Robert Stewart, M.D.
Institute of Psychiatry
London, England

2003 Investigator-Initiated Research Grant

Assessment tools for diagnosing Alzheimer’s disease were developed in patient populations made up primarily of middle-class European Americans or Europeans. An area of particular need in dementia research is to validate these assessment tools or determine appropriate norms with these tools among individuals from various cultural and ethnic backgrounds.

African Caribbean populations have a high prevalence of stroke, high blood pressure, and diabetes—factors that may be associated with an increased risk of developing dementia. This presents a challenge for Caribbean nations and immigrant communities in the United States, Canada, and the United Kingdom. There is a pressing need for population research but a lack of culturally valid instruments to detect cognitive impairment.

The proposed study will recruit Caribbean-born people, age 65 and older, at sites in Barbados, Tobago, London, and Toronto. Fifty people with dementia and 100 people with normal cognitive skills will be recruited at each site. Interviews will be carried out with participants and a close friend or relative using research instruments that have been widely used internationally. This study will investigate how well these various instruments identify people with dementia and will establish normal ranges of assessment scores in control groups. A further objective will be to describe and compare the caregiving experiences and the extent to which they are influenced by behavioral symptoms and prevailing attitudes about dementia and caregiving.