Perceptions and Beliefs of Memory Loss and Dementia Among Korean, Samoan, Cambodian, and Chinese Older Adults: A Cross-Cultural Qualitative Study

Zhai, Shumenghui; Kim, Boeun; Li, Jingyi; Wi, Dahee; Chey, Sopheakvatey; Li, Ge; Rungruangkonkit, Sangjan; Belza, Basia

doi:10.3928/00989134-20220506-03

Cited by 7 publications

(13 citation statements)

References 33 publications

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“…One study included both laypersons and PCCs [ 28 ]. Several studies specifically explored the beliefs, attitudes, and knowledge of US racial and ethnic minority groups: 2 each were conducted with Black/African American [ 29 , 30 ] or Asian American participants [ 31 , 32 ], 3 with Latino participants [ 33 – 35 ], and 2 with racially and ethnically diverse participants [ 36 – 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Researchers found that Native American, Chinese American, and Vietnamese American respondents were specifically concerned about stigma associated with MCI or ADRD and how stigma may impact their family relationships [ 38 ]. Two other studies suggested that individuals may not distinguish normal aging from cognitive decline [ 32 , 41 ]. For example, in a study of 62 older Asian American participants, 95% of participants assumed that memory loss was part of normal aging [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two other studies suggested that individuals may not distinguish normal aging from cognitive decline [ 32 , 41 ]. For example, in a study of 62 older Asian American participants, 95% of participants assumed that memory loss was part of normal aging [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

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Understanding barriers to and facilitators of clinician-patient conversations about brain health and cognitive concerns in primary care: a systematic review and practical considerations for the clinician

Borson,

Small,

O’Brien

et al. 2023

BMC Prim. Care

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Background Primary care clinicians (PCCs) are typically the first practitioners to detect cognitive impairment in their patients, including those with Alzheimer’s disease or related dementias (ADRD). However, conversations around cognitive changes can be challenging for patients, family members, and clinicians to initiate, with all groups reporting barriers to open dialogue. With the expanding array of evidence-based interventions for ADRD, from multidomain care management to novel biotherapeutics for early-stage AD, incorporating conversations about brain health into routine healthcare should become a standard of care. We conducted a systematic review to identify barriers to and facilitators of brain health conversations in primary care settings. Methods We systematically searched PubMed, Scopus, Web of Science, and the Cochrane Library for qualitative or quantitative studies conducted in the US between January 2000 and October 2022 that evaluated perceptions of cognition and provider-patient brain health conversations prior to formal screening for, or diagnosis of, mild cognitive impairment or ADRD. We assessed the quality of the included studies using the Mixed Methods Appraisal Tool. Results In total, 5547 unique abstracts were screened and 22 articles describing 19 studies were included. The studies explored perceptions of cognition among laypersons or clinicians, or provider-patient interactions in the context of a patient’s cognitive concerns. We identified 4 main themes: (1) PCCs are hesitant to discuss brain health and cognitive concerns; (2) patients are hesitant to raise cognitive concerns; (3) evidence to guide clinicians in developing treatment plans that address cognitive decline is often poorly communicated; and (4) social and cultural context influence perceptions of brain health and cognition, and therefore affect clinical engagement. Conclusions Early conversations about brain health between PCCs and their patients are rare, and effective tools, processes, and strategies are needed to make these vital conversations routine.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Understanding barriers to and facilitators of clinician-patient conversations about brain health and cognitive concerns in primary care: a systematic review and practical considerations for the clinician

Borson,

Small,

O’Brien

et al. 2023

BMC Prim. Care

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“…Aging studies involving SA 33 adults are generating epidemiological insight into psychosocial factors influencing brain health; however, neuroimaging data – including willingness to undergo brain imaging – are lacking. 34 With exceptions, 35 , 36 cross‐racial/ethnic studies on dementia attitudes (excluding those assessing only one racial/ethnic group) have historically recruited mostly White, Black, and Hispanic participants. We did not find a difference in MRI safety perceptions among racial/ethnic groups, but we did find greater belief in internal LoC for dementia risks among SA respondents.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with attitudes toward research MRI in older Asian Americans

