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Older adults' concerns about cognitive health: commonalities and differences among six United States ethnic groups

Published online by Cambridge University Press:  20 January 2011

JAMES N. LADITKA ,
SARAH B. LADITKA ,
RUI LIU ,
ANNA E. PRICE ,
BEI WU ,
DANIELA B. FRIEDMAN ,
SARA J. CORWIN ,
JOSEPH R. SHARKEY ,
WINSTON TSENG  and
REBECCA HUNTER
...Show all authors
JAMES N. LADITKA*
Affiliation:
Department of Public Health Sciences, University of North Carolina at Charlotte, USA.
SARAH B. LADITKA
Affiliation:
Department of Public Health Sciences, University of North Carolina at Charlotte, USA.
RUI LIU
Affiliation:
Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, North Carolina, USA.
ANNA E. PRICE
Affiliation:
Department of Health and Exercise Science, Furman University, Greenville, South Carolina, USA.
BEI WU
Affiliation:
Gerontology Program, University of North Carolina at Greensboro, USA.
DANIELA B. FRIEDMAN
Affiliation:
Department of Health Promotion, Education, and Behaviour, University of South Carolina, Columbia, USA.
SARA J. CORWIN
Affiliation:
Department of Health Promotion, Education, and Behaviour, University of South Carolina, Columbia, USA.
JOSEPH R. SHARKEY
Affiliation:
Texas Healthy Aging Research Network Collaborating Center (TxHAN) at the School of Rural Public Health, Texas A&M Health Science Center, College Station, USA.
WINSTON TSENG
Affiliation:
School of Public Health, University of California, Berkeley, USA.
REBECCA HUNTER
Affiliation:
Carolina Geriatric Education Centre, and Centre for Ageing and Health, University of North Carolina at Chapel Hill, USA.
REBECCA G. LOGSDON
Affiliation:
Psychosocial and Community Health, University of Washington School of Nursing, Seattle, USA.
*
Address for correspondence: James N. Laditka, Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA. E-mail: jladitka@uncc.edu
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Abstract

We studied concerns about cognitive health among ethnically diverse groups of older adults. The study was grounded in theories of health behaviour and the representation of health and illness. We conducted 42 focus groups (N=396, ages 50+) in four languages, with African Americans, American Indians, Chinese Americans, Latinos, Whites other than Latinos (hereafter, Whites) and Vietnamese Americans, in nine United States locations. Participants discussed concerns about keeping their memory or ability to think as they age. Audio recordings were transcribed verbatim. Constant comparison methods identified themes. In findings, all ethnic groups expressed concern and fear about memory loss, losing independence, and becoming ‘a burden’. Knowing someone with Alzheimer's disease increased concern. American Indians, Chinese Americans, Latinos and Vietnamese Americans expected memory loss. American Indians, Chinese Americans and Vietnamese Americans were concerned about stigma associated with Alzheimer's disease. Only African Americans, Chinese and Whites expressed concern about genetic risks. Only African Americans and Whites expressed concern about behaviour changes. Although we asked participants for their thoughts about their ability to think as they age, they focused almost exclusively on memory. This suggests that health education promoting cognitive health should focus on memory, but should also educate the public about the importance of maintaining all aspects of cognitive health.

Keywords

cognitionageingAlzheimer's diseasedementiamemoryqualitative researchfocus groupsbrain health
Type
Submitted Articles
Information
Ageing & Society , Volume 31 , Issue 7: Rethinking Theoretical and Methodological Issues in Intergenerational Family Relations Research , October 2011 , pp. 1202 - 1228
Copyright
Copyright © Cambridge University Press 2011

