Assessment and diagnosis of dementia in Hispanic and non-Hispanic white outpatients

Sayegh, Philip and Knight, Bob G. (2013) Assessment and diagnosis of dementia in Hispanic and non-Hispanic white outpatients. The Gerontologist, 53 (5). pp. 760-769. ISSN 0016-9013


Purpose: We examined whether (a) neuropsychological test performance (NP) or (b) informant reports of patients’ functional abilities or (c) behavioral and psychological symptoms (BPS) predicted dementia diagnoses to different degrees among Hispanic and non-Hispanic Whites (NHWs).

Design and Methods: Our sample included 444 Hispanic and 444 (randomly selected from 11,081) NHW outpatients diagnosed with normal cognition or dementia at their initial evaluations. We tested for significant ethnic-group differences in dementia diagnosis predictors using NP and the 2 informant reports, covarying for age, sex, and education.

Results: When using ethnic group–specific norms, NP and functional abilities predicted diagnosis in both groups with no significant differences but BPS was only significant in Hispanics. When using combined ethnic group norms, the only major difference was that BPS approached but did not meet statistical significance in Hispanics.

Implications: Clinicians may be aware of the limitations of NP and may thus be informally adjusting their overall impressions of patients’ NP among Hispanics and weighing certain tests differentially across ethnic groups when assessing dementia. Though these approaches may be aimed at reducing misdiagnosis, their effectiveness is questionable and they may be driving systematic differences in diagnosis within and across ethnicities. In addition, informant-reported functional abilities may be less sensitive to ethnicity-related influences and represent an important, ethnically neutral area in dementia assessment. The predictive value of informant-reported BPS in the diagnostic process across ethnic groups warrants further attention.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Permanent restricted access to Published version due to publisher's copyright policy.
Faculty/School / Institute/Centre: Historic - Faculty of Sciences - Department of Psychology
Date Deposited: 11 Jan 2016 23:50
Last Modified: 13 Feb 2017 06:23
Uncontrolled Keywords: ethnicity; Latino/a; neuropsychology; functional Assessment questionnaire; neuropsychiatric inventory questionnaire
Fields of Research : 11 Medical and Health Sciences > 1103 Clinical Sciences > 110308 Geriatrics and Gerontology
Socio-Economic Objective: E Expanding Knowledge > 97 Expanding Knowledge > 970117 Expanding Knowledge in Psychology and Cognitive Sciences
C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920503 Health Related to Specific Ethnic Groups
Identification Number or DOI: 10.1093/geront/gns190

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