Ageing and Society

Articles

How do older people describe others with cognitive impairment? A multiethnic study in the United States

SARAH B. LADITKAa1 c1, JAMES N. LADITKAa1, RUI LIUa2, ANNA E. PRICEa3, DANIELA B. FRIEDMANa4, BEI WUa5, LUCINDA L. BRYANTa6, SARA J. CORWINa4 and SUSAN L. IVEYa7

a1 Department of Public Health Sciences, University of North Carolina at Charlotte, NC, USA.

a2 Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.

a3 Department of Physical Therapy and Human Movement Sciences, Sacred Heart University, Fairfield, CT, USA.

a4 Department of Health Promotion, Education, and Behaviour, University of South Carolina, Columbia, SC, USA.

a5 School of Nursing, Duke University, Durham, NC, USA.

a6 Department of Community and Behavioural Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA.

a7 Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, CA, USA.

ABSTRACT

We studied how older people describe others with cognitive impairment. Forty-two focus groups represented African Americans, American Indians, Chinese Americans, Latinos, Vietnamese Americans, and Whites other than Latinos (Whites) (N = 396, ages 50+), in nine locations in the United States of America. Axial coding connected categories and identified themes. The constant comparison method compared themes across ethnic groups. African Americans, American Indians and Whites emphasised memory loss. African Americans, American Indians, Latinos and Whites stressed withdrawal, isolation and repetitive speech. African Americans, American Indians, Vietnamese Americans and Whites emphasised ‘slow thinking’. Only Whites described mood swings and personality changes. Many participants attributed dementia to stress. Terms describing others with dementia included ‘Alzheimer's’, ‘dementia’, ‘senile’ and ‘crazy’. Euphemisms were common (‘senior moment’, ‘old timer's disease’). Responses focused on memory, with limited mention of other cognitive functions. Differences among ethnic groups in descriptions of cognitive health and cognitive impairment underscore the need to tailor public health messages about cognitive health to ways that people construe its loss, and to their interest in maintaining it, so that messages and terms used are familiar, understandable and relevant to the groups for which they are designed. Health promotion efforts should develop ethnically sensitive ways to address the widely held misperception that even serious cognitive impairment is a normal characteristic of ageing and also to address stigma associated with cognitive impairment.

(Accepted November 28 2011)

(Online publication January 03 2012)

KEY WORDS

  • Alzheimer's disease;
  • brain health;
  • cognition;
  • dementia;
  • focus groups;
  • memory;
  • qualitative research;
  • senility

Correspondence:

c1 Address for correspondence: Sarah B. Laditka, Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA. E-mail: sladitka@uncc.edu