Bridging Disciplinary Boundaries (January 11 - 14, 2007)

The purpose of the study is (1) to provide detailed documentation about current status of knowledge and perceptions about Alzheimer's Disease (AD) among Korean immigrants, (2) to examine factors affecting those knowledge and perceptions; and (3) to provide useful information for developing culturally tailored educational and preventive intervention strategies for future AD caregivers. Using self-administered questionnaire, data was collected from 209 middle-aged and elder first generation Korean Americans residing in Los Angeles County. AD knowledge was assessed by 5 subscales about factual knowledge, symptoms, risk and protective factors, diagnosis and treatment. AD perception was assessed by 5 subscales about cause, treatment, prevention, controllability, and consequences. In addition, knowledge about community services, exposure to persons with AD and AD caregivers, concern about developing AD and other illnesses, acculturation and background characteristics were measured. Results show that Korean immigrants have significant misconceptions about AD: 84% thought that memory loss and associated behaviors are normal consequences of aging; 66% reported that AD is a form of insanity; and 60% believed that forgetfulness in old age indicates beginning of AD.Most Korean immigrants (69% to 79%) in the sample well recognized symptoms related to cognitive impairment, including judgment problems, disorientation, and repeating questions. However, they missed common middle stage symptoms and less than half recognized symptoms such as anger, suspicion, violent behavior, inappropriate sexual behavior, and hallucination. There was serious lack of knowledge about medication for AD: 64% did not know the existence of medication to delay progression of AD and only half knew about available medication to control behavioral symptoms. Korean immigrants interpreted AD as more of personal issues rather than medical condition: 75% thought that living alone in old age is a possible cause of AD; 61% for introvert or passive personality; 65% for having unresolved personal/family conflicts; and 44% for environmental changes due to immigration. Structural equation analyses suggest that females who have more education, do not have chronic illness, are more acculturated, are more exposed to persons with AD and caregivers, and are more informed about community services have higher level of AD knowledge than their counterparts; those who are more concerned about developing AD and other illnesses and more knowledgeable about AD perceive more possible causes of AD; and elders who are more exposed to persons with AD and caregivers and perceive more causes of AD are more positive toward AD treatment. Acculturation plays as a mediator between education and AD knowledge and exposure to AD mediates relationship between social network and community services knowledge. Following implications will be discussed: (1) a great need of public education for Korean immigrants to increase knowledge about AD, its unknown causes, symptoms by stage, and available treatment; (2) the importance of cultural understanding of the disease in therapeutic relationships with elder clients and their families; and (3) development of targeted educational and intervention strategies that accommodate differing persons' AD knowledge levels and perceptions.