Researchers have recently become very interested in the affects of culture on the diagnosis and treatment of Alzheimer’s and dementia in America. They believe the exploration of cultural influences is critical, as culture affects understanding of dementia, how services are utilized, and the psychosocial experiences of the families of those with dementia. As of 2005 the population of adults 65 years or older in the United States was 8% African-American, 5% Latino, and 2.3% Asian-Pacific Islander, but by 2050 these numbers are projected to increase to 12% African-American, 16% Latino, and 6.5% Asian-Pacific Islander. These cultures are of particular interest because African-Americans are two times more likely and Latinos are one and a half times more likely to develop Alzheimer’s or dementia. While Asians, though less likely to develop the disease, face intense social stigmas.
One of the primary issues in dealing with Alzheimer’s or dementia for minorities is timely diagnosis. On average African-Americans wait 6 years after the first signs of Alzheimer’s/dementia before seeking a diagnosis, while the delay for Caucasians averages only 2 years. The reasons for the delay in diagnosis is generally a cultural misunderstanding of the signs of, and a lack of knowledge about the disease.
Among many minorities the initial signs of Alzheimer’s or dementia are attributed to the normal process of aging. African-Americans see it as “the old timer’s” disease. Latinos use the phrase “el loco” for the craziness, and the Chinese refer to “hu tu” for becoming forgetful in old age. Through these beliefs they normalize the symptoms and miss the signs of a more serious problem.
Once a deeper problem is recognized there are additional obstacles to gaining a diagnosis. Most minorities do not turn directly to medical care. They rely primarily on the advice of family and then turn to an outside source. African-Americans rely heavily on religious leaders, Latinos turn to friends, while Caucasians rely on doctors. The knowledge base of each of these groups dramatically effects the care they receive, and the timely treatment of the disease. Recognizing these primary sources of information emphasizes the importance of public education on these diseases.
This also affirms the strong need for primary care physicians to become more aware and proactive in the diagnosis of Alzheimer’s and dementia. In 1999 a team of researchers (Boise, Morgan, Kaye & Camicioli) found that many caregivers delayed seeking a diagnosis because they lacked information about dementia and did not know which doctors to ask.
Early detection and preventative care are the most important steps in retarding the onset of dementia. It is essential to increased public and clinician awareness to catch and treat the disease early. Action to increase awareness will have a great impact on the treatment of these ravishing diseases, particularly among those minorities most susceptible.