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Prevalence of Dementia and Its Subtypes in the Japanese American Population of King County, Washington State: The Kame Project

Author/s: Graves, A. B. Larson, E. B. Edland, S. D. Bowen, J. D. MCCormick, W. C. MCCurry, S. M. Rice, M. M. Wenzlow, A. Uomoto, J. M. | Year: 1996 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia

Reference: Graves, A. B., E. B. Larson, S. D. Edland, J. D. Bowen, W. C. MCCormick, S. M. MCCurry, M. M. Rice, A. Wenzlow and J. M. Uomoto (1996). "Prevalence of Dementia and Its Subtypes in the Japanese American Population of King County, Washington State: The Kame Project." American Journal of Epidemiology 144(8): 760-771.

Key Words:
Japanese, cross country comparison, dementia prevelance
Research aim:
Studies of Asian populations generally have reported prevalence rates for dementia similar to those of predominantly Caucasian populations, but relative prevalence rates of Alzheimer's disease and vascular dementia have differed. Prevalence rates of dementia, Alzheimer's disease, and vascular dementia were examined in the Japanese American population aged over 65 years in King County, Washington State in order to determine if Asian populations have
Results/Conclusion:
Persons with lower education had higher overall rates of dementia than those with higher education, but this tendency became weak and inconsistent when rates were age-stratified. The prevalence of dementia in this geographically defined population of Japanese Americans was somewhat higher than prevalence rates reported from Japan, and the distribution of dementia subtypes more closely resembled that found in Caucasian populations in North America and Europe than previously reported in Asian populations.
Implications:
Cultural Group(s):
Japanese Americans
Location of study:
United States
Age group:
65+
Number included in study:
1,985
Type of participants:
persons with at least 50% Japanese heritage
Research approach:
Quantitative
Type of data:
Primary
Secondary data sources used:
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:

Screening and Diagnostic Assessment of Non-english Speaking People with Dementia: Guidelines and System Recommendations for Practitioners, Service Managers and Policy Makers

Author/s: Grypma, R Mahajani, S Tam, E | Year: 2007 | Publication type: Report | Peer reviewed: | Topic area/s: Dementia

Reference: Grypma, R., S. Mahajani and E. Tam (2007). Screening and Diagnostic Assessment of Non-english Speaking People with Dementia: Guidelines and System Recommendations for Practitioners, Service Managers and Policy Makers. Canberra: Alzheimer's Australia.

Key Words:
dementia, assessment tools, culturally appropriate tools
Research aim:
These Guidelines and System Recommendations are intended to provide information for assessors when they are planning the dementia screening or assessment of a non-English speaking person. They apply to all elements of the screening, assessment and diagnosis process, including cognitive, neuropsychological and functional assessments. They reflect good assessment principles in general, but have been written specifically with dementia-related assessments in mind.
Results/Conclusion:
The Guidelines and System Recommendations document contains recommendations for resources and processes to be put into place to enable practitioners to make best use of these guidelines.
Implications:
Cultural Group(s):
Non-English speaking person
Location of study:
Australia (national)
Age group:
Number included in study:
N/A
Type of participants:
Research approach:
Type of data:
Secondary data sources used:
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:
Not primary research - set of guidelines developed for use in cognitive assessments with people from a non-English speaking background.

Review of CALD dementia resources in Australia

Author/s: Hayward-Wright, N McKenzie, Elizabeth | Year: 2005 | Publication type: Report | Peer reviewed: | Topic area/s: Dementia

Reference: Hayward-Wright, N. and E. McKenzie (2005). Review of CALD dementia resources in Australia. Alzheimer's Australia Victoria, National Cross Cultural Dementia Network.

