Stress that people keep inside may be quietly damaging brain health in older Chinese Americans, according to new research from Rutgers Health.
The study found that “stress internalization”—a pattern where people absorb stress and feelings of hopelessness rather than expressing or addressing them—was linked to faster memory decline in this community.
The findings, published in The Journal of Prevention of Alzheimer’s Disease, are based on the largest community study of older Chinese Americans to date.
Researchers focused on this group because Asian Americans, and especially older Chinese Americans, are often underrepresented in studies about brain aging.
“With the number of older Asian Americans growing quickly, it’s important to understand the unique challenges they face when it comes to brain health,” said Michelle Chen, lead author of the study and a core member of the Center for Healthy Aging Research at the Rutgers Institute for Health, Health Care Policy and Aging Research.
Chen and her team noted that the “model minority” stereotype—which paints Asian Americans as universally successful, educated, and healthy—can hide the real struggles some face.
For many older Chinese Americans, language barriers, cultural differences, and the stress of adapting to life in the U.S. can be major sources of strain. These challenges are similar to those faced by other immigrant communities, but the way they are experienced and expressed may differ.
“Stress and hopelessness can often go unnoticed in older adults, but they can have a big impact on how the brain ages,” Chen explained. “The good news is that these feelings are changeable. Our goal is to use this research to guide culturally sensitive stress-reduction programs that can help older adults protect their brain health.”
To investigate the issue, the researchers used data from the Population Study of ChINese Elderly (PINE), which interviewed more than 1,500 Chinese Americans aged 60 and older in the Chicago area between 2011 and 2017.
Participants were surveyed over three different time periods, and the researchers tracked their memory performance alongside three social and behavioral factors:
– Stress internalization – the habit of holding in stress and feelings of hopelessness.
– Neighborhood or community cohesion – how connected and supported people feel in their local area.
– External stress alleviation – help or support from others that can reduce stress.
The results were clear: people who reported higher levels of stress internalization experienced more memory decline over time. In contrast, community cohesion and outside help did not show a significant link to memory changes.
The study’s authors say this is an important finding because it points to a modifiable risk factor—something that can be addressed through intervention. If older adults can learn strategies to manage stress more effectively, they may be able to slow down or prevent cognitive decline.
The research was supported by the Rutgers-NYU Resource Center for Alzheimer’s and Dementia Research in Asian and Pacific Americans, co-led by William Hu, who also coauthored the study. Other coauthors include Yiming Ma, Charu Verma, and Stephanie Bergren.
This study highlights the role of emotional and psychological health in brain aging, particularly within immigrant communities that may face unique cultural and language-related stressors.
The strong connection between stress internalization and memory decline suggests that brain health isn’t only about physical factors like diet or exercise—it’s also about how people handle life’s pressures.
Because stress internalization is a modifiable factor, targeted interventions such as culturally adapted counseling, mindfulness programs, or peer support groups could have a meaningful impact.
However, since the study focused only on older Chinese Americans in one geographic area, further research is needed to see if the findings apply to other Asian American subgroups or immigrant communities. Still, the results provide a strong case for integrating mental health support into strategies for preventing age-related cognitive decline.
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The study is published in The Journal of Prevention of Alzheimer s Disease.
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