Stability and change in acculturation-related characteristics in older Latinos: Implications for culturally compatible ADRD research

Abstract

Introduction: 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.

Methods: Self-identified Latinos (n = 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.

Results: Although none of the SASH metrics changed over time (P-values ≥ 0.25), all Familism metrics declined over time (P-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.

Discussion: 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.

Keywords: Alzheimer's disease and related dementias clinical trials; Hispanics; Latinos; acculturation; familism; inclusion science; longitudinal change.

FIGURE 1

Representation of change in familism over time with 95% confidence intervals also depicted in fully adjusted models (i.e., Model 2) accounting for age, sex, education, income, years living in one of the 50 US states and/or the District of Columbia, and interactions of each of these variables with time. Years in study as reflected on the x‐axis begins at study baseline (i.e., “0”) with each subsequent visit representing the first (“1”) repeat visit, the second (“2”) repeat visit, and so on, with “5” representing the fifth repeat visit. Given visits are annual and started with baseline, the fifth repeat visit equates to the 6th year in the study.