The Role of Stress, Perceived Discrimination, and Skin Tone on Cognitive Performance in Puerto Rican Adults

Objectives: This study aimed to examine the associations between cognition, skin tone, and stress in a heterogeneous sample of Puerto Rican adults. Method: Participants included 1,502 Puerto Ricans from the first wave of the Boston Puerto Rican Health Study. Structural equation modeling was used to analyze the associations between skin tone groups, stressful life events (i.e., perceived discrimination and number of adverse life events), perceived stress, allostatic load, and cognition. Results: The model fit examining the relationship between stress and cognition was excellent even after introducing covariates. When considering skin tone, model fit was also acceptable. Greater allostatic load predicted lower levels of cognition in the overall sample and in individuals with darker skin tones. Higher levels of perceived stress predicted lower levels of cognition in the overall sample and all skin tone groups except in individuals with white skin tones. Stressful events significantly predicted cognition in the overall sample. Conclusions: Results provide evidence of an interaction in which the relationship between stress and cognition differs across skin tone groups, even within an ethnic group. This suggests a modifying role of intersecting identities (e.g., ethnicity by skin tone) in understanding health outcomes. Additional research with a robust, diverse sample of Hispanic/Latin Americans is needed to continue examining the heterogeneity of heritage groups across various health outcomes.