Attitudes towards screening for cognitive dysfunction: Interviews with Latinx adults with type 2 diabetes

Abstract

AbstractBackgroundOne in nine Latinx adults over 45 years old experience subjective cognitive decline (SCD). Yet less than half of people with SCD discuss symptoms with their provider (BRFSS, 2015‐2018). Because current diagnostic criteria focus on dementia, a later stage pathology, the window of opportunity for effective interventions may be missed. Cognitive screening can help identify pathology, and it can also assist in identifying those at risk for higher health care utilization. In qualitative interviews, Latinx adults with T2DM frequently avoided asking about cognitive problems or cognitive health due to stigma or discrimination (Cuevas & Zuñiga, 2020). The purpose of this project was to understand relevant factors affecting cognitive screening, which is critical for designing effective and timely interventions.MethodData was collected using semi‐structured interviews with Latinx adults with type 2 diabetes. General questions were asked regarding knowledge of cognitive screening, risks for cognitive dysfunction, and attitudes towards screening. Interviews were transcribed, entered into NVivo software, and analyzed using grounded theory techniques.ResultInterviews ranged from 30 minutes to 1 hour. Participants (n= 30) were 53% Female; mean age: 66.4 years; Mean A1C: 9.7%; and 57% Mexican American. Participants who were younger and had higher levels of education were more likely to report comfort with cognitive screening. Inability to work related to a possible diagnosis of dementia was a concern related to screening for most participants. However, that was not a reason to decline screening. Participants (88%) wanted more information on how the results of screening tests would be used as well as information on how to maintain or improve “brain health.” Although not part of the interview guide 45% said they would prefer to see healthcare providers with similar ethnic backgrounds.ConclusionOverall, screening for cognitive dysfunction was well received by participants. Themes included some hesitancy to be screened but also a desire to know more about risks for dementia and how to maintain health. Given the encouraging results, a larger study further exploring these themes with Latinx adults and comparing them with provider and clinic factors affecting screening is being conducted.