Depressive Symptoms in Chinese-American Subjects with Cognitive Impairment

Abstract

Objectives To assess the prevalence of geriatric depression in Chinese American patients with cognitive impairment and to compare the prevalence to that of cognitively normal elderly Chinese Americans and Caucasians. Design We compared rates of depressive symptomatology in elderly Chinese Americans to a matched group of Caucasians, with and without dementia, and assessed rates of treatment for depression across all groups. Setting Academic subspecialty referral clinic. Participants Participants included a total of 137 elderly, cognitively impaired and cognitively normal Chinese Americans and 140 Caucasians with and without cognitive impairment. Measurements Demographic (e.g. age, education, race, language ability), cognitive (MMSE score), medical (e.g. cardiovascular morbidity) and functional (Clinical Dementia Rating Scale) risk factors were assessed for association with depressive symptomatology as measured by the Geriatric Depression Scale (GDS). Results Depression (GDS score ≥ 6 out of 15) was significantly more common in cognitively impaired Chinese Americans (35%) versus cognitively impaired Caucasians (15%, χ2 = 33.8, p<0.05), and Chinese Americans were less likely to be on treatment for depression (12%) than Caucasians (37%, χ2 = 41, p<0.05). Cognitive and functional impairment, age and education were all independent predictors of GDS score. Rates of depression were not significantly different in cognitively normal Chinese American (6%) and Caucasian (0%) groups. Conclusions These findings indicate that elderly Chinese Americans with cognitive impairment are at significantly increased risk for unrecognized depression and that education, and/or other cultural factors associated with education may contribute to this risk.

Annual review of Asian American Psychology, 2014.

“…Cho, Park, Bernstein, Roh, & Jeon, 2014; Masuda, Mandavia, et al, 2014; Remigio-Baker, Hayes, & Reyes-Salvail, 2014; Tuason et al, 2014; Yeh, Liao, et al, 2014). Depression/anxiety/somatization was studied across different developmental periods of the life course: adolescence to emerging adulthood (Lund et al, 2014; Yeh, Liao, et al, 2014), emerging adulthood to middle adulthood (Masuda, Mandavia, et al, 2014; Tuason et al, 2014), older adulthood (Chao et al, 2014), or all of the above in the same study (S. Cho et al, 2014; Remigio-Baker et al, 2014).…”

Longitudinal Association of Dementia and Depression

“…Also, other factors such as race/ethnicity, education, income, language, acculturation, and family and community support need to be considered when examining the recognition and treatment of depression in diverse elders with cognitive impairment. 30 …”

Dementia Health Promotion for Chinese Americans

“…As a minority group, Chinese Americans are at especially high risk for delayed diagnosis and suboptimal management of dementia [ 7 - 10 ]. Chinese patients often delay seeking dementia care until the severe stages of neuropsychiatric symptoms when compared to Caucasian patients [ 7 ].…”

“…Following a diagonisis of neurocognitive disorder, Asian American patients were less likely to receive dementia treatment than their white counterparts [ 9 ]. Moreover, while clinical depressive symptoms were more common among Chinese American dementia patients, they were less likely to receive antidepressant therapy than white subjects [ 10 ].…”