Acculturation, Socioeconomic Status, and Cognitive Functioning Among Older Immigrants in the United States: An Interaction Analysis

This study investigated how acculturation and socioeconomic status (SES) jointly influence cognitive health among older immigrants in the US. We analyzed nationally representative data from the 2011–2014 NHANES for 797 older immigrants aged 60 and older. Acculturation was measured by language spoken at home (English vs. other) and length of US residence, while SES was derived by latent class analysis using family poverty-to-income ratio, education, longest-held occupation, and health insurance coverage. Cognitive performance was evaluated using standardized neuropsychological tests. Speaking English at home was associated with better cognitive performance ( p < 0.01). Crucially, SES significantly moderated this relationship ( p < 0.05 for interaction); the cognitive benefits of English use were more pronounced for low-SES immigrants. Length of US residence showed weaker associations and was not moderated by SES. Linguistic acculturation is a vital component of comprehensive approaches to mitigate cognitive decline and advance health equity in the US’ rapidly growing aging immigrant population.