reserves was entered independently. According to the formula 50 + 8m, where m represents the number of independent variables to be included in a regression model (Tabachnick & Fidell, 1996), a sample size of 106 to 114 participants is recommended for a model with 7 to 8 predictors. The current sample size of 158 provides sufficient statistical power for the proposed model. All analyses were performed using Stata Version 16 (StataCorp LLC, College Station, TX).

Results

Descriptive Characteristics of the Sample

The sample included a total of 158 participants: 52 Chinese, 54 Koreans, and 52 Vietnamese. The vast majority were foreign-born (98.1%) and completed the survey in their native language (96.8%). On average, participants had lived in the U.S. for approximately 34 years (SD = 12.5). The mean age of the participants was 73.5 years (SD = 7.97), with a range from 60 to 90. More than half (57%) were female, and 67.1% were married. On average, participants had 3.51 chronic medical conditions (SD = 2.42); about three-quarters (73%) had at least two conditions. The mean number of years of education was 13.3 (SD = 4.01), and the mean acculturation score was 7.78 (SD = 4.93). The average network size and diversity were 3.84 (SD = 4.89) and 2.73 (SD = 2.25), respectively. The MoCA scores averaged 22.5 (SD = 4.18), and the score distribution was approximately normal, with a skewness of −0.75 (SE = 0.19) and a kurtosis of 0.21 (SE = 0.38). The descriptive characteristics of the sample are summarized in Table 1.

Table 1.

Descriptive Characteristics of the Sample (n = 158)

	%	M ± SD (range)
Age		73.5 ± 7.97 (60−90)
Sex
Male	43.0
Female	57.0
Ethnicity
Chinese	32.9
Korean	34.2
Vietnamese	32.9
Marital status
Not married	32.9
Married	67.1
Chronic medical conditions		3.51 ± 2.42 (0−12)
Education		13.3 ± 4.01 (0−25)
Acculturation		7.78 ± 4.93 (0−27)
Network size (total number of close friends)		3.84 ± 4.89 (0−50)
Network diversity		2.73 ± 2.25 (0−9)
Cognitive function		22.5 ± 4.18 (8−29)

Bivariate Correlations Among Study Variables

Table 2 presents correlations among the main study variables. Education, acculturation, and network diversity were positively associated with one another. Network size was significantly correlated with network diversity, indicating that individuals with more friends were likely to have more diverse social networks. Higher cognitive function was observed among those with more years of education, higher levels of acculturation, and greater diversity in social networks. The highest correlation was between education and acculturation (r = .47, p < .001), and there was no concern about collinearity.

Table 2.

Bivariate Correlations Among the Main Study Variables (n = 158)

	1	2	3	4	5
1. Education	──
2. Acculturation	.47***	──
3. Network size	.07	.02	──
4. Network diversity	.20**	.44***	.19*	──
5. Cognitive function	.36***	.39***	.09	.26**	──

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

Multivariate Regression Models of Cognitive Function

Prior to conducting the multivariate analysis, we assessed linearity and homoscedasticity using scatterplots with regression lines and residual plots. No curved patterns were observed, and the residuals appeared randomly scattered around zero. The variance inflation factors (VIFs) in the models were all below 1.71, indicating no concerns about multicollinearity.

Table 3 summarizes the results of three linear regression models examining cognitive function in relation to each of the cognitive reserve factors under investigation: education, acculturation, and network characteristics. The models demonstrate the significant independent effects of education (B [SE] = .28 [.07], p < .001), acculturation (B [SE] = .17 [.06], p < .01), and network diversity (B [SE] = .26 [.12], p < .05). In all models, age and ethnicity were significant covariates; younger age and Korean ethnicity, compared to Chinese, were associated with higher cognitive function. The amount of variance explained in each model ranged between 42% and 43%. In addition to these direct effect models, we tested the interactions among all predictor variables, but no significance was found.

Table 3.

Multivariate Regression Models of Cognitive Function

	B (SE)
	Model 1	Model 2	Model 3
Cognitive reserve
Education	.28 (.07)***	──	──
Acculturation	──	.17 (.06)**	──
Network size	──	──	.04 (.05)
Network diversity	──	──	.26 (.12)*
Covariate
Age	−.28 (.03)***	−.26 (.04)***	−.29 (.03)***
Sex (female)	.59 (.57)	.30 (.58)	.06 (.58)
Ethnicity
Chinese	[Reference]	[Reference]	[Reference]
Korean	2.01 (.64)**	2.38 (.65)***	2.46 (.66)***
Vietnamese	.06 (.64)	.03 (.66)	−.24 (.65)
Marital status (married)	.14 (.58)	.25 (.59)	.14 (.60)
Chronic medical conditions	.10 (.11)	.06 (.11)	.07 (.11)
R²	.43***	.43***	.42***

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

Discussion

This investigation was prompted by the growing population of older Asian immigrants in the U.S. (Hanna & Batalova, 2021; Mizoguchi et al., 2019) and the need to address sociocultural factors related to their brain aging and cognitive health (Jang et al., 2020; Tang et al., 2023). Using a sample of community-dwelling older Chinese, Korean, and Vietnamese immigrants in Southern California, we hypothesized that cognitive reserve factors—specifically education, acculturation, and network characteristics—would be positively associated with cognitive function. Findings from our analyses generally support the proposed hypotheses.

