PINE Study Sheds Light on Unique Needs of the US Chinese Aging Population

The US Chinese aging population has experienced a rapid growth in recent years. However, research about the social networks of older immigrant adults has been lacking. That scarcity of information has led to a lack of understanding that has limited the ability of US healthcare professionals and policy makers to provide the best strategies to improve the health and wellbeing of older Chinese adults.

In 2017, researchers reported on the results of the Population Study of Chinese Elderly in Chicago (PINE study), a population-based epidemiological study of more than 3000 community-dwelling Chinese American adults aged 60 or above, in multiple journals. During the study period, participants were followed-up at intervals of 2 years in order to understand their current status and to observe changes over time that would allow researchers to better understand the unique health needs of this population.

In a paper published in Gerontology, researchers reported that:

• Participants who reported higher levels of emotional closeness with social network members were more likely to report good or very good health, as well as good or very good quality of life.
• Older Chinese adults’ social networks are largely kin-centered; 95% to 96% of participants’ networks were composed of kin.
• Despite the trend toward kin-based social networks, and while more than half of respondents reported that they lived with a spouse, 38.5% reported that they would be unlikely to discuss medical decisions with a spouse.

Data reported elsewhere showed that patients who had the highest levels of social support from their networks had higher utilization of cancer screenings, fewer depressive symptoms, and better global cognitive function.

Further data from the study add complexity the picture of this population, demonstrating that:

• Self-neglect (manifested as hoarding, poor personal hygiene, unsanitary conditions, lack of utilities, and need of home repair) was prevalent among the older adults (aged 80 years or more) among this population (mild self-neglect: 34.6%; 95% CI, 30.9-38.4; moderate or severe self-neglect: 15.6%; 95% CI, 12.8-18.6).
• Among those who had self-neglect, 62.3% reported having depressive symptoms.
• 54.4% of participants reported having experienced depressive symptoms in the last 2 weeks at the time of being interviewed.
• Unmet expectations of filial piety (comprising such domains as care, respect, greeting, happiness, obedience, and financial support) were associated with the incidence and severity of feelings of hopelessness in this population.
• Older adults who received low levels of filial piety were 2.74 times (2.26-3.33) more likely to perceive their stress levels as high.
• After adjusting for socio-demographics and medical comorbidities, lower levels of perceived filial piety were associated with greater severity of loneliness.
• The incidence of elder abuse was 8.8% overall (4.8% psychological, 2.9% financial, 0.5% physical, 0.1% sexual abuse, and 1.1% caregiver neglect).

In a statement, XinQi Dong, MD, MPH, the lead investigator of the PINE study, said, “People usually think of the US Chinese population as a ‘model minority,’ which hides the physical and psychological health challenges this population faces. With this data, we can find out the causes of certain health outcomes and figure out how to prevent disease and improve wellbeing through culturally appropriate interventions.”