The cultural influence of values, norms, meanings and perceptions in understanding dementia in ethnic minorities Dilworth–Anderson, Peggy; Gibson Brent E. Information for Authors Alzheimer Disease & Associated Disorders Abstract The study of issues related to culture and ethnicity in Alzheimer's disease is still incomplete. This article focuses on the insufficient research that has been done to determine how culture influences caregiving for older people with dementia. It is important to consider how cultural norms and values influence the meanings that different ethnic groups give to dementia. Family caregiving and help-seeking are affected by meanings that family members assign. This area needs more research. Researchers and practitioners can also benefit Alzheimer patients and caregivers by including cultural and social information from diverse groups in their research and practice models.
Different societies and cultures have different perceptions of old age. In Western societies, the loss and multiple functions that are lost and the inability to create a social stigma result in the loss of youth. No matter what their ethnicity, dementia is common in the elderly. The cognitive domain has always been considered more important than other mental domains in countries that are dominated by Western philosophy. Understanding cultural factors is crucial to understanding aging and dementia. Current biomedical models, which focus only on the individual and disregard the sociocultural context, dominate current research. Aim: This study aims to examine how dementia is perceived by ethnically diverse groups in different cultures. Methods: Google Scholar and Medline searches were performed for articles, chapters, or books that were published prior to 2014. The search terms included anthropology and culture as well as the elderly and dementia. This indexed search was used to find publications that could be used as a reference. Results: Although dementia can be experienced at any age, it is a condition that is often inherited from the culture where the person is living. Many countries are still unable to identify the sociocultural factors that cause dementia. Conclusion: The sociocultural concept of Alzheimer's disease is a growing interest in interpreting the symptoms of dementia. These complex chronic conditions can be managed more effectively if culture and dementia are merged. Social interaction is based on the ability to comprehend other people's mental states. This includes desires, beliefs, and intentions. The dysfunction of this system is believed to be responsible for the interpersonal difficulties experienced by patients with frontotemporal dementia (FTD) behavioral variants. To assess theory-of-mind reasoning in patients with FTD, we used first-order and second-order false belief tasks. We also used cognitively matched patients with Alzheimer's disease (AD) to compare the results. In the cognitively demanding second-order false-belief tasks, both patient groups performed equally poorly relative to healthy elderly. This shows that cognitive demands play a significant role in false-belief task performance. Despite the stark differences in their social graces, both patient groups achieved ceiling performance in first-order false belief tasks with minimal cognitive demands. These results indicate that AD and FTD-b do not have a conceptual deficit in mind (as measured by false-belief tasks). This study investigated the relationship between the Family Pictures (FP subtest) of the Wechsler Memory Scale III (WMS III) and verbal memory measures. Patients with epilepsy who had temporal surgery did not experience a significant change in their FP scores from before to after surgery. However, postoperative FP performance was less good for those who had right temporal lobectomy than those who had left temporal lobectomy. The logical Memory subtest of the WMS-III was the strongest predictor of FP. The results suggest that FP measures verbal and visual memories and is sensitive to lateralization. According to the neurodevelopmental model, neurocognitive disorders are core characteristics of schizophrenia spectrum disorder. This study examined the neurocognitive performance in high-risk patients and participants who were symptomatically diagnosed with schizophrenia. It also included first-episode patients. The tests were for verbal memory, executive function, working memory, and attention. The study included 54 schizophrenia-prone participants and 37 first-episode patients. Comparing normative data, the high-risk group had a similar cognitive performance profile as the first episode participants. Both patient groups had neurocognitive functioning that was in line with the norm for most cognitive domains. The average intellectual functioning in both patient groups was higher than the other. However, there were lower "hit rates" for both the Continuous Performance Test-Identical Pairs Versions (CPT-IP), subtests "Figures", and "Symbols" in the first episode group. Comparing the clinical groups revealed that first-episode participants had more impairments in these parameters than high-risk patients. The results show that high-risk patients perform at an average level of neurocognitive performance in all domains tested, compared to normative data. Attention abilities were lower than norm values in first-episode patients.
Animal and human studies have shown that systemic inflammation (inflammation occurring outside of the central nervous systems) can play a critical role in neurodegeneration, Alzheimer’s disease pathology, cognitive decline, and neurodegeneration in older adults. The presence of elevated blood levels of proinflammatory cytokines or chemokines in the blood can be caused by infections, chronic diseases, stress, physical and psychological traumas, as well as other factors such as subclinical processes like cellular senescence. The body's pro-inflammatory cytokines can cause a pro-inflammatory environment within the central nervous system. They do this by crossing the blood-brain barrier, signaling via endothelial cells and circumventricular organs, as well as stimulating the vagus nerve which stimulates the detection of inflammatory protein via direct afferent connections to a brain stem. Through each of these routes, systemic inflammation is believed to induce reactive, proinflammatory microglia and astrocytic phenotypes which can promote tau hyperphosphorylation, b-amyloid oligomerization, complement activation, and the breakdown of neurotransmitters into potentially harmful bioactive metabolites. These molecular changes can trigger or worsen neurodegenerative processes in older people, which could eventually lead to cognitive decline and dementia.
Sources:
https://pubmed.ncbi.nlm.nih.gov/18686116/
https://eurekamag.com/research/053/203/053203074.php
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