Conceptions of Dementia in a Multiethnic Sample of Family Caregivers

Abstract

Understanding variability in conceptions of dementia in multiethnic populations is important to improve care and guide research. 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. This is a cross-sectional study conducted in Boston and the San Francisco Bay area. Participants were a convenience sample of 92 family dementia caregivers from four ethnic/racial groups: African-American, Anglo European-American, Asian-American, and Latino. In-depth, qualitative interviews explored the caregivers' ideas about the nature and cause of dementia (i.e., explanatory models). Explanatory models of caregivers were categorized as biomedical, folk, or mixed (folk/biomedical). Quantitative analyses examined the association between ethnicity and other caregiver characteristics, and explanatory model type. 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. Further research on cross-ethnic differences in a larger, more-representative sample is needed.

Elevated inflammatory markers in diabetes‐related dementia

“…That is, cancer usually shows cell overgrowth and/or cell survival, but Alzheimer's disease usually shows neuron cell degeneration and/or neuron cell death. 4 This can partially explain the inverse relationship between cancer and Alzheimer's disease. However, scant evidence is available regarding the association between Alzheimer's disease and hepatocellular carcinoma (HCC) in older people in Taiwan.…”

“…As such, properly informed females are the bridge to early disease recognition and seeking treatment. 3,4 If Asian-American females do not understand that dementia decreases lifespan, this could delay early medical intervention. 4 The study's limitations include the participant group consisting mainly of females and research only consisting of three questions.…”

“…3,4 A recent study showed that higher IL-6 and TNF-α levels were associated with poorer cognitive ability in people with type 2 DM. 5 The present results suggest a possible role for IL-6 in cognitive impairment in the non-AD pattern group.…”

“…This could be related to Asian-American females creating stronger social support; that they are more likely than men to serve as caregivers to those with dementia. 3,4 Prior studies have shown, even without education as a confounding factor, these caregivers combine a folk and biomedical model to describing dementia. 3 With consistently misinformed female caregivers continuing their role every generation, differences in sex impressions of dementia could develop due to how information is disseminated to the next generation of caregivers.…”

“…4 The study's limitations include the participant group consisting mainly of females and research only consisting of three questions. Despite these limitations, the present study alludes to the gaps in knowledge needing to be filled in the Asian-American community.…”