Latino immigrants in the United States represent diverse national origins, with Mexicans comprising the largest group. Cognitive health disparities among Latino immigrants may reflect differences in migration experiences, including age at migration, socioeconomic differences, and acculturation. Whether Mexican immigrants differ from Latin American immigrants in cognitive outcomes remains unclear.
Objective
This study examined the independent and interactive effects of Mexican origin and age at migration on cognitive levels and decline compared to other Latin American immigrants. We also test whether socioeconomic and acculturation factors help explain differences in cognitive outcomes.
Methods
Data came from 2077 Latino immigrants in the Health and Retirement Study (2014–2020). Cognition was assessed using the Telephone Interview for Cognitive Status. Mixed-effects models evaluated the main and interaction effects of origins and age at migration on age-related decline, controlling for demographic, health-related, socioeconomic, and acculturation covariates.
Results
Mexican immigrants had significantly lower cognitive levels than Latin American immigrants. However, after adjusting for socioeconomic indicators and language acculturation, Mexican immigrants demonstrated higher cognitive scores. Among Mexicans, late-life migration was associated with significantly poorer cognitive levels, which persisted after accounting for socioeconomic and acculturation factors. No significant differences were observed in rates of cognitive decline by origin or age at migration.
Conclusions
Late-life migration is associated with poorer cognitive outcomes among Mexican immigrants. Findings indicate that socioeconomic and acculturation factors mask underlying differences in cognitive performance between Mexican and Latin American immigrants, underscoring the need to consider both migration experiences and social context when evaluating cognitive disparities.
GarcíaCGarciaMASheftelMG. Heritage, birthplace, age at migration, and education as life course mechanisms influencing cognitive aging among Latinos. In: AngelJLTorres-GilFMMarkidesKS (eds) Older Mexicans and Latinos in the United States: where worlds meet. Cham: Springer, 2024, pp.119–150.
2.
SáenzRMoralesMCRayo-GarzaC. Latina/os in the United States: Diversity and change. 2nd ed. Cambridge, UK: Polity Press, 2024.
3.
SteplerRBrownA. Hispanics in the United States statistical portrait. Report. Pew Research Center, Washington, DC, September 2016.
4.
RajanKBWeuveJBarnesLL, et al.Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimers Dement2021; 17: 1966–1975.
5.
DurandJMasseyDS. Mexican Migration to the United States: a critical review. Lat Am Res Rev1992; 27: 3–42.
6.
OrnelasIJYamanisTJRuizRA. The health of undocumented Latinx immigrants: what we know and future directions. Annu Rev Public Health2020; 41: 289–308.
7.
TorresSASantiagoCDWaltsKK, et al.Immigration policy, practices, and procedures: the impact on the mental health of Mexican and Central American youth and families. Am Psychol2018; 73: 843–854.
8.
GarciaMADiminichEDLuP, et al.Caregiving for foreign-born older adults with dementia. J Gerontol B Psychol Sci Soc Sci2023; 78: S4–S14.
9.
GarciaMATarrafWReyesAM, et al.Gender, age of migration, and cognitive life expectancies among older Latinos: evidence from the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci2022; 77: e226–e233.
10.
HillTDAngelJLBalistreriKS. Does the “healthy immigrant effect” extend to cognitive aging? In: AngelJLTorres-GilFMMarkidesKS (eds) Aging, health, and longevity in the Mexican-origin population. New York: Springer, 2012, pp.19–33.
11.
XuHVorderstrasseAAMcConnellES, et al.Migration and cognitive function: a conceptual framework for global health research. Glob Health Res Policy2018; 3: 1–12.
12.
HalfonNForrestCB. The emerging theoretical framework of life course health development. In: HalfonNForrestCBLernerRMFaustmanEM (eds) Handbook of life course health development. Cham: Springer, 2017, pp.19–43.
13.
DaviesAABastenAFrattiniC. Migration: a social determinant of the health of migrants. Eurohealth (Lond)2009; 16: 10–12.
14.
Van HearNBakewellOLongK. Push-pull plus: reconsidering the drivers of migration. In: CarlingJCollinsF (eds) Aspiration, desire and the drivers of migration. London: Routledge, 2020, pp.19–36.
15.
MonfaredAATHummelNChandakA, et al.Prevalence estimation of dementia/Alzheimer’s disease using health and retirement study database in the United States. J Prev Alzheimers Dis2024; 11: 1183–1188.
16.
GrewalDKPatapoffMALiou-JohnsonV, et al.The absence of formal work experience may affect the rate of cognitive decline in older adult women: findings from the health and retirement study. Front Glob Womens Health2024; 5: 1458553.
17.
FisherGGRyanLH. Overview of the health and retirement study and introduction to the special issue. Work Aging Retire2018; 4: 1–9.
18.
Health and Retirement Study. Public use dataset. Report. Ann Arbor, MI: University of Michigan, 2025.
19.
Díaz-VenegasCDownerBLangaKM, et al.Cognitive functioning of US adults by race and hispanic origin. In: AngelJLTorres-GilFMMarkidesKS (eds) Contextualizing health and aging in the americas: effects of space, time and place. Cham: Springer, 2018, pp.85–107.
20.
CrimminsEMKimJKLangaKM, et al.Assessment of cognition using surveys and neuropsychological assessment: the Health and Retirement Study and the Aging, Demographics, and Memory Study. J Gerontol B Psychol Sci Soc Sci2011; 66: i162–i171.
21.