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References

Albert, M. S., Brown, D. R., Buchner, D., Laditka, J. N., Launer, L. J., Scherr, P., Thies, W. and Wagster, M. V. 2007. The healthy brain and our aging population: translating science to public health practice. Alzheimer's & Dementia, 3, supplement 1, S3–.5CrossRefGoogle ScholarPubMed
Alzheimer's Association. 2008. Alzheimer's disease facts and figures. Alzheimer's and Dementia, 4, 2, 110–33.CrossRefGoogle Scholar
Alzheimer's Association and American Heart Association. 2008. Findings from the African American Heart and Brain Health Survey. Alzheimer's Association, Chicago.Google Scholar
Anderson, L. A., Day, K. L., Beard, R. L., Reed, P. S. and Wu, B. 2009. The public's perceptions about cognitive health and dementia among the United States population: a national review. The Gerontologist, 249, supplement 1, S3–11.CrossRefGoogle Scholar
Ayalon, L. and Arean, P. A. 2004. Knowledge of Alzheimer's disease in four ethnic groups of older adults. International Journal of Geriatric Psychiatry, 19, 1, 51–7.CrossRefGoogle ScholarPubMed
Bandura, A. 1986. Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice-Hall, Englewood Cliffs, New Jersey.Google Scholar
Braun, K. L. and Browne, C. V. 1998. Perceptions of dementia, caregiving, and health seeking among Asian and Pacific Islander Americans. Health and Social Work, 23, 4, 262–74.CrossRefGoogle ScholarPubMed
Bryant, L. L., Laditka, J. N., Laditka, S. B. and Mathews, A. E. 2009. Characteristics of the Healthy Brain sample: representing diversity among older Americans. The Gerontologist, 49, supplement 1, S23–9.CrossRefGoogle Scholar
Centers for Disease Control and Prevention and Alzheimer's Association. 2007. The Healthy Brain Initiative: A National Public Health Road Map to Maintaining Cognitive Health. Alzheimer's Association, Chicago.Google Scholar
Chodzko-Zajko, W. J., Proctor, D. N., Fiatarone, M. A., Minson, C. T., Nigg, C. R., Salem, G. J. and Skinner, J. 2009. Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41, 7, 1510–30.CrossRefGoogle ScholarPubMed
Connell, C. M., Roberts, J. S. and McLaughlin, S. J. 2007. Public opinion about Alzheimer's disease among Blacks, Hispanics, and Whites: results from a national survey. Alzheimer's Disease and Associated Disorders, 21, 3, 232–40.CrossRefGoogle ScholarPubMed
Corner, L. and Bond, J. 2004. Being at risk of dementia: fears and anxieties of older adults. Journal of Aging Studies, 18, 145–55.CrossRefGoogle Scholar
Cutler, N., Whitelaw, N. and Beattie, B. 2002. American Perceptions of Aging in the 21st Century: A Myths and Realities of Aging Chart Book. National Council on Aging, Washington DC.Google Scholar
Cutler, S. J. and Hodgson, L. G. 1996. Anticipatory dementia: a link between memory appraisals and concerns about developing Alzheimer's disease. The Gerontologist, 36, 5, 657–64.CrossRefGoogle ScholarPubMed
Dark-Freudeman, A., West, R. L. and Viverito, K. M. 2006. Future selves and aging: older adults' memory fears. Educational Gerontology, 32, 2, 85–109.CrossRefGoogle Scholar
Friedman, D. B., Laditka, J. N., Hunter, R., Ivey, S. L., Wu, B., Laditka, S. B., Tseng, W., Corwin, S. J., Liu, R. and Mathews, A. E. 2009. Getting the message out about cognitive health: a cross-cultural comparison of older adults' media awareness and communication needs on how to maintain a healthy brain. The Gerontologist, 49, supplement 1, S50–60.CrossRefGoogle Scholar
Gaines, A. G. 1989. Alzheimer's disease in the context of black (southern) culture. Health Matrix, 6, 4–8.Google Scholar
Gallassi, R., Bisulli, A., Oppi, F., Poda, R. and Di Felice, C. 2008. Subjective cognitive complaints, neuropsychological performance, affective and behavioural symptoms in non-demented patients. International Journal of Geriatric Psychiatry, 23, 1, 95–101.CrossRefGoogle ScholarPubMed
