Kota Karthik J, Dawson Alice, Papas Julia, Sotelo Victor, Su Guibin, Li Mei-Ling, Lee Woowon, Estervil Jaunis, Marquez Melissa, Sarkar Shromona, Lopez Lisa Lanza, Hu William T
Departments of Neurology Institute for Health, Health Care Policy, and Aging Research Rutgers Biomedical and Health Sciences New Brunswick New Jersey USA.
Departments of Medicine Rutgers-Robert Wood Johnson Medical School Institute for Health, Health Care Policy, and Aging Research Rutgers Biomedical and Health Sciences New Brunswick New Jersey USA.
Alzheimers Dement (N Y). 2024 Feb 9;10(1):e12449. doi: 10.1002/trc2.12449. eCollection 2024 Jan-Mar.
South Asian (SA) and East Asian (EA) older adults represent the fastest-growing racial/ethnic groups of Americans at risk for dementia. While recruiting older SA adults into a brain health study, we encountered unexpected hesitancy toward structural brain magnetic resonance imaging (MRI) analysis and stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as personal MRI experience, perceived MRI safety, and concerns for personal risk for future dementia/stroke.
We developed a brief cross-sectional survey to assess older adults' MRI experiences and perceptions, desire to learn of six incidental findings of increasing impact on health, and attitudes related to dementia (including LoC) and research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey (offered in English, Chinese, Korean, and Spanish) and modeled the proportional odds (PO) for favorable attitudes toward research activities.
Seventy-seven SA and 84 EA respondents were analyzed alongside 95 White, Black, or Hispanic adults. White (PO = 2.54, = 0.013) and EA (PO = 2.14, = 0.019) respondents were both more likely than SA respondents to endorse healthy volunteers' participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents ( = 0.006) but still shared SA respondents' lower wish (measured by proportion of total) to learn of incidental MRI findings.
SA-and EA compared to SA-older adults had low desire to learn of incidental MRI findings but had different attitudes toward future dementia/stroke risks. A culturally appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research.
Older Asian Americans have limited interest in incidental findings on research MRISouth Asians are most likely to attribute dementia to people's own behaviorsSouth Asians' attitudes mediate lower support for healthy volunteers in researchSouth and East Asians differ in dementia worries and research-related attitudes.
南亚裔（SA）和东亚裔（EA）老年人是美国痴呆症风险增长最快的种族/族裔群体。在招募老年南亚裔成年人参与一项脑健康研究时，我们意外发现他们对脑部结构磁共振成像（MRI）分析存在犹豫态度，以及对未来痴呆症风险的内控点（LoC）存在污名化态度。我们推测，对MRI相关研究的支持受到这些态度以及个人MRI体验、感知到的MRI安全性和对未来痴呆症/中风个人风险的担忧的影响。
我们开展了一项简短的横断面调查，以评估老年人的MRI体验和认知、了解六项对健康影响日益增加的偶然发现的意愿，以及与痴呆症（包括LoC）和研究参与相关的态度。我们从新泽西州/纽约市地区招募了256名受访者（74%报告年龄在50岁以上）的便利样本，以完成该调查（提供英文、中文、韩文和西班牙文版本），并对研究活动的积极态度建立比例优势（PO）模型。
对77名南亚裔和84名东亚裔受访者以及95名白人、黑人或西班牙裔成年人进行了分析。白人（PO = 2.54，P = 0.013）和东亚裔（PO = 2.14，P = 0.019）受访者比南亚裔受访者更有可能支持健康志愿者参与研究，白人受访者和南亚裔受访者之间的差异由后者对痴呆症风险更强的内控点所介导。东亚裔受访者比南亚裔受访者更担心未来的痴呆症/中风（P = 0.006），但在了解MRI偶然发现的意愿（以总数的比例衡量）上仍与南亚裔受访者相当。
与南亚裔老年人相比，东亚裔老年人对了解MRI偶然发现的意愿较低，但对未来痴呆症/中风风险的态度不同。一种符合文化习惯的披露MRI偶然发现的方案可能会提高南亚裔和东亚裔参与脑健康研究的程度。
美国亚裔老年人对研究MRI的偶然发现兴趣有限
南亚裔最有可能将痴呆症归因于人们自己的行为
南亚裔的态度导致对健康志愿者参与研究的支持较低
南亚裔和东亚裔在痴呆症担忧和研究相关态度上存在差异
