BEHAVIORAL SYMPTOMS IN ALZHEIMER's DISEASE AMONG ETHNIC MINORITIES

Abstract

Background and Objective: Behavioral disturbances in patients with Alzheimer's disease are a major determinant of need for psychiatric services among elderly persons. Despite the disproportionate growth of the older minority population and the anticipated rapid rise in prevalence of dementia, participation of ethnic minorities in behavioral research on AD has been limited by language and cultural barriers. This descriptive study examined behavioral symptoms in an ethnolinguistically heterogeneous group of minority elderly with AD, as a starting point for the design of culturally congruent dementia services. Method: Potential subjects were identified in collaboration with community social services agencies serving ethnic minorities and enrolled in a multi-ethnic registry of the University of Washington ADRC. One hundred nineteen (91 women, 28 men) met NINCDS-ADRDA diagnostic criteria for probable or possible AD and DSM-IV criteria for AD. Ethnicities included African American (n=35), Asian-Pacific Islander (n= 62; Chinese, Korean, and Filipino), Hispanic (n=15), and Native American (n=7). Half spoke a language other than English. Behavioral symptoms were rated by caregiver interview using the BEHAVE-AD and dementia was staged using the CDR. Results: The mean BEHAVE-AD total score was 13.1 ± 8.3 and no significant differences between ethnic groups were observed. One or more symptoms occurred in 114 (96%) of this sample. Most occurred during CDR stage 1 to 3, with the peak at stage 3. Behavioral symptoms were less frequent in CDR stage 4 and 5. Conclusion: In this sample, ethnic minorities demonstrated levels of AD-associated psychopathology comparable to those previously reported in whites and at similar levels of disease severity. These data emphasize the need for development of geropsychiatric services accessible to older minorities, many of whom do not speak English, and the potential of University-community collaborations to bring older minorities into clinical dementia research.