Culture-fair behavioral symptom differential assessment and intervention in dementing illness

Ethnically diverse populations are not represented in the dementia-related noncognitive behavioral symptom research arena. Some of the obstacles are structural, centering around the lack of inclusion of ethnic minority groups within existing projects. These impediments are surmountable by the systematic targeting and incorporation of ethically diverse populations in research and the deployment of a variety of research-related outreach approaches. The more formidable barriers are conceptual. They relate to the need to differentiate cultural factors from socioeconomic and social status (SES) artifacts and to include life-long exposure to various forms of prejudice and discrimination, all of which can come together in the late-life manifestation of behavioral symptoms. A culture-fair behavioral assessment and intervention model is presented. It allows researcher and clinician alike access to ethnocultural data, while differentiating SES influences. A comparative Hispanic/Anglo dementia caregiver pilot study has provided a partial test of the model with statistically significant outcomes. Two-tailed t tests (p < or = 0.05) uncovered ethnic group differences with respect to four specific dimensions of caregiving. The differences were demonstrated around reactivity to caregiving burden, caregiver health status, coping and helpseeking styles, and configuration of social support received from social network members. Further multiple regression analysis sustained the observed differences despite income, education, and mean age variance between the two ethnic groups. The model has an overall multicultural applied intent. More study is indicated.