Key Words:
Research aim:
The aim of this project has been to ascertain what dementia and dementia related resources (books, leaflets/pamphlets, videos, DVDs, audiotapes, multi-media kits) are currently available in Australia and would be suitable for use by people from Culturally and Linguistically Diverse (CALD) communities; specifically Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Latvian, Macedonian, Maltese, Polish, Russian, Serbian, Spanish, Tagalog / Filipino, Turkish and Vietnamese.
Results/Conclusion:
The outcome of these activities has been the production of a catalogue of CALD resources (separate from this report) and a database of all CALD resources which will be for internal Alzheimer's Australia use only. The production of a printed catalogue for external distribution is not recommended as it will become immediately out of date and does not include other language material that is available, such as Korean and Portuguese.
Implications:
Cultural Group(s):
Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Latvian, Macedonian, Maltese, Polish, Russian, Serbian, Spanish, Tagalog / Filipino, Turkish and Vietnamese.
Location of study:
Age group:
Number included in study:
N/A
Type of participants:
Research approach:
Type of data:
Secondary data sources used:
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:
Of little value to the current review - exept to note that this has been done for a particular organisation

Pathways to dementia diagnosis: Evidence of cross-ethnic differences

Author/s: Hinton, L Franz, C Friend, J | Year: 2004 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia, Carers of CALD Older People

Reference: Hinton, L., C. Franz and J. Friend (2004) "Pathways to dementia diagnosis: Evidence of cross-ethnic differences" Alzheimer's Disease and Associated Disorders: an International Journal 18(3):134-144

Key Words:
Dementia, older people, CALD, diagnosis, family care-givers
Research aim:
(1) To describe pathways to diagnosis from the perspective of family caregivers and (2) to compare help-seeking patterns and experiences across three ethnic groups.
Results/Conclusion:
Help-seeking was most often initiated by family members or formal care providers (ie, healthcare providers or social workers), usually in outpatient primary care settings but also elsewhere (eg, social service agencies, hospitals). "Secondary" formal helpers were often involved, usually through self-referral by families rather than by healthcare providers. While most families reported receiving a "final" diagnosis, a small minority of predominantly Chinese-American families did not. Four distinct pathways to diagnosis were identified and found to vary significantly across the three ethnic groups, which we label as smooth pathways, crisis events pathways, fragmented pathways, and dead-end pathways. Adverse experiences in the healthcare system were common and included unsatisfactory diagnosis disclosure and explanation, inadequate workup, uncaring or insensitive attitude, language barriers, and discrimination.
Implications:
Adverse experiences in the healthcare system were common and included unsatisfactory diagnosis disclosure and explanation, inadequate workup, uncaring or insensitive attitude, language barriers, and discrimination. Cross-ethnic differences were found in both pathway types and in adverse experiences.
Cultural Group(s):
CALD
Location of study:
United States
Age group:
Not specific - carers
Number included in study:
39 family caregiver interviews
Type of participants:
Family Caregivers of CALD
Research approach:
Qualitative
Type of data:
Primary
Secondary data sources used:
None
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:

Conceptions of dementia in a multiethnic sample of family caregivers

Author/s: Hinton, L Franz, CE Yeo, G Levkoff, SE | Year: 2005 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia

Reference: Hinton, L., C. Franz, G. Yeo and S. Levkoff (2005). "Conceptions of dementia in a multiethnic sample of family caregivers." Journal of the American Geriatrics Society 53(8): 1405-1410.

Key Words:
dementia, caregiving, health literacy, perceptions of dementia
Research aim:
The objectives of this study were to describe caregiver conceptions of dementia using a previously developed typology and to examine the correlates of conceptions of dementia in a multiethnic sample.
Results/Conclusion:
Overall, 54% of caregivers, including 41% of Anglo European Americans, held explanatory models that combined folk and biomedical elements (i.e., mixed models). For example, many families attributed Alzheimer's disease and related dementias to psychosocial stress or normal aging. Ethnicity, lower education, and sex were associated with explanatory model type in bivariate analyses. In multiple logistic regression analysis, minority caregivers (P<.02) and those with less formal education (P<.02) were more likely to hold mixed or folk models of dementia. Although minority and nonminority caregivers often incorporated folk models into their understanding of dementia, this was more common in minority caregivers and those with less formal education.
Implications:
Further research on cross-ethnic differences in a larger, more-representative sample is needed.
Cultural Group(s):
African-American, Anglo-American, Asian-American, Latino
Location of study:
United States (Boston and San Francisco)
Age group:
mean age 50+ (caregivers)
Number included in study:
92
Type of participants:
family caregivers of people with dementia
Research approach:
Mixed methods
Type of data:
Primary
Secondary data sources used:
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:

