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Specialized Adult Day Programs and Family Resources. Supportive. Social. Stimulating. Safe. Ray Valle PhD Mario Garrett PhD Anette Asher Dawn Carnerie DeStefani , BSW. Diversity in dementia. MetLife Foundation 2010

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diversity in dementia

Ray Valle PhD

Mario Garrett PhD

Anette Asher

Dawn CarnerieDeStefani, BSW

Diversity in dementia

MetLife Foundation 2010

  • 2011 in Alzheimer's & Dementia: National Institute on Aging + Alzheimer's Association
  • International studies
  • Caregivers
  • Local

Ethnic Composition in San Diego

  • Realities of Cultural Diversity
  • Sweeps of Cultural Immigrants
san diego county population growth
San Diego County population growth

California receives ~ 38% of all Immigrants to the USA


San Diego County


San Diego County

population by nativity and hispanic 2007 60 2 latinos born in us
Population by Nativity, and Hispanic: 200760.2% latinos Born in US

Elizabeth M. Grieco. Race and Hispanic Origin of the Foreign-Born Population in the United States: 2007. American Community Survey Reports. 2010 U.S. Department of Commerce. Economics and Statistics Administration. U.S. CENSUS BUREAU


698,000 immigrants

  • 23% of the total population
  • 76% since 1980
  • 24% in last 10 yrs
  • From Mexico = 47%
  • From Philippines = 13%

San Diego County

latino dementia prevalence

National Studies

  • Local Studies
  • Quandary: Services are Local Prevalence Rates are National
Latino dementia prevalence

Projections: Developing an Algorithm

  • Demography of Aging in Place
  • Projections of Dementia

Developing Dementia Prevalence Rates Among Latinos: A Locally-Attuned, Data-Based, Service Planning Tool

Ramón Valle, PhD

Mario Garrett, PhD

Roberto Velasquez, MSG


The Algorithm

Population projections were obtained from the State of California, Department of Finance’s (CDF),population projections for counties for 2000-2050

Haan, M. N., Mungas, D. M., Gonzalez, H. M, Ortiz, T. A., Acharya, A., & Jagust W. J. (2003). From Prevalence of Dementia in Older Latinos: The Influence of Type 2 Diabetes Mellitus, Stroke and Genetic Factors. Journal of the American Geriatric Society 51:169–177

ADAD Prevalence RatesMalesFemales`

60-69 1.31% 60-69 0.61%

70-79 4.66% 70-79 4.71%

80-84 10.00% 80- 9.46%

85+ 23.33% 85+ 17.65 %

ALL 4.05% ALL 3.76%


Male Female

Age 1 year

Latino vs White

2000, 2010, 2030, 2050


The Algorithm

D.A. Evans et al, “Estimated Prevalence of Alzheimer’s Disease in the United States” The Milbank Quarterly 68:2 (1990) 267-289

Evan’s Combined & Haan Comparative Latino ADAD Prevalence Rates

Evans Haan’sMale/Female Male/Female

65-74 3.9% 65-74 2.4%

75-84 16.4% 75-84 6.4%

85 + 47.55% 85+ 19.5%

All 11.3% All 5.0%


San Diego Latino 60+ Aging-in-Place Estimates 2000-2050

Table 1a:

Percentage difference from 2000

Year Latino 60 + Anglo 60+Latino 60 + Anglo 60+

200048,299 306,947------- -------

2010 80,180 348,24366% 13%

2030 214,426 618,244 344% 101%

2050 363,372 636,145 652% 107%


Latino Age 60+ San Diego ADAD Prevalence Projections 2000-2050

Table 1c Percentage difference from 2000

Year Latino 60 + Anglo 60+ Latino 60 + Anglo 60+

2000 1,889 16,592 --------- --------

2010 3,267 18,025 73% 9%

2030 8,815 29,019 367% 74%

2050 23,289 48,152 1,133% 190%

learning objectives

Understanding depression & other mental systems Dementia

  • Developing culturally specific treatments
  • Ways to engage communities
  • Resources & access to patients
Learning Objectives
reality on the ground1

Understanding Dementia is to see how

in-discriminate it is. Every patient presents symptoms uniquely.

    • Degenerative, terminal
    • Beta Amyloid protein (the goop), tau and tangles
Reality on the ground
reality on the ground3

Dementia and Depression

  • Service Organizations
    • Adult Day Care
    • Programs: brain fitness, support groups, caregiver training
Reality on the ground
glenner memory care center


  • Demographics: Diversity is here
  • Approach: How and what we do serves as outreach in community
Glenner memory Care center
glenner memory care center1

Approach: How and what we do serves outreach in community

    • Day Care
    • Support Groups
    • In-Service training
    • New Programs: Oak Tree Brain Fitness Club, Train the Trainer
Glenner memory Care center
what we all can do in the community

Learn early signs of dementia/non-amnestic mild cognitive impairment.

  • Work closely with special interest groups or associations.
    • National Association of Hispanic Nurses http://nahnnet.organd in SD
    • San Diego Black Nurses Association
    • The Philippine Nurses Assoc. of San Diego County
What we all can do in the community
techy tools for you and clients

Runkeeper (free iPhone app)

  • Anti-aging games (fun internet site)
  • The Glenner Memory Care Centers new iPad App. To be launched in January. (working on a app name… Memory Maker, Memory Finder…
Techy tools for you and clients
techy tools for you and clients1
Techy tools for you and clients

Go to Apple’s App Store


FREE App due to release in

January 2012.

Drop off your business card

at the Glenner exhibit table or

contact us to get on

mailing list for the



latino caregivers

The Latino culture respects their elderly and usually accompanies an expectation that the family will provide all care needs for their loved ones.

There is usually reluctance and distrust of community options such as day care and nursing home placement.

Few services have successfully provided a culturally correct and competent model that includes the proper language, sights, sounds and rapport.

Latino caregivers
latino caregivers1

Latino caregivers express many of the same concerns as other ethnicities: denial, stress, resistance but one area that separates them is their concerns with doctors in the U.S. Many continue to travel to Mexico as they feel their doctors are more patient and less rushed.

Voices of Latino Caregiving, Latino Alzheimer’s Community Forum June 19, 2010

Latino Caregivers
caregiver stress and depression

Latino caregivers often resist outside support and therefore carry high amounts of stress and a higher risk of depression.

There are a limited amount of physicians and professionals that are bilingual to obtain a proper diagnosis and treatment plan for the caregiver and their loved one.

Caregiver stress and depression
glenner southbay adhc cbas

Center is located in a primarily Latino neighborhood.

Enrollment of 80% Spanish Speaking participants.

Staff are bilingual, activities and meals are geared to represent the participants.

Professional staff also speak Spanish to provide support and resources.

Ample time is given to build rapport with home visits and assessments.

Have used Latino caregivers in a volunteer capacity to market in the community.

Glenner Southbay ADHC/CBAS
future and recommendations

Apply Algorithm to other Ethnic Groups

  • Develop Protocol for addressing Diversity in Dementia
  • Final Remarks
Future and recommendations