William T. Liu

A CHINESE VERSION OF THE MINI-MENTAL STATE EXAMINATION; IMPACT OF ILLITERACY IN A SHANGHAI DEMENTIA SURVEY

A dementia screening survey was carried out in Shanghai using a culturally adapted Chinese version of the Mini-Mental State Examination. A probability sample of 5055 community-dwelling elderly in Shanghai was surveyed, 1497 aged 55-64, 2187 aged 65-74, and 1371 aged 75 and over. In the 73.3% of the subjects who had gone to school, using the age and education adjustments suggested by Kittner et al. (1986), [Kittner et al. J Chron Dis 39: 163-170; 1986] suitable cutoff scores could readily be selected to identify the subjects who should be examined intensively for the presence of dementia. However, in the 26.7% who had not gone to school, there was a significant increase in low scores on the mental status test as well as a different error pattern, reflecting the lack of formal education. Methods for following cognitive changes in illiterate individuals need further development.

Panel V: Adaptive Health Behaviors Among Ethnic Minorities

Race, ethnicity, and cultural attitudes and practices are among the variables that influence health behaviors, including adaptive health behaviors. The following discussions highlight the important role of social conditions in shaping health behaviors and the central role of family in promoting health across the Asian, Hispanic, Native American, and African American ethnic groups. Factors that may lead to health-damaging behaviors are also discussed. The need for additional research that identifies correlations among physiological, social, and behavioral factors and health behaviors, as well as underlying mechanisms, is called for.

Nutritional status of Chinese-, Korean-, and Japanese-American elderly.

OBJECTIVE To examine the nutritional status of three major subgroups of Asian-American elderly. SUBJECTS The sample consisted of 169 Chinese, 90 Korean, and 50 Japanese elderly who lived in five apartment buildings for senior citizens in Chicago, Ill. MAIN OUTCOME MEASURES Twenty-four-hour dietary recalls were used to evaluate dietary intake. Anthropometric measures of height, weight, and triceps skinfold thickness were also obtained. RESULTS Many Asian-American elderly consume an inadequate amount of dietary calcium. A large percentage of Korean elderly also consume inadequate amounts of protein and vitamins A and C. Underweight was more common than obesity among these ethnic elderly groups. APPLICATIONS The information in this article provides valuable data to the Asian-American community for program planning as well as to health providers who work with individual Asian-American elderly to meet their nutrition needs.

Intergenerational Relations and the Aged among Japanese Americans

Immigrant groups frequently experience a widening intergenerational gap as the younger generation improves in social status. That such ascendancy is accompanied by intergenerational conflict and strain is clearly borne out by the experience of many Japanese Americans. Using data gathered from over 100 pairs of mother and daughter respondents, this study explores the impact of social mobility of the younger generation of Japanese Americans upon relations with their first-generation parents. Also explored is the subsequent psychological well-being of the older Japanese immigrant, including a look at the structure of their social network.

Methodological problems and policy implications in Vietnamese refugee research.

This article is written with two objectives: First, to describe some of the critical methodological problems encountered in our research with Vietnamese refugees in San Diego, California, about which few studies have been conducted previous to their arrival in 1975. Second, to discuss the policy implications of research beset with these difficulties, some of which are unique to studies of refugee populations per se, while others are common to research on small ethnic minorities in general. This article focuses on four major issues: the quality of refugee studies; the purpose and functions of such research; the ethical dilemmas of studying refugees; and public policy implications of refugee research. Recommendations are offered to resolve some of these issues which would call for policy changes both in the ways refugee research are conducted, and in the training of researchers themselves.

Adaptive health behaviors among ethnic minorities.

Race, ethnicity, and cultural attitudes and practices are among the variables that influence health behaviors, including adaptive health behaviors. The following discussions highlight the important role of social conditions in shaping health behaviors and the central role of family in promoting health across the Asian, Hispanic, Native American, and African American ethnic groups. Factors that may lead to health-damaging behaviors are also discussed. The need for additional research that identifies correlations among physiological, social, and behavioral factors and health behaviors, as well as underlying mechanisms, is called for.

Fertility and kinship in the Philippines

The objective in this book is to describe how the people from 1 area of central Philippines (Cebu Province) have coped with the realities of large family size i.e. what have they done to limit their number of births; what do they know about contraceptive methods; how successful have they been in using contraceptive methods; and how do people of lower socioeconomic status deal with the psychic and economic burden of raising children. Focus is on how the family serving as an intermediary between the cultural system and the individual shapes the individuals perception of kinship duties and obligations assists her/him in coping with the exigencies of sheer survival and reproduction and in turn influences his/her family building processes. The attempt is made to identify some of the social institutions and value systems that encourage the propagation of large families and to provide a preliminary understanding of the patterns of interaction between husband and wife families and relatives friends and neighbors. The data presented come from 22 unstructured intensive interviews and a total of more than 2000 cases obtained through sample surveys conducted in the city and in the barrios. Of the total 1521 cases were from the metropolitan area of Cebu City. The Filipinos regardless of their socioeconomic standing and educational attainments were found to be enmeshed in a web of kinship which impinged on and is impinged upon by conjugal relationships and childbearing. There was a fair amount of ignorance regarding family planning yet it is erroneous to believe that Filipinos are without aspirations toward the ideal of a smaller family. It is simply that in the daily lives of the Cebuanos the ideal must take its place in a hierarchy of priorities of which economic survival is highest. Modern medicine and western contraceptive technology were found to have little functional significance in the lives of the humble residents in the central Philippines. The policy implication is that the dissemination of modern contraceptives goes beyond the mere transplantation of new methods.

Cross-cultural studies of dementia: Use of a Chinese version of the Blessed-Roth Information-Memory-Concentration test in a Shanghai dementia survey.

A culturally adapted Chinese version of the Blessed-Roth Information-Memory-Concentration test (CIMC) was used in a dementia screening survey of a probability sample of 5,055 elderly Shanghai residents. The individual items on the CIMC that best predicted the overall score were similar to the best predictor of an American version of the IMC. Performance on the CIMC was markedly affected by the level of education or lack thereof. In a subsample for whom clinical diagnoses were obtained, it was possible to establish cutoff values on the CIMC by stratifying the sample according to education.

Health Services for Asian Elderly

Between 1970 and 1980, there has been an increase of more than 140% of Asians in America, mainly through the influx of new immigrants as a result of the 1965 legislative amendment to the old national quota immigration law. Along with the increase of new immigrants and their families, we experienced a sudden awareness of the problems of the immigrant elderly in addition to those who came during the first decade of the present century as farm labor from China and the Philippines, as well as the very old Issei (first generation) and the aging Nisei (second generation) from Japan. Our data showed that not all elderly Asians are taken care of by their kin or the ethnic community facilities. Compared with the general American population, such elderly populations have problems associated with economic conditions, cultural mismatch, as well as the structural factors of ethnic communities that left many elderly living alone or with nonrelatives. The myths of the support group have not been rigorously investigated in such ethnic communities.