Glaser, B. G. and Strauss, A. 1967. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine de Gruyter, Chicago.Google Scholar
Glodzik-Sobanska, L., Reisberg, B., De Santi, S., Babb, J. S., Pirraglia, E., Rich, K. E., Brys, M. and de Leon, M. J. 2007. Subjective memory complaints: presence, severity and future outcome in normal older subjects. Dementia and Geriatric Cognitive Disorders, 24, 3, 177–84.CrossRefGoogle ScholarPubMed
Green, L. W. and Kreuter, M. W. 2005. Health Program Planning: An Educational and Ecological Approach. Fourth edition, McGraw Hill, New York.Google Scholar
Hendrie, H. C., Albert, M. S., Butters, M. A., Gao, S., Knopman, D. S., Launer, L. J., Yaffe, K., Cuthbert, B. N., Edwards, E. and Wagster, M. V. 2006. The NIH Cognitive & Emotional Health Project: report of the Critical Evaluation Study Committee. Alzheimer's & Dementia, 2, 1, 12–32.CrossRefGoogle ScholarPubMed
Hinton, L., Franz, C. E., Yeo, G. and Levkoff, S. E. 2005. Concepts of dementia in a multiethnic sample of caregivers. Journal of the American Geriatrics Society, 53, 8, 1405–10.CrossRefGoogle Scholar
Hinton, L., Guo, Z., Hillygus, J. and Levkoff, S. 2000. Working with culture: a qualitative analysis of barriers to the recruitment of Chinese-American family caregivers for dementia research. Journal of Cross Cultural Gerontology, 15, 2, 119–37.CrossRefGoogle Scholar
Jessen, F., Wiese, B., Cvetanovska, G., Fuchs, A., Kaduszkiewicz, H., Kölsch, H., Luck, T., Mösch, E., Pentzek, M., Riedel-Heller, S. G., Werle, J., Weyerer, S., Zimmerman, T., Maier, W. and Bickel, H. 2007. Patterns of subjective memory impairment in the elderly: association with memory performance. Psychological Medicine, 37, 12, 1753–62.CrossRefGoogle ScholarPubMed
Krout, J. A., Cutler, S. J. and Coward, R. T. 1990. Correlates of senior center participation: a national analysis. The Gerontologist, 30, 1, 72–9.CrossRefGoogle ScholarPubMed
Laditka, J. N., Beard, R. L., Bryant, L. L., Fetterman, D., Hunter, R., Ivey, S. L., Logsdon, R. G., Sharkey, J. R. and Wu, B. 2009. Promoting cognitive health: a formative research collaboration of the Healthy Aging Research Network. The Gerontologist, 49, supplement 1, S12–17.CrossRefGoogle Scholar
Laditka, S. B., Corwin, S. J., Laditka, J. N., Friedman, D. B., Liu, R., Mathews, A. E. and Wilcox, S. 2009 a. Methods and management of the Healthy Brain Study: a large multi-site qualitative research project. The Gerontologist, 49, supplement 1, S18–22.CrossRefGoogle Scholar
Laditka, S. B., Corwin, S. J., Laditka, J. N., Liu, R., Tseng, W., Wu, B., Beard, R. L., Sharkey, J. R. and Ivey, S. L. 2009 b. Attitudes about aging well among a diverse group of older Americans: implications for promoting cognitive health. The Gerontologist, 49, supplement 1, S30–9.CrossRefGoogle ScholarPubMed
Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick-Miller, L. and Roitaille, C. 1997. Illness representations: theoretical foundations. In Petrie, K. J. and Weinman, J. A. (eds), Perceptions of Health and Illness: Current Research and Applications. Harwood Academic Publishers, Reading, UK, 77–102.Google Scholar
Leventhal, H. and Crouch, M. 1997. Are there differences in perceptions of illness across the lifespan? In Petrie, K. J. and Weinman, J. A. (eds), Perceptions of Health and Illness: Current Research and Applications. Harwood Academic Publishers, Reading, UK, 19–76.Google Scholar
Low, L. F. and Anstey, K. J. 2009. Dementia literacy: recognition and beliefs on dementia of the Australian public. Alzheimer's and Dementia, 5, 43–9.CrossRefGoogle ScholarPubMed
Matsubayashi, K., Ishine, M., Wada, T., Ishimoto, Y., Hirosaki, M., Kasahara, Y., Kimura, Y., Konno, A., Nakatsuka, M., Sakamoto, R., Fujisawa, M., Okumiya, K. and Otsuka, K. 2009. Changing attitudes of elderly Japanese toward disease. Journal of the American Geriatrics Society, 57, 9, 1732–3.CrossRefGoogle ScholarPubMed