Kota,

Dawson,

Papas

et al. 2024

A&D Transl Res & Clin Interv

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INTRODUCTIONSouth Asian (SA) and East Asian (EA) older adults represent the fastest‐growing racial/ethnic groups of Americans at risk for dementia. While recruiting older SA adults into a brain health study, we encountered unexpected hesitancy toward structural brain magnetic resonance imaging (MRI) analysis and stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI‐related research was influenced by these attitudes as well as personal MRI experience, perceived MRI safety, and concerns for personal risk for future dementia/stroke.METHODSWe developed a brief cross‐sectional survey to assess older adults’ MRI experiences and perceptions, desire to learn of six incidental findings of increasing impact on health, and attitudes related to dementia (including LoC) and research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey (offered in English, Chinese, Korean, and Spanish) and modeled the proportional odds (PO) for favorable attitudes toward research activities.RESULTSSeventy‐seven SA and 84 EA respondents were analyzed alongside 95 White, Black, or Hispanic adults. White (PO = 2.54, p = 0.013) and EA (PO = 2.14, p = 0.019) respondents were both more likely than SA respondents to endorse healthy volunteers’ participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p = 0.006) but still shared SA respondents’ lower wish (measured by proportion of total) to learn of incidental MRI findings.DISCUSSIONSA—and EA compared to SA—older adults had low desire to learn of incidental MRI findings but had different attitudes toward future dementia/stroke risks. A culturally appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research.Highlights Older Asian Americans have limited interest in incidental findings on research MRI South Asians are most likely to attribute dementia to people's own behaviors South Asians’ attitudes mediate lower support for healthy volunteers in research South and East Asians differ in dementia worries and research‐related attitudes

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“…Aging studies involving EA [31] and SA [32] older adults are starting to generate epidemiological insight into psychosocial factors influencing brain health in these populations, but neuroimaging dataincluding willingness to undergo advanced brain imaging -are lacking. [33] With some exceptions, [34,35] cross-racial/ethnic studies on dementia attitudes (not including those which only assessed one racial/ethnic group) have historically recruited mostly White, Black, and Hispanic participants. We did not find a difference in perception of MRI safety among racial/ethnic groups, but we found greater belief of internal LoC for dementia risks among SA respondents.…”

Section: Discussionmentioning

confidence: 99%

Too much information? Asian Americans’ preferences for incidental brain MRI findings

Kota

Dawson

Papas

et al. 2023

Preprint

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INTRODUCTION: South Asian (SA) and East Asian (EA) older adults represent the fastest growing group of Americans at risk for dementia, but their participation in aging and dementia research has been limited. While recruiting healthy SA older adults into a brain health study, we encountered unexpected hesitancy towards structural brain MRI analysis along with some stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as one's own MRI experience, perceived MRI safety, and concerns for one's own risks for future dementia/stroke. METHODS: We developed a brief cross-sectional survey to assess older adults' MRI experiences and perceptions, desire to learn of six incidental findings of increasing health implications, and attitudes related to dementia as well as research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey, and modeled the proportional odds (P.O.) for pro-research attitudes. RESULTS: 77 SA and 84 EA respondents were analyzed with 95 non-Asian adults. White (P.O.=2.54, p=0.013) and EA (P.O.=2.14, p=0.019) respondents were both more likely than SA respondents to endorse healthy volunteers' participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p=0.006), but still shared SA respondents' low desire to learn of incidental MRI findings. DISCUSSION: SA and EA older adults had different attitudes towards future dementia/stroke risks, but shared a low desire to learn of incidental MRI findings. A culturally-appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research.

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Perceptions and Beliefs of Memory Loss and Dementia Among Korean, Samoan, Cambodian, and Chinese Older Adults: A Cross-Cultural Qualitative Study

Cited by 7 publications

References 33 publications

Understanding barriers to and facilitators of clinician-patient conversations about brain health and cognitive concerns in primary care: a systematic review and practical considerations for the clinician

Understanding barriers to and facilitators of clinician-patient conversations about brain health and cognitive concerns in primary care: a systematic review and practical considerations for the clinician

Factors associated with attitudes toward research MRI in older Asian Americans

Too much information? Asian Americans’ preferences for incidental brain MRI findings

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