Improving care for ethnic minority elderly and their family caregivers across the spectrum of dementia severity

Author/s: Hinton, L. | Year: 2002 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia, Carers of CALD Older People

Reference: Hinton, L. (2002) "Improving care for ethnic minority elderly and their family caregivers across the spectrum of dementia severity" Alzheimer's Disease and Associated Disorders: an International Journal 16 (Supp 2):S50-S55

Key Words:
Caregiving, informal social networks, help-seeking, barriers to care, dementia, primary care
Research aim:
As our elderly population becomes more ethnically diverse, there is a pressing need to understand the unique challenges and opportunities this presents for research and service delivery. This paper outlines key research areas and methods to move the field forward.Key research issues are outlined that reflect observations of someone who conducts research from a social and cultural perspective, plowing the intellectual terrain at the interface of medical anthropology and health services research. Four key areas are described along with examples of research questions. The first topic area, intraethnic diversity, can be viewed as an important theme that should be carried through other areas of research. The remaining three stand on their own as key foci for research.
Results/Conclusion:
Key research issues are outlined as observations from someone who conducts research from a social and cultural perspective, through the interface of medical anthropology and health services research. Four key research areas are described along with examples of research questions. The first topic area, intraethnic diversity, can be viewed as an important theme that should be carried through other areas of research described.
Implications:
Much has been learned about the implications of this ethnic and cultural diversity for dementia research. Building on this base, it will be important for researchers to go beyond demonstrating differences and similarities between ethnic minority and non-ethnic minority groups, to highlight sources of intraethnic diversity, and to specify the underlying processes that contribute to crossethnic differences.
Cultural Group(s):
CALD
Location of study:
United States
Age group:
Not specific - carers
Number included in study:
N/A
Type of participants:
None
Research approach:
Type of data:
Literature review
Secondary data sources used:
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:

Introduction: Exploring the Relationships Among Aging, Ethnicity, and Family Dementia Caregiving

Author/s: Hinton, L. Fox, K. Levkoff, S. | Year: 1999 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia, Carers of CALD Older People, Reserch Methodology

Reference: Hinton, L., K. Fox and S. Levkoff (1999) "Introduction: Exploring the Relationships Among Aging, Ethnicity, and Family Dementia Caregiving" Culture, Medicine & Psychiatry 23(4):403-413

Key Words:
Dementia, Caregivers, Older People, Caregiving
Research aim:
Introduces a set of papers featured in the December 1999 issue of "Culture, Medicine and Psychiatry," which analyzed narratives of caregivers of elders with dementia in Boston, Massachusetts.
Results/Conclusion:
Provides methods shared across the papers includinga multidimensional framework for ethnicity and directions for future research
Implications:
Cultural Group(s):
CALD
Location of study:
United States
Age group:
Not specific - carers
Number included in study:
N/A
Type of participants:
Research approach:
Type of data:
Literature review
Secondary data sources used:
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:

The host-homes program: an innovative model of respite for carers of people with dementia

Author/s: Holm, Sonya Ziguras, Stephen | Year: 2003 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia, Respite

Reference: Holm, S. and S. Ziguras (2003) "The host-homes program: an innovative model of respite for carers of people with dementia" Australasian Journal on Ageing 22(3):141-145

