Despite a higher prevalence of dementia, ethnic minority elders in the U.S. are underdiagnosed and at greater risk of not receiving appropriate care than their white counterparts. Early detection of dementia allows for a transition to early dementia care for community-dwelling elderly that may delay or slow deterioration of cognitive functions and functional disabilities and enable families to adequately plan for the potential challenges of dementia caregiving. Currently, little is known about how to effectively identify undiagnosed individuals with probable dementia in community-based settings that serve diverse racial and ethnic minorities and how to transition them into the health care system for necessary diagnostic follow-up and care for dementia. This proposed research addresses the critical gaps by focusing on dementia assessments and follow-up in one of the fastest-growing ethnic minority populations?Korean Americans (KAs). Our collaborative, interdisciplinary research team has more than 10 years of community-based, participatory research experience in the KA community and has laid the groundwork for the current application. In particular, we have conducted the first community-based epidemiological study which estimated the prevalence of dementia among KA elders. Moreover, we successfully trained bilingual community health workers (CHWs) and obtained evidence to support the feasibility and efficacy of using CHWs to assess dementia in community- residing Korean elders and promote linkage to medical service for dementia among KA elders with probable dementia while improving caregiver psychological outcomes. To this end, the goals of our study are to identify community-residing Korean elderly with probable dementia and to test the effects of dementia literacy training and navigation assistance by CHWs to transition affected Korean elders and their caregivers into the healthcare system for adequate diagnostic follow-up and care. CHWs have been used to eliminate health disparities in resource-poor communities with positive outcomes. The adoption of trained CHWs for cognitive health is a new strategic approach which could be highly applicable to many linguistic and/or socially-isolated racial/ethnic minority communities with limited resources.
Early detection of dementia allows for a transition to early dementia care that may delay or slow deterioration of cognitive functions and functional disabilities and enable families to adequately plan for the potential challenges of dementia caregiving. Currently, little is known about how to effectively evaluate and screen undiagnosed individuals with probable dementia in community-based settings that serve diverse racial/ethnic minorities and how to transition them into the healthcare system for necessary diagnostic follow-up and care for dementia. Using Korean Americans as an example, we propose to test trained community health workers as an effective and sustainable approach for early detection of dementia and care in racial/ethnic minority communities with limited resources.
