Study of Bay Area Vietnamese refugees probes war impacts on aging brains

A few years ago, Van Ta Park’s brother was killed on a morning jog by a driver who ran a red light. When the time came, her father could not bring himself to board the boat taking the family to scatter the ashes of his only son into the ocean. In a flashback, he recalled fleeing the aftermath of the Vietnam War by sea as a young man and went into a sharp cognitive decline after the fresh tragedy.

Born in Vietnam, Park arrived in San Jose via Houston, where her family first touched down as refugees in 1980. With no memories of the journey, she asked her parents for theirs. Her mother recounted holding her, then still a baby, in front of her on the trip out of Vietnam because pirates were rumored less likely to rape women with infants.

Among refugees, such accounts were normally glazed over. “They had the attitude of ‘Everyone went through it – what makes them different?’ They felt that they couldn’t complain. And we had to move on,” said Park, a professor at UCSF’s nursing school.

Yet Park remained curious about what was behind the depression and dementia she witnessed around her while growing up, and built a career in community-based scientific research.

Among Park’s projects is the Vietnamese Insights Into Aging Program, an unprecedented long-term study of Vietnamese refugees and immigrants 65 and up, led by principal investigator Oanh L. Meyer, a social psychology researcher at UC Davis whose refugee family has experienced dementia.

Science has already proven that war trauma can cause cognitive decline, especially with age. But most research is based on American military veterans or survivors in Vietnam. The researchers hope their work will provide broader insights into the long-term impacts of war trauma on civilians and refugees.

The National Institutes of Health awarded the researchers a five-year $7.2 million grant to follow 500 aging survivors of the Vietnam War residing in Sacramento and San Jose.

“They’re a highly vulnerable group who hasn’t been examined. Everyone endured war — they all lived through it their entire life,” Meyer said.

The project, now in its final round of assessments, measures clinical metrics such as blood pressure, metabolics and mental health indicators, while gathering qualitative information through extensive one-on-one interviews conducted three times a year.

The study’s initial results revealed the expected negative impacts of war but, also showed that some survivors summoned the powers of inner strength or gratitude to cope.

“In general, society thinks about the bad, but we also want to study what happens in light of these experiences,” Park said. “How do they play into buffering increased risk for dementia and Alzheimer’s? How did the survivors survive, and how did they flourish?”

“If we can predict factors that protect brain health,” Meyer said, “that could help other populations as well.”

Among the 529 studies funded by the NIH between 1992 and 2018, a minuscule number — just 0.17% — have been focused on Asian American, Native Hawaiian and Pacific Islander participants, but this research adds to that.

“It’s sort of a new thing to look at Asian Americans and Alzheimer’s – hopefully this is the beginning of having that representation,” Meyer said.

The International Children Assistance Network’s Family Resource Center helped recruit volunteers for the San Jose portion of the study.

“This was a huge educational journey I embarked on, too. Typically, people think of researchers as mad scientists with their hair standing on end in their ivory towers. They don’t understand it takes data from them to find solutions for them,” said the network’s executive director Quyen Vuong.

On a Friday morning, Hòa Mai, 82, and Lan Nguyễn, 72, friends from the same senior apartment complex, sat at a table in the sunny courtyard of the Vietnamese American Cultural Center in San Jose before meeting with research staff.

Mai, who fought with the South Vietnamese navy during the Vietnam War, tried to escape re-education camp seven times in three years before making his way to the United States. He has the common refugee medical conditions of diabetes, high blood pressure and high cholesterol, and worries about his memory.

“Being able to talk with someone else makes me feel much better because somebody cares,” Mai said in Vietnamese. He said he hopes researchers note the extent of the isolation and depression among older refugees, and how he and his counterparts feel like they are still part of society when they know they have not been forgotten.

“The need to feel connected echoes not just throughout the community but around the world,” said Mai, who said he taught his children, including his son, a captain in the U.S. Army who went twice to Iraq and works at the U.S. Department of Defense, to serve others. “So, I’m proud of my children contributing to this new home.”

“I’m very grateful for a chance to participate — I’ve learned a lot and share what I’ve learned with friends,” said Nguyễn.

Both Mai and Nguyễn have enjoyed annual meetings when researchers share their findings with the participants as equal research partners. Like small gift cards compensating for their time, the event is a great perk.

Meyer said participants sometimes gain individual benefits from the research, too, such as neuropsychological evaluations they might get through their regular health care. “I think people really want to tell their story,” she added.

Park still struggles with a dearth of research about Vietnamese Americans — one that understates community needs and makes it difficult to request support.

The research team is seeking more funding to keep following their current subjects, add 500 more from California and expand clinical procedures.

Obstacles abound. The Trump administration attempted to retract NIH grants earlier this year in its campaign to eliminate diversity, equity and inclusion initiatives, but UCSF filed a class-action lawsuit that resulted in reinstatement of the funds, including for Park’s studies.

Park is also working on several other research projects about cognition in Asian populations,and remains determined after resisting decades of pressure to change her scope and methods.

“Community research takes a long time,” she said, “but if you do it right, it just flows, and you see meaningful results.”