OBJECTIVES: This prospective cohort study examined the relationship between depressive symptoms and onset of functional disability over 2 years among US Chinese older adults, a rapidly growing minority older adult population. DESIGN AND SETTING: This study used survey data from 2713 Chinese older adults who completed both baseline (2011‐2013) and follow‐up (2013‐2015) interviews of the Population Study of Chinese Elderly in Chicago. Depressive symptoms were assessed at baseline by the nine‐item Patient Health Questionnaire. Functional disability was measured by three validated scales, Katz Index of Independence in Activities of Daily Living (ADLs), the Lawton Instrumental Activities of Daily Living (IADLs) scale, and the Rosow and Breslau mobility scale. Multivariate logistic regression was conducted to examine the relationship between baseline depressive symptoms and the development of functional disability (ADLs, IADLs, mobility) at 2‐year follow‐up while adjusting for covariates. RESULTS: Of the 2713 participants, 5.2% experienced ADL disability onset, 35.6% experienced IADL disability onset, and 23.3% experienced mobility disability onset over 2 years. After adjusting for covariates, the odds of ADL disability onset (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02‐1.11), IADL disability onset (OR = 1.05; 95% CI = 1.01‐1.09), and mobility disability onset (OR = 1.05; 95% CI = 1.01‐1.09) were consistently higher in US Chinese older adults with higher levels of depressive symptoms than their less‐depressed counterparts. Other significant risk factors included older age and more chronic physical conditions. CONCLUSION: Study findings underscore a significant relationship between depressive symptoms and onset of functional disability. Screening and, subsequently, treating depressive symptoms have the potential to reduce disability among US Chinese older adults. Culturally relevant depressive symptom screening may help identify Chinese older adults who are at greater risks for the development of functional disability. J Am Geriatr Soc 67:S538–S544, 2019.

Objectives: This study aims to investigate the relationship between quantity, quality, and composition of social networks and depressive symptoms among U.S. Chinese older adults. Methods: Data were derived from the Population Study of Chinese Elderly (PINE) (N = 3,157), a study of Chinese older adults aged 60 and above in Chicago. We assessed quantitative (network size and volume of contact), qualitative (emotional closeness), and composition (proportion kin, proportion female and proportion coresident) aspects of social networks. Depressive symptoms were measured by the Patient Health Questionnaire-9. Negative binomial and logistic regressions were conducted. Results: Older adults who had three to five network members with strong ties, a medium level of contact, and a high level of emotional closeness were less likely to experience depression than their counterparts. Quantitative and qualitative dimensions of social networks have stronger protective effects than the composition dimension. Conclusions: U.S. Chinese older immigrants with different levels of social network characteristics have different risks of depression, suggesting targeted subpopulation assessments to facilitate the delivery of more appropriate and effective treatment to those most in need. Clinical Implications: Health-care professionals and social service agencies are suggested to develop intervention programs to promote mental health through increasing strong ties and improving the quality of social networks for U.S. Chinese older immigrants.

OBJECTIVES: To investigate the relationship between different definitions and subtypes of elder mistreatment (EM) and yearly mortality. DESIGN: Population‐based epidemiological study. SETTING: Greater Chicago area. PARTICIPANTS: Chinese Americans aged 60 and older (N=3,157). MEASUREMENTS: Data were collected from 2011 to 2017, with mortality data collected over the subsequent 4 years. Face‐to‐face in‐home interviews were conducted. EM was measured using a brief screening tool (10 items) and a detailed assessment (56 items) and defined using different criteria for overall and specific subtypes of EM. Mortality was ascertained during follow‐up. Cox proportional hazards models were used. RESULTS: Four hundred seventy‐five (15.2%) participants reported EM. Severe and moderate EM were associated with greater risk of 1‐year (hazard ratio (HR)=2.51, 95% confidence interval (CI)=1.04–6.03; HR=2.55, 95% CI=1.08–6.03), 2‐year (HR=1.68, 95% CI=1.01–2.78; HR=1.69, 95% CI=1.04–2.74), 3‐year (HR=1.73, 95% CI=1.17–2.55; HR=1.73, 95% CI=1.19–2.51) and 4‐year (HR=1.51, 95% CI=1.08–2.10; HR=1.48, 95% CI=1.08–2.04) mortality. A broad definition of EM was associated with greater risk of 3‐year and 4‐year mortality. With respect to subtypes of EM, psychological mistreatment and caregiver neglect were associated with greater mortality risk, whereas the relationships between psychological mistreatment, caregiver neglect and mortality risk varied according to definitional criteria. DISCUSSION: Different definitions and subtypes of EM had different associations with mortality in Chinese‐American older adults. This study challenges assumptions about consequences of EM and calls for customized interventions for EM in minority populations. J Am Geriatr Soc 67:S506–S512, 2019.

OBJECTIVES: The prevalence and health consequences of comorbid depressive symptoms (DSs) and chronic medical conditions (CMCs) among older ethnic minority populations remain poorly understood. To bridge this gap, the present cross‐sectional study examined the prevalence of comorbid DS‐CMC and the association between such comorbidity and health services use among US Chinese older adults. DESIGN AND SETTING: Data were from the Population Study of Chinese Elderly in Chicago (N = 3157). The relationship between comorbid DS‐CMC and health service use (ie, emergency department [ED] visits and hospitalizations) was investigated by stratifying the sample into four groups: (1) neither DSs nor CMCs (ie, heart disease, stroke, cancer, high cholesterol, diabetes, high blood pressure, hip fraction, thyroid, and osteoarthritis); (2) DSs only; (3) CMCs only; and (4) comorbid DS‐CMC. Multivariate negative binomial regression models were conducted to determine the relationship between comorbid DS‐CMC and health service use. RESULTS: Participants were 73 years old on average. The prevalence of comorbid DSs ranged between 0.7% and 4.6% across various CMCs. The odds of DSs were at least twice as high among US Chinese older adults with CMCs than those without the various conditions. Compared with US Chinese older adults with neither DSs nor CMCs, those with comorbid DS‐CMC had more ED visits (rate ratio [RR] = 3.32; 95% confidence interval [CI] = 2.03‐5.42) and hospitalizations (RR = 3.12; 95% CI = 1.95‐4.97). CONCLUSION: Recognition and treatment of comorbid DS‐CMC warrant increased policy and clinical attention. The findings underscore the potential need to develop effective services targeting DSs among US Chinese older adults with CMCs. J Am Geriatr Soc 67:S545–S550, 2019.

Background: Suicide is a large and growing public health problem. Little is known about the attributes of suicidal ideation (SI) in the contexts of immigration. This qualitative study aims to explore immigration- and acculturation-related attributes of SI among older immigrants. Methods: A qualitative semi-structured interview design. Interview were conducted with 57 older Chinese immigrants in Chicago with self-reported SI in the past month. Results: In addition to attributes of SI which have been well documented in the literature, we identified immigration- and acculturation-related attributes, including linguistic and cultural barriers of being integrated to the receiving communities, acculturation gaps in intergenerational support, and uselessness. Conclusions: Findings of the study highlight the intersectionality of race, culture, and aging regarding SI, which are essential to improve recognition and understanding of SI among immigrant populations.