Activities and Cognitive Health among Native Hawaiian Older Adults.

The number of older adults aged 65 and older in Hawaiʻi has been increasing (Administration for Community Living, 2021). With this, there are growing concerns on issues with cognitive impairment and related diseases. Native Hawaiians (NHs) experience health disparities related to high risk of cardiovascular conditions, which are known to be risk factors of cognition (Ganbat & Wu, 2021). NHs are disproportionately affected by dementia and subjective cognitive decline (Alzheimer’s Association, 2021; Ganbat & Wu, 2021). In 2020, 29,000 people aged 65 and older had Alzheimer’s in Hawaiʻi, and this number is expected to increase to 35,000 by 2025 (Alzheimer’s Association, 2021). Productive activities and leisure activities have been linked to positive health outcomes in older adults. Yet, less is known if these beneficial effects extend to NH older adults. This article identifies the associations between various activities and cognitive health among this population. This study is guided by the productive aging framework (Morrow-Howell et al., 2001). Productive activities are paid or nonpaid activities performed by older adults that bring social benefits (Hooyman et al., 2017). A growing body of literature suggests the cognitive health benefits of these productive activities and other leisure activities. In addition to strength-based approaches to productive aging, research about Kanaka Maoli (NHs) has focused on social constructs regarding space, place, and self-identity (Yeh et al., 2021) as factors with impacts on the social habits of their kūpuna (older adults). Among these, the ecological model for NH well-being (McGregor et al., 2003) discusses concepts from the Hawaiian language such as ʻāina (land), aloha (love/compassion), kuleana (responsibility/role), lōkahi (unity/balance/harmony), mālama (to care for someone or something), and ʻohana (family). This model focuses on access to land and organization of the family (McGregor & MacKenzie, 2014), as well-being is linked to natural resources for both subsistence and cultural practices.