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Cross Cultural abstracts and tables:

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1.  A Long-Range Innovative Approach To Reducing Health Disparities: The National Institute On Aging’s Resource Centers For Minority Aging Research
2.  Assessing Cross-Cultural Comparability In Mental Health Among Older Adults
3.  Cross-Cultural Assessment Of Geriatric Depression: A Review Of The CES-D And The GDS
4.  Item Bias In Cognitive Screening Measures: Comparisons Of Elderly White, Afro-American, Hispanic And High And Low Education Subgroups
5.  Operating Characteristics Of Brief Screens For Dementia In A Multicultural Population  
6.  Relative Rates Of Dementia By Multiple Case Definitions, Over Two Prevalence Periods, In Three Sociocultural Groups
7.  Screening Scales For Dementia: Toward Reconciliation Of Conflicting Cross-Cultural Findings  

Journal of Mental Health and Aging, Vol. 7, No. 1, 2001

 A Long-Range Innovative Approach To Reducing Health Disparities: The National Institute On Aging’s Resource Centers For Minority Aging Research

Sidney M. Stahl, PhD

Abstract:  

The health status of racial and ethnic groups in the U.S. has improved steadily over the last several decades.  At the same time, however, health disparities between minority and non-minority groups have increased.  As part of its mission to improve the health of older Americans, the National Institute on Aging (NIA) is committed to reducing this minority/non-minority differential and its social sequelae.  Both the NIA Strategic Plan and the NIA Health Disparities Strategic Plan commit the Institute to reducing health disparities among older persons and to enhancing resources to support high-quality research by training and attracting a diverse work force.  To these ends, NIA focuses research and training directly on identifying the determinants of health disparities and designing interventions to minimize these disparities.  Disparity reduction is a long-term and multidisciplinary activity.  Therefore, NIA initiated a program to reinforce the scientific infrastructure addressing health promotion, disease and disability prevention, the management of disease, and access to services for minority aging populations.  NIA, with participation from the National Institute of Health’s Office of Research on Minority Health and the National Institute of Nursing Research, funds six Resource Centers for Minority Aging Research (RCMAR).  The Appendix lists RCMAR locations and investigators.  These Centers address social science, clinical, methodological, and health services research issues among the largest minority groups throughout the U.S.

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Journal of Mental Health and Aging, Vol. 7, No. 1, 2001

Assessing Cross-Cultural Comparability In Mental Health Among Older Adults

Jersey Liang, PhD

Abstract:  

This article provides a brief review of the implications of cultural differences in mental health assessment.  Issues of comparability in mental health across different ethnic, racial, and cultural groups will be examined within the framework of factorial invariance.  In particular, comparability is conceptualized as a continuum involving increasingly restrictive assumptions such as conceptual, metric, and structural equivalence.  Emphases will be placed on the application of structural equation modeling (SEM) in addressing analytical issues related to cross-cultural comparability.

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Journal of Mental Health and Aging, Vol. 7, No. 1, 2001

Cross-Cultural Assessment Of Geriatric Depression: A Review Of The CES-D And The GDS .

Ada C. Mui, PhD

Denise Burnette, PhD

Li Mei Chen, MSW

Abstract:  

This article reviews published studies on the utility and psychometric properties of the two most widely used screening instruments for depressive symptomatology among older populations, the Center for Epidemiological Studies-Depression Scale (CES-D) and the Geriatric Depression Scale (GDS).  Studies on the CES-D confirms its usefulness for measuring depression in diverse groups of older adults, however, further research examining criterion validity among different cultural groups is needed.  Sociocultural and health-related factors appeared to influence differential patterns of item endorsement and factor structures of the CES-D in these studies.  The composition and hierarchy of factors varied: the well-being factor was consistently problematic in non-Western cultures, two rather than four factors were a better fit for data on Hispanic elders, the interpersonal problem factor was most salient for African Americans, and depressed affect and somatic factors were conflated for American Indians. Research on the psychometric properties of the GDS suggests that without alterations it may not be sufficiently valid for use in other cultures. 

