Stress that people turn inward may be quietly increasing the risk of memory loss in older Chinese Americans, according to new research from Rutgers Health.
The study, published in The Journal of Prevention of Alzheimer’s Disease, was conducted by researchers at the Rutgers Institute for Health, Health Care Policy and Aging Research. It explored a range of factors that could either raise or reduce the risk of cognitive decline in Chinese adults over age 60.
This group was selected in part because older Chinese Americans have often been overlooked in research on brain aging, leaving important gaps in understanding how memory loss develops in this population.
“With the number of older Asian Americans growing significantly, it’s vital to better understand the risk factors of memory decline in this understudied population,” said Michelle Chen, a core member of the Center for Healthy Aging Research at Rutgers and the study’s lead author.
Cultural Pressures and Hidden Emotional Strain
The researchers noted that cultural expectations may play a role in shaping mental health outcomes. The model minority stereotype — which portrays Asian Americans as consistently successful, educated and healthy — can create added pressure while also masking emotional struggles.
At the same time, many older immigrants face challenges such as language barriers and cultural differences, which can contribute to ongoing stress. While these issues are not unique to Asian Americans, the researchers say they may be particularly relevant in this context.
“Stress and hopelessness may go unnoticed in aging populations, yet they play a critical role in how the brain ages,” said Chen, who is also an assistant professor of neurology at Rutgers Robert Wood Johnson Medical School. “Because these feelings are modifiable, our goal is for this research to inform culturally sensitive stress-reduction interventions to mitigate these feelings in older adults.”
Large Study Tracks Memory Changes Over Time
To better understand these effects, the team analyzed data from the Population Study of ChINese Elderly (PINE), the largest community-based cohort study focused on older Chinese Americans. The dataset included interviews conducted from 2011 to 2017 with more than 1,500 participants living in the Chicago area.
The researchers examined three key sociobehavioral factors: stress internalization, neighborhood or community cohesion and external stress alleviation.
Key Finding Points to Internalized Stress
Among these factors, internalized stress stood out. This form of stress includes feelings of hopelessness and a tendency to absorb stressful experiences rather than express or resolve them. It was strongly linked to worsening memory across three waves of the PINE study.
In contrast, the other factors did not show a significant connection to changes in memory over time.
Implications for Prevention and Support
Because internalized stress can potentially be addressed, the findings suggest an opportunity to develop targeted strategies that support emotional well-being and cognitive health in older adults. The researchers emphasize the importance of culturally sensitive approaches that take into account the unique experiences of aging immigrant populations.
The study was supported by the Rutgers-NYU Resource Center for Alzheimer’s and Dementia Research in Asian and Pacific Americans, co-led by William Hu of Rutgers Institute for Health and Rutgers Robert Wood Johnson Medical School. Coauthors include Yiming Ma, Charu Verma, Stephanie Bergren and William Hu of Rutgers Institute for Health.