Key Words:
Dementia, respite, service provision, Koori, non-English speaking backgrounds,
Research aim:
To investigate the operation of an innovative community respite program run by the Brotherhood of St Laurence: the Banksia 'host-home' program, which was designed to provide respite for up to six people with dementia in a care-worker's home.
Results/Conclusion:
People using the program were those who experienced barriers utilising centre-based programs for older people for a range of reasons including advanced dementia, hearing difficulties, difficulties in social interaction or confusion. Carers were very appreciative of the service, and care-recipients appeared to enjoy the program immensely, citing caring staff, social contact and activities as things they appreciated most. The host-home program provided an accessible respite option for those unable to use centre based services. It enabled more individually tailored activities, greater socialisation and greater attention from staff than possible in centre-based services.
Implications:
Since the model creates the potential for cost shifting and because of difficulties in supervising staff in their own homes, sidelines and standards appropriate to host-home programs should be established to ensure quality of care and to protect paid staff and service users.
Cultural Group(s):
Not specific to CALD but includes CALD participants
Location of study:
Victoria
Age group:
Not specfic - services providers, family carer givers and care recipients
Number included in study:
4 service providers, 7 care givers, 18 care recipients
Type of participants:
Service providers, care givers and respite recipients
Research approach:
Type of data:
Mixed
Secondary data sources used:
Program data from service provider
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:

Frequency of Dementia Etiologies in Four Ethnic Groups

Author/s: Hou, C. E. Yaffe, K. Pérez-Stable, E. J. Miller, B. L. | Year: 2006 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia

Reference: Hou, C., K. Yaffe, E. Pérez-Stable, E. and B. Miller (2006) "Frequency of Dementia Etiologies in Four Ethnic Groups" Dementia and Geriatric Cognitive Disorders 22(1):42-47

Key Words:
Dementia, Alzheimer disease, other forms of dementia
Research aim:
Research on dementia among ethnically diverse populations in the USA has focused primarily on Alzheimer disease and vascular dementia, but there are limited data on other neurodegenerative causes of dementia. This paper explores these other casues of dementia for this population group.
Results/Conclusion:
The percentage of non-Whites diagnosed as having dementia with Lewy bodies was lower than that of Whites. Frontotemporal lobar degeneration was as common in Asians and Pacific Islanders compared to Whites, but less common in Blacks and Latinos. Progressive supranuclear palsy was more frequent in Asians and Pacific Islanders compared to Whites, but equally common in Blacks and Latinos.
Implications:
Additional study is needed on the social and biological factors that infl uence the diagnosis and prevalence of non-Alzheimer and nonvascular dementias among diverse ethnic groups.
Cultural Group(s):
CALD
Location of study:
United States
Age group:
65+
Number included in study:
6,525
Type of participants:
people diagnosed with dementia in 10 Californian Dementia Diagnostic and Treatment Centres
Research approach:
Mixed methods
Type of data:
Secondary
Secondary data sources used:
Client data from 10 Dementia clinics in California
Specific scales or analytical techniques used:
Frequencies of dementia diagnoses by different demographics, including ethnicity
Implications/ Recommendations:
Notes:

The debate on ethnicity and dementia: from category fallacy to person-centred care?

Author/s: Iliffe, S. Manthorpe, J. | Year: 2004 | Publication type: Journal article | Peer reviewed: | Topic area/s: Dementia

Reference:

Key Words:
Research aim:
Positioning paper: We argue that these issues are applicable to all individuals with dementia, independent of apparent ethnicity, and that promotion of cultural competence in service provision should not be relegated to an ethnic minority agenda.
Results/Conclusion:
the experiences of people with dementia and their carers show that the important issues for service providers to consider are language, religious belief and observance, cultural practices (including food and personal care practices) and social support and coping mechanisms (i.e. do not group everyone from a particular ethnicity into a single category or group). We argue that these issues are applicable to all individuals with dementia, independent of apparent ethnicity, and that promotion of cultural competence in service provision should not be relegated to an ethnic minority agenda.
Implications:
The task for health and social care providers is therefore to recognise the diversity of users and to increase access to appropriate quality mainstream person-centred services, rather than to develop segregated or specialized services.
Cultural Group(s):
Location of study:
Age group:
Number included in study:
N/A
Type of participants:
Research approach:
Positioning paper
Type of data:
Secondary data sources used:
Specific scales or analytical techniques used:
Implications/ Recommendations:
Notes:
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