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Journal of Clinical Epidemiology, 1995, Vol. 48, No. 4, pp. 473-483

 Item Bias In Cognitive Screening Measures: Comparisons Of Elderly White, Afro-American, Hispanic And High And Low Education Subgroups

 Jeanne A. Teresi

Robert R. Golden

Peter Cross

Barry Gurland

Marjorie Kleinman

David Wilder

Abstract:  

 A study of item bias in standard cognitive screening measures was conducted in a sample of Afro-American, Hispanic and non-Hispanic white elderly respondents who were part of a dementia case registry study. The methods of item-response theory were applied to identify biased items.  Both cross-cultural and high and low education groups were examined to determine which items were biased.  Out of 50 cognitive items examined from six widely used cognitive screening measures, 16 were identified as biased for either high and low education groups or ethnic/racial group membership. [PUBLICATION ABSTRACT]

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The American Journal of Geriatric Psychiatry, 1995,  Vol. 3, No. 2, pp. 96-107

 Operating Characteristics Of Brief Screens For Dementia In A Multicultural Population

 David Wilder, Ph.D.

Peter Cross, M. Phil.

Jiming Chen, Ph.D.

Barry Gurland, M.D.

Rafael A. Lantigua, M.D.

Jeanne Teresi, Ph.D.

Mabel Bolivar, B.A.

Priscilla Encarnacion, B.A.

Abstract:   

Operating characteristics of seven screens for dementia were compared across various groups for 795 persons who had received a criterion diagnostic evaluation.  Area under the curve (AUC), based on receiver operating characteristics, was compared between and within scales as an indication of their efficiency.  Differences in AUC were only 5% across all the scales for the entire sample, but increased to 11% across sociocultural groups and scales and to 20% across education groups and scales.  Two scales (the Mini-Mental State Exam and the Short Portable Mental Status Questionnaire) misclassified most nondementias for the entire sample, and all scales misclassified most nondementias among persons with less than 5 years of education. Findings could support a recommendation that certain shorter scales be used because they perform as well as longer ones, are more consistent across cultural and educational groups, and can be more easily modified to improve performance in culturally diverse populations. [PUBLICATION ABSTRACT]

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The American Journal of Geriatric Psychiatry, 1995, Vol. 3, No. 1, pp.6-20

 Relative Rates Of Dementia By Multiple Case Definitions, Over Two Prevalence Periods, In Three Sociocultural Groups

 Barry Gurland, M.D.

David Wilder, Ph.D.

Peter Cross, M. Phil.

Rafael Lantigua, M.D.

Jeanne A. Teresi, Ph.D.

Virginia Barrett, Dr. P.H.

Yaakov Stern, Ph.D.

Richard Mayeux, M.D., M.S.E.

Abstract:  

The North Manhattan Aging Project registry, using both Reporting and Survey Components, identifies dementia cases among Latino, African-American, and non-Latino white sociocultural groups (9,349 persons 65 years of age or older) in contiguous census tracts.  During a 2-year prevalence period of the reporting component, 1,592 persons were reported to the Registry and screened with five widely used brief cognitive measures; 844 were evaluated in a Aclinical core,@ and 452 met research criteria for dementia, covering all subtypes, according DSM-III-R criteria.  Thirteen different case definitions for dementia were applied to the sociocultural groups at three levels of educational achievement, examining for associations with rates of dementia cases and controlling for age.  The following findings were robust across case definitions: sociocultural membership was not associated, but lower education was associated, with increased rates of recorded dementia; however, the patterns of the association with education varied across sociocultural groups. [PUBLICATION ABSTRACT]

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International Journal of Geriatric Psychiatry, Vol. 7: 105-113, 1992

 Screening Scales For Dementia: Toward Reconciliation Of Conflicting Cross-Cultural Findings

 Barry J. Gurland

David E. Wilder

Peter Cross

Jeanne Teresi

Virginia Barrett

Abstract:  

A compendium instrument of five widely used dementia screening scales was applied to 550 subjects 65 years and older.  Black, Hispanic and white groups were approximately equal in size.  Recruitment was designed to produce an uneven and unknown mix of dementia cases and normals among these groups.  A complex challenge to assessment and classification was thus contrived, approximating key aspects of the problem posed to cross-cultural epidemiology.  The published scoring systems of these dementia screens gave drastically conflicting results for absolute and culturally relative rates of cognitive impairment.  The conflicts between scales appeared to be largely due to the varying sensitivities of the scales and, to a lesser extent, sociocultural bias.  The conflicts were partially resolved through adjustments of the scale cut points. [PUBLICATION ABSTRACT]

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