FaulJDRodgersWLWeirDR. Health and Retirement Study imputation of cognitive functioning measures. Report, University of Michigan, Ann Arbor, MI, 2019.
22.
HeeringaSG. Imputation of item missing data in the Health and Retirement Survey. In: Proceedings of the Section on Survey Research Methods; 1993; Alexandria (VA). Alexandria (VA): American Statistical Association, 1993, pp. 107-116.
23.
McCammonRFisherGHassanH, et al.Health and Retirement Study imputation of cognitive functioning measures: 1992–2018. Report, University of Michigan, Ann Arbor, MI, 2022.
24.
GarciaMAGarcíaC. Cognitive difficulties among middle-aged and older Latino adults: within-group variation across US states. J Gerontol B Psychol Sci Soc Sci2026; 81: gbaf249.
25.
GarciaMAOrtizKArévaloSP, et al.Age of migration and cognitive function among older Latinos in the United States. J Alzheimers Dis2020; 76: 1493–1511.
26.
MorellCHBrantLJFerrucciL. Modeling change in longitudinal studies: use age only or initial age and time. J Gerontol A Biol Sci Med Sci2008; 63: 215–222.
27.
RobertSHouseJS. SES Differentials in health by age and alternative indicators of SES. J Aging Health1996; 8: 359–388.
28.
ShibaKKubzanskyLDWilliamsDR, et al.Associations between purpose in life and mortality by SES. Am J Prev Med2021; 61: e53–e61.
29.
XuXLiangJBennettJM, et al.Socioeconomic stratification and multidimensional health trajectories. J Gerontol B Psychol Sci Soc Sci2015; 70: 661–671.
30.
RaghupathiWRaghupathiV. An empirical study of chronic diseases in the United States. Int J Environ Res Public Health2018; 15: 431.
31.
VivotAPowerMCGlymourMM, et al.Modeling practice effects in cognitive change. Am J Epidemiol2016; 183: 302–314.
32.
CabassaLJ. Measuring acculturation: where we are and where we need to go. Hisp J Behav Sci2003; 25: 127–146.
33.
ErrisurizVLZambranaREParra-MedinaD. Critical analyses of Latina mortality. BMC Public Health2024; 24: 190.
34.
EliasSTurkson-OcranRKoiralaB, et al.Cardiovascular risk factors among Latino immigrant subgroups. J Am Heart Assoc2023; 12: e027433.
35.
ClarkALThomasKROrtegaN, et al.Psychosocial-behavioral phenotypes in older adults. Alzheimers Dement2024; 20: 1360–1373.
36.
StickelAMTarrafWWuB, et al.Cognition and daily functioning in Latino populations. J Alzheimers Dis2020; 77: 1267–1278.
37.
VegaWARodriguezMAGruskinE. Health disparities in the Latino population. Epidemiol Rev2009; 31: 99–112.
38.
CheungBYChudekMHeineSJ. Evidence for a sensitive period for acculturation. Psychol Sci2011; 22: 147–152.
39.
AlamRBSingletonCRAguiñagaS, et al.Acculturation and cognitive performance. J Alzheimers Dis2022; 85: 535–544.
40.
SternYBarnesCAGradyC, et al.Cognitive reserve and resilience. Neurobiol Aging2019; 83: 124–129.
41.
GutierrezMWahrendorfMMilaniS, et al.Education, occupation, and cognitive function. J Gerontol B Psychol Sci Soc Sci2024; 79: gbad155.
42.
TreasJGubernskayaZ. Immigration, aging, and the life course. In: LKGFerraroKF (eds) Handbook of aging and the social sciences. 8th ed. London: Elsevier, 2016, pp.143–161.
43.
CalvoNGarcíaAMManoiloffL, et al.Bilingualism and cognitive reserve. Front Aging Neurosci2016; 7: 249.
44.
RoteSMAngelJL. Gender-based pathways to cognitive aging. J Gerontol B Psychol Sci Soc Sci2021; 76: e165–e175.
45.
BeardHAMarkidesKSGhatrifMA, et al.Diabetes medication use and geriatric syndromes. Ann Pharmacother2010; 44: 1376–1383.
46.
DownerBKumarAVeerankiSP, et al.Dementia risk index for Mexican Americans. J Am Geriatr Soc2016; 64: e265–e269.
47.
AngelRJAngelJLDíaz VenegasC, et al.Age at migration and mortality. J Aging Health2010; 22: 914–931.
48.
LupienSJMaheuFTuM, et al.Stress and cognition. Brain Cogn2007; 65: 209–237.
49.
MonserudMA. Cognitive trajectories among Mexican-origin immigrants. Ethn Health2021; 26: 720–736.
50.
ComijsHCvan den KommerTNMinnaarRW, et al.Life events and cognitive decline. J Gerontol B Psychol Sci Soc Sci2011; 66: i111–i120.
51.
GeorgakisMKPapadopoulosFCBeratisI, et al.Validation of TICS for dementia detection. Clin Neuropsychol2017; 31: 61–71.
SalthouseTA. Review of cognitive aging. J Int Neuropsychol Soc2010; 16: 754–760.
54.
LindenbergerUBaltesPB. Intellectual functioning in old age. Psychol Aging1997; 12: 410–432.
55.
PerezCAilshireJ. Sociocultural variation in undiagnosed diabetes. Innov Aging2018; 2: 18.
56.
BugliariDCarrollJHaydenO, et al.RAND HRS longitudinal file 2020 (V1) documentation. Report, RAND Center for the Study of Aging, Santa Monica, CA, 2023.
