0966 Sleep, Circadian Rhythms, and Cognitive Frailty in Older Chinese Immigrants: Protocol for an Observational Study

Abstract Introduction Immigrant workers are integral members of the American society. While efforts have been made to support their health needs, the challenge of caring for their aging parents has often been overlooked. These aging parents, whose lives are closely tied to their adult children, are referred to as the ‘zeroth generation’ immigrants. Compared with first-generation immigrants, these ‘zeroth generation’ immigrants may experience even higher rates of sleep and circadian rhythm disturbances, due to factors linked to immigration and acculturation. This observational study aims to examine the relationships of sleep and circadian rhythms with frailty and cognition among older Chinese immigrants in the US. Methods We plan to recruit Chinese immigrants aged ≥65 years old to complete a series of tests and questionnaires. Specifically, we will assess participants’ general cognitive abilities (Mini-Mental State Exam), episodic memory (word list recall, story recall task), working memory (digit span test), and executive function (Trail making task, Stroop test). Grip strength and walking speed will be tested to assess frailty. Participants will also wear an actigraphy device and complete sleep diaries for 10 consecutive days. Questionnaires will collect demographic information, lifestyle, chronotype, living conditions, language experience, education and employment history, immigration and travel history, medical history and medication use, frailty, sleep quality, sleepiness, migration-acculturative stress, depressive symptoms, and subjective cognitive decline. Results We anticipate enrolling 200 participants, balanced by immigration generation and sex, in the first phase of the study. We anticipate that the zeroth-generation participants experience poorer sleep and circadian health, including lower sleep quality, shorter sleep duration, increased daytime sleepiness, and greater rest-activity rhythm disturbances, as well as higher frailty prevalence and worse cognitive performance than their first-generation immigrant peers. Additionally, we expect that heightened acculturative stress mediates the associations between sleep and circadian health, with frailty and cognition, particularly in the zeroth-generation immigrants. Conclusion This study will provide new insights into the sleep and circadian health challenges faced by the zeroth-generation Chinese immigrants and their impact on frailty and cognitive aging. Findings will inform interventions and policies to promote health equity, addressing the specific needs of this vulnerable demographic. Support (if any)