Compared to younger Asian populations, our sample of older Asian immigrants had lower levels of formal education, although their average educational attainment was comparable to that of the overall U.S. population aged 65 and older (U.S. Census Bureau, 2023). As inferred by place of birth (98.1% foreign-born) and survey language preference (96.8% preferred their native language), acculturation scores were notably low (M = 7.78, SD = 4.93) on a scale ranging from 0 to 40. On average, participants reported having fewer than four close friends. Network diversity scores were also on the lower end, with a mean of 2.73 (SD = 2.25) out of a possible range of 0 to 9. The sample’s cognitive function was similar to that of the U.S. older adult population. When the suggested MoCA cut-off of 26 was applied (Nasreddine et al., 2005), 72% of the sample was identified as having some level of cognitive impairment—mirroring the rate found in a nationally representative sample of U.S. older adults (Dale et al., 2018).

In multivariate models, we found that three out of the four cognitive reserve variables—education, acculturation, and network diversity—had a significant direct effect on cognitive function after controlling for covariates. Supporting its role as a key element of cognitive reserve (Andel et al., 2006; Lee et al., 2003; Stern, 2002), higher education emerged as a strong promoting factor for cognitive function. In accordance with previous studies with older immigrants (e.g., Choi et al., 2020; Lamar et al., 2021; Tang et al., 2023), we also found a positive association between acculturation and cognitive function. Our finding supports the critical role of acculturation as an immigrant-specific cognitive reserve (Martinez-Miller et al., 2020; Mendoza et al., 2022; Xu et al., 2017). Given the close connection between education and acculturation (Choi et al., 2020; Lamar et al., 2021; Tang et al., 2023), we also tested their interaction effect but found no statistical significance. This finding suggests that each plays an independent role in promoting cognitive health. Given that detecting a statistically significant interaction often requires a large sample, the interplay between education and acculturation warrants further investigation.

Guided by the concepts of bonding and bridging social capital (Kawachi et al., 2008), we examined the role of network size and diversity. Although the count of close friends had no impact, the significance of network diversity was supported. The finding is in line with previous studies demonstrating the cognitive health benefits of bridging connections in diverse populations (e.g., Cornwell, 2011; Peng et al., 2021; Perry et al., 2022), including older ethnic immigrants (e.g., Jang et al., 2022). Older adults with more diverse social networks exhibited better cognitive function, and this relationship may be attributable to several underlying mechanisms. First, socializing with individuals from diverse backgrounds may reflect an openness to experience and a willingness to embrace different perspectives—traits associated with cognitive flexibility and adaptability. Second, diverse social networks may directly stimulate cognitive function by exposing individuals to novel information and viewpoints (Ali et al., 2018; Ellwardt et al., 2015). Such exposure can enhance critical thinking and problem-solving abilities. Third, engaging with socially diverse others often necessitates the management and recall of complex interpersonal information, thereby exercising memory and executive function (Ali et al., 2018; Ellwardt et al., 2015). For instance, engaging with individuals from diverse backgrounds requires the shifting of cognitive frameworks, a process that constitutes a form of cognitive exercise (Peng et al., 2021). Finally, greater network diversity increases the likelihood of bridging connections across social groups, which may empower older adults to maintain autonomy and independence while enriching cognitive capacity (Cornwell, 2011; Jang et al., 2022; Peng et al., 2021; Perry et al., 2022).

Interpretations of our findings should be made with careful consideration of the study’s limitations. Most notably, causal inferences cannot be definitively drawn from cross-sectional data. Although cognitive function was conceptualized as an outcome influenced by cognitive reserve factors, the possibility of reverse causation (e.g., higher cognitive function enabling older adults to engage with more diverse social networks) cannot be excluded. Second, the generalizability of the findings to the broader population of older Asian immigrants is limited due to the use of non-probability sampling from selected ethnic groups within a single geographic area. The non-representative nature of the sample warrants caution when making comparisons across ethnic groups. Additionally, the volunteer nature of the sample—comprising community-dwelling, non-institutionalized older adults—may have led to the underrepresentation of individuals with more disadvantaged social or health characteristics. Furthermore, interactions among cognitive reserve variables should be re-examined using a larger sample. In future research, the use of longitudinal data involving diverse groups of older Asian immigrants is strongly recommended. Future studies should also examine the psychosocial and cultural factors (e.g., personality traits, sense of control, cultural beliefs, and community support) that may influence the relationship between cognitive reserve and cognitive functioning.

Despite these limitations, our findings offer important implications for promoting cognitive health among older Asian immigrants. Although educational attainment is typically established earlier in life and remains fixed in later adulthood, it serves as a valuable proxy for cognitive reserve. As such, it can help identify individuals who may be at elevated risk for cognitive decline. This makes it a practical and accessible marker for guiding targeted prevention and intervention strategies aimed at promoting cognitive health and delaying the onset of impairment. The findings related to acculturation and network diversity underscore the importance of providing cultural and language education for older immigrants, as well as creating opportunities for social interaction and community integration. Such initiatives may support both cultural adaptation and cognitive health promotion by fostering diverse social engagement and strengthening cognitive reserve. Moving beyond the traditional notion of the ethnic enclave (Guo et al., 2022), our findings highlight the cognitive benefits of integrating older immigrants into broader social contexts. This shift emphasizes the importance of inclusive environments that encourage cross-cultural interactions and social connectedness beyond co-ethnic networks.

Footnotes

Acknowledgments

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

ORCID iD

Yuri Jang

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the National Institute of Minority Health and Health Disparities of the National Institutes of Health under Award number R01MD015186-03S1.

Declaration of Conflicting Interests

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

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