Findings support inclusion of key factors in the SHBM relevant to perceived threat of AD and help enrich the understanding of AD literacy from both scientific and cultural perspectives. AD education programs and interventions should help address crucial cultural beliefs related to AD and the emotional consequences (e.g., concerns or fear of AD) that might be due to the exposure to AD factual knowledge, particularly for those with limited education.

Acculturation levels influence awareness of an AD, and family values are crucial in EoL care decision making. Cultural factors should be considered in designing and delivering appropriate programs to promote knowledge of EoL care among Chinese-American elders and their families.

AD educational programs should target domains (e.g., risk factors, symptoms, and caregiving) about which Chinese American elders tend to have less knowledge; AD information should be disseminated through appropriate media to outreach Chinese American elders more effectively. Addressing the biases in elders' cultural beliefs of AD should be incorporated in AD educational programs.

ObjectivesThis study focused on perceived threat of Alzheimer's disease and related dementias (ADRD) in Chinese older adults and investigated its associations with their perceived stigma and knowledge of ADRD.MethodsWe examined Chinese older adults' perceived threat of ADRD and its associations with perceived stigma, knowledge of ADRD, family variables and health variables. Data for this cross‐sectional study were collected by student interviewers in 2016. The participants (N = 754) were recruited from two urban communities in mainland China and their ages ranged from 60 to 89 (M = 69.54, SD = 7.35).ResultsHierarchical regression analyses indicated that those who are younger, have more depressive symptoms and lower levels of family cohesion are more likely to worry about ADRD. More ADRD knowledge and higher levels of perceived stigma are significantly associated with perceived threat of ADRD. Community site moderated the relationship between stigma and perceived threat of ADRD.ConclusionsIntervention or service programs need to promote ADRD knowledge and awareness in a culturally sensitive way as well as address stigma and fear toward ADRD in the older population. Future studies are needed to incorporate more cultural and environmental factors to fully understand Chinese older adults' attitudes toward and literacy of ADRD.

Family support and conflict play a prominent role in explaining depressive symptoms among Chinese American older adults. The effect of acculturation is minimal when older adults have supportive families and good health. Interventions or services aimed at promoting family harmony for members of this population should be considered.