MetLife Foundation. 2006. Americans Fear Alzheimer's More Than Heart Disease, Diabetes, or Stroke, But Few Prepare. MetLife Foundation, New York.Google Scholar
Muhr, T. and Friese, S. 2004. User's Manual for ATLAS.ti 5.0. ATLAS.ti Scientific Software Development, Berlin.Google Scholar
National Council on Aging. 2010. Senior centers. Available online at http://www.ncoa.org/strengthening-community-organizations/senior-centers/ [Accessed 29 July 2010].Google Scholar
Painter, J. E., Borba, P. C., Hynes, M., Mays, D. and Glanz, K. 2008. The use of theory in health behavior research from 2000 to 2005: a systematic review. Annals of Behavioral Medicine, 25, 358–62.CrossRefGoogle Scholar
Plassman, B. L., Langa, K. M., Fisher, G. G., Herringa, S. G., Weir, D. R., Ofstedal, M. B., Burke, J. R., Hurd, M. D., Potter, G. G., Rodgers, W. L., Steffens, D. C., Willis, R. J. and Wallace, R. B. 2007. Prevalence of dementia in the United States: the Aging, Demographics, & Memory Study. Neuroepidemiology, 29, 125–32.CrossRefGoogle ScholarPubMed
Prochaska, J. O. and Velicer, W. F. 1997. The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 1, 38–48.CrossRefGoogle ScholarPubMed
Rabins, P. V. 2007. Do we know enough to begin prevention intervention for dementia? Alzheimer's & Dementia, 3, supplement 1, S86–8.CrossRefGoogle ScholarPubMed
Rimmer, E., Wojciechowska, M., Stave, C., Sgnanga, A. and O'Connell, B. 2005. Implications of the Facing Dementia Survey for the general population, patients and caregivers across Europe. International Journal of Clinical Practice, 146, 17–24.CrossRefGoogle Scholar
Roberts, J. S., Connell, C. M., Cisewski, D., Hipps, Y. G., Demissie, S. and Green, R. C. 2003. Differences between African Americans and Whites in their perceptions of Alzheimer's disease. Alzheimer's Disease and Associated Disorders, 17, 1, 19–26.CrossRefGoogle Scholar
Rosenstock, I. 1974. Historical origins of the Health Belief Model. Health Education Monographs, 2, 4.Google Scholar
Strauss, A. C. and Corbin, J. 1998. Basics of qualitative research. Second edition, Sage, Thousand Oaks, California.Google Scholar
Unverzagt, F. W., Gao, S., Baiyewu, O., Ogunniyi, A. O., Gureje, O., Perkins, A., Emsley, C. L., Dickens, J., Evans, R., Musick, B., Hall, K. S., Hui, S. L. and Hendrie, H. C. 2001. Prevalence of cognitive impairment: data from the Indianapolis Study of Health and Aging. Neurology, 57, 9, 1655–62.CrossRefGoogle ScholarPubMed
US Census Bureau 2010. Current Population Survey. HINC-02: Age of Householder – Households, by Total Money Income in 2007. US Census Bureau, Washington DC. Available online at http://www.census.gov/hhes/www/macro/032008/hhinc/new02_001.htm [Accessed 7 August 2010].Google Scholar
van Uffelen, J. G., Chin, A.Paw, M. J., Hopman-Rock, M. and van Mechelen, W. 2009. The effects of exercise on cognition in older adults with and without cognitive decline: a systematic review. Clinical Journal of Sport Medicine, 18, 6, 486–500.CrossRefGoogle Scholar
Welch, D. C. and West, R. L. 1995. Self-efficacy and mastery: its application to issues of environmental control, cognition, and aging. Developmental Review, 15, 150–71.CrossRefGoogle Scholar
Wilcox, S., Sharkey, J. R., Mathews, A. E., Laditka, J. N., Laditka, S. B., Logsdon, R. G., Sahyoun, N., Robare, J. F. and Liu, R. 2009. Perceptions and beliefs about the role of physical activity and nutrition on brain health in older adults. The Gerontologist, 49, supplement 1, S61–71.CrossRefGoogle Scholar
World Health Organization 2004. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363, 157–63.CrossRefGoogle Scholar
Wu, B., Goins, R. T., Laditka, J. N., Ignatenko, V. and Goedereis, E. 2009. Gender differences in views about cognitive health and healthy lifestyle behaviors among rural older adults. The Gerontologist, 49, supplement 1, S72–8.CrossRefGoogle ScholarPubMed