Chow T W, Ross L, Fox P, Cummings J L, Lin K M
Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA.
Int J Geriatr Psychiatry. 2000 Sep;15(9):838-47. doi: 10.1002/1099-1166(200009)15:9<838::aid-gps209>3.0.co;2-u.
Alzheimer's disease is as prevalent among Asian ethnic minority groups as among Caucasians. We explored Asian groups' utilization of available Alzheimer's disease services in California, using a uniquely large sample of Asian-Americans. The Minimum Uniform Dataset includes data from nine California Alzheimer's Disease Diagnostic and Treatment Centers. Of the 9,451 cases included in the Minimum Utilizable Dataset, 4.2% were Asian (primarily Chinese), 0.8% Filipino, 0.3% Pacific Islander, and 75.9% Caucasian. In comparison to their numbers within the nine California countries served, Asian ethnic elders were underrepresented in enrollment by approximately 50%, except at one center where all staff were bilingual. The centers referred a significantly greater proportion of Asian than Caucasian patients for financial help (47.8 vs. 7.4%, P < 0.001), case management (47.8 vs. 22.3%, P < 0.001), and to Alzheimer's disease day care (41.3 vs. 28.4%, P < 0.05). A significantly greater proportion of Asian caregivers received referrals to caregiver resource centers (32.6 vs. 61.3%, P < 0.001) and financial help (29.6 vs. 4.7%, P < 0.001). A smaller proportion of Asian patients received referrals to home health services than Caucasians (4.3 vs. 14.9%, P < 0.05). Filipino patients were also referred more frequently to financial assistance than Caucasians (P < 0.05). Asians and Pacific Islanders under-enroll at centers specializing in AD care. Bilingual staff at centers specializing in dementia care, training for community physicians who treat these patients, and establishment of caregiver support groups within Asian and Pacific Islander communities may enhance the enrollment of these elders. AD care centers in areas supporting Asian and Filipino families may need to concentrate resources on providing financial assistance in case management.
阿尔茨海默病在亚裔少数族裔群体中的患病率与白人群体相当。我们利用一个规模独特的亚裔美国人样本,探讨了加利福尼亚州亚裔群体对现有阿尔茨海默病服务的利用情况。最低统一数据集包含来自加利福尼亚州九个阿尔茨海默病诊断和治疗中心的数据。在最低可用数据集中的9451个病例中,4.2%为亚裔(主要是华裔),0.8%为菲律宾裔,0.3%为太平洋岛民,75.9%为白人。与在加利福尼亚州九个服务地区的人数相比,亚裔老年患者在登记人数中的占比少了约50%,但在一个所有工作人员都具备双语能力的中心除外。这些中心将亚裔患者转介寻求经济帮助(47.8%对7.4%,P<0.001)、病例管理(47.8%对22.3%,P<0.001)以及阿尔茨海默病日托服务(41.3%对28.4%,P<0.05)的比例显著高于白人患者。接受转介到照顾者资源中心(32.6%对61.3%,P<0.001)和经济帮助(29.6%对4.7%,P<0.001)的亚裔照顾者比例明显更高。与白人相比,接受转介到家庭健康服务的亚裔患者比例更小(4.3%对14.9%,P<0.05)。菲律宾裔患者被转介寻求经济援助的频率也高于白人(P<0.05)。亚裔和太平洋岛民在专门从事阿尔茨海默病护理的中心登记人数不足。专门从事痴呆症护理的中心配备双语工作人员、对治疗这些患者的社区医生进行培训,以及在亚裔和太平洋岛民社区建立照顾者支持小组,可能会增加这些老年患者的登记人数。在支持亚裔和菲律宾裔家庭的地区,阿尔茨海默病护理中心可能需要集中资源提供病例管理方面的经济援助。