JMIR Publications

ABSTRACT

Background:

In the United States, Asian Americans represent the fastest growing population group, and are highly diverse linguistically, culturally, and demographically. However, in most national studies, Asian American groups are aggregated, masking potential health disparities. Further, racial and ethnic minorities, especially first-generation immigrants, are at a particularly elevated risk of cognitive impairment.

Objective:

The Aging in Kerala Americans Research (AKKARE) study aims to examine both positive and negative migration effects on health in first-generation Kerala Americans, focusing on cognition and dementia. We will assess on the effect of immigrant/cultural factors and social relations on cognitive aging from epidemiological, biological, and vascular perspectives. This protocol describes the study design and procedures for the AKKARE study.

Methods:

AKKARE proposes to enroll 400 older first-generation Kerala Americans from the tri-state area. A smaller subset of these participants will complete blood tests (n = 360) and neuroimaging studies (n = 160). We will assess the role of immigration/cultural effects on cognitive function, mood, and quality of life, as well as biological and vascular aging. We will conduct follow-up assessments at 12-month intervals for up to five years.

Results:

AKKARE (Grant #1R01AG084567-01) was funded by the US National Institutes of Health in 2024 and received approval from the Stony Brook University Institutional Review Board to start the study in 2025. Enrollment is actively ongoing.

Conclusions:

As there is presently a lack of fundamental data on the epidemiology in diseases of aging in Indian American immigrants, AKKARE will provide new insights into factors of risk and resilience associated with cognitive impairment in this group and in the broader older adult population.