Cultural competency critical in elder care

The need to address disparities in treatment and diagnosis of Alzheimer's and other age-related diseases increases as the percentage of minorities in the elderly population increases.

By Victoria Stagg Elliott, AMNews staff. Aug. 6, 2001.

When Maureen T. Sturman, MD, assesses the patients who come to her clinic for signs of Alzheimer's or other forms of dementia, she is able to test them not just in Spanish but in the specific dialect they speak -- something she considers crucial for an accurate evaluation.

Translators are available not just for the most common languages spoken in her area, such as Polish and Chinese, but for many other Asian, European and African languages.

There are important reasons for such accommodations.

"If it's a family member translating for the neuropsych test, they may unintentionally assist on the patient's behalf," she said.

It's all part of an emerging awareness of the role cultural difference can play in recognizing Alzheimer's. While administering the tests, for instance, Dr. Sturman uses a computer program that adjusts the scores for the patient's educational level. She has also had to learn the different ways ethnic groups will interpret and present their symptoms.

As the director of the one-year-old memory assessment clinic run by Cook County Hospital in Chicago, these are the kinds of steps she has had to take for her predominantly African-American and Latino patients. She is part of a growing movement of health care workers who are starting to deal with the aging of America, the expected increase in age-related illnesses, and also the increasingly multi-ethnic nature of this elderly patient population.

Minorities now make up 16% of those over the age of 65. By 2050, a quarter of all elderly will be members of minority groups, according to Ramón Valle, PhD, professor emeritus at San Diego State University's School of Social Work. The life expectancies of minorities will also catch up with Caucasians, with the average Latino living to 87 and Asian- American to 86. In addition, research suggests Latinos and African-Americans may be more susceptible to Alzheimer's, although actual prevalence among minorities is unknown. [...]