Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-23T05:37:47.610Z Has data issue: false hasContentIssue false
  • English
  • Français

Perceived stigma towards Alzheimer's disease and related dementia among Chinese older adults: do social networks matter?

Published online by Cambridge University Press:  25 September 2020

Xiang Gao Open the ORCID record for Xiang Gao [Opens in a new window] ,
Fei Sun ,
Lucas Prieto  and
Vijeth Iyengar
Xiang Gao*
Affiliation:
School of Sociology, Huazhong University of Science and Technology, Wuhan, China
Fei Sun
Affiliation:
School of Social Work, Michigan State University, East Lansing, Michigan, USA
Lucas Prieto
Affiliation:
School of Social Work, Michigan State University, East Lansing, Michigan, USA
Vijeth Iyengar
Affiliation:
US Administration on Aging/Administration for Community Living, US Department of Health and Human Services, Washington, DC, USA
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

In mainland China, as the population ages, Alzheimer's disease and related dementia (ADRD) is estimated to increase among Chinese older adults. Chinese older adults tend to hold stigmatising beliefs about ADRD that in turn affect their help-seeking behaviour and receipt of prevention and treatment. The Framework Integrating Normative Influences on Stigma provides a rationale for Chinese older adult's stigma about ADRD. Questionnaires were administered in person to 754 older adults (42% male, mean age = 69.54 years) from two urban communities in mainland China. We examined ADRD stigma and the associations with real-life exposure, knowledge of ADRD, health conditions and social networks. This study found that Chinese older adults who had good family quality, lower depression (as measured by the Center for Epidemiological Studies Depression Scale) and better cognitive health (as measured by the Montreal Cognitive Assessment) were more likely to have lower perceived stigma. Conversely, those individuals who experienced neglect and had more ADRD knowledge exhibited higher levels of perceived stigma. Social networks moderated the associations between cognitive scores and perceived stigma. This research suggested that the quality of one's social networks is essential to reduce perceived stigma among Chinese older adults. Future research should continue to explore ADRD stigma among Chinese older adults to help guide relevant interventions, services and supports for this population.

Keywords

perceived stigmasocial networkscognitive health
Type
Article
Information
Ageing & Society , Volume 42 , Issue 5 , May 2022 , pp. 1100 - 1116
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, SM and Partee, DJ (1998) Integrating psychosocial rehabilitation in a community-based faculty nursing practice. Journal of Psychosocial Nursing and Mental Health Services 36, 24–28.CrossRefGoogle Scholar
Alzheimer's Association (2013) Alzheimer's Disease Facts and Figures. Available at http://www.alz.org/downloads/facts_figures_2013.pdf.2013.Google Scholar
Boey, KW (1999) Cross-validation of a short form of the CES-D in Chinese elderly. International Journal of Geriatric Psychiatry 14, 608–617.3.0.CO;2-Z>CrossRefGoogle Scholar
Burgener, SC and Berger, B (2008) Measuring perceived stigma in persons with progressive neurological disease: Alzheimer's dementia and Parkinson's disease. Dementia 7, 31–53.CrossRefGoogle Scholar
Burgener, SC, Buckwalter, K, Perkhounkova, Y and Liu, MF (2015) The effects of perceived stigma on quality of life outcomes in persons with early-stage dementia: longitudinal findings: part 2. Dementia 14, 609–632.CrossRefGoogle ScholarPubMed
Carpenter, BD, Balsis, S, Otilingam, PG, Hanson, PK and Gatz, M (2009) The Alzheimer's Disease Knowledge Scale: development and psychometric properties. The Gerontologist 49, 236–247.CrossRefGoogle ScholarPubMed
Chang, Q, Sha, F, Chan, CH and Yip, PS (2018) Validation of an abbreviated version of the Lubben Social Network Scale (‘LSNS-6’) and its associations with suicidality among older adults in China. PLOS ONE 13, e0201612.CrossRefGoogle Scholar
Cheng, ST, Lam, L, Chan, L, Law, A, Fung, A, Chan, WC, Tam, C and Chan, WM (2011) The effects of exposure to scenarios about dementia on stigma and attitudes toward dementia care in a Chinese community. International Psychogeriatrics 23, 1433–1441.CrossRefGoogle Scholar
Cheung, FM, Leung, K, Fan, RM, Song, WZ, Zhang, JX and Zhang, JP (1996) Development of the Chinese personality assessment inventory. Journal of Cross-cultural Psychology 27, 181–199.CrossRefGoogle Scholar
Davies, K (2011) Knocking on doors: recruitment and enrichment in a qualitative interview-based study. International Journal of Social Research Methodology 14, 289–300.CrossRefGoogle Scholar
Gao, X, Sun, F and Hodge, DR (2016) Elder mistreatment among Chinese American families: do acculturation and traditionalism matter? Journals of Gerontology: Psychological Sciences and Social Sciences 74B, 465–473.Google Scholar
Gao, X, Gao, X, Guo, L, Sun, F and Zhang, A (2020) Perceived threat of Alzheimer's disease and related dementias in Chinese older adults: the role of knowledge and perceived stigma. International Journal of Geriatric Psychiatry 35, 223–229.CrossRefGoogle ScholarPubMed
Goffman, E (1963) Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Gold, TB (1985) After comradeship: personal relations in China since the Cultural Revolution. The China Quarterly 104, 657–675.CrossRefGoogle Scholar
Gray, HL, Jimenez, DE, Cucciare, MA, Tong, HQ and Gallagher-Thompson, D (2009) Ethnic differences in beliefs regarding Alzheimer disease among dementia family caregivers. American Journal of Geriatric Psychiatry 17, 925–933.CrossRefGoogle ScholarPubMed
Hatzenbuehler, ML, Phelan, JC and Link, BG (2013) Stigma as a fundamental cause of population health inequalities. American Journal of Public Health 103, 813–821.CrossRefGoogle ScholarPubMed
Herrmann, LK, Welter, E, Leverenz, J, Lerner, A, Udelson, N, Kanetsky, C and Sajatovic, M (2018) A systematic review of dementia-related stigma research: can we move the stigma dial? American Journal of Geriatric Psychiatry 26, 316–331.CrossRefGoogle ScholarPubMed
Katz, S, Ford, AB, Moskowitz, RW, Jackson, BA and Jaffe, MW (1963) Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. Journal of the American Medical Association 185, 914–919.CrossRefGoogle ScholarPubMed
Laditka, SB, Laditka, JN, Liu, R, Price, AE, Friedman, DB, Wu, B, Bryant, LL, Corwin, SJ and Ivey, SL (2013) How do older people describe others with cognitive impairment? A multiethnic study in the United States. Ageing & Society 33, 369–392.CrossRefGoogle Scholar
La Fontaine, J, Ahuja, J, Bradbury, NM, Phillips, S and Oyebode, JR (2007) Understanding dementia amongst people in minority ethnic and cultural groups. Journal of Advanced Nursing 60, 605–614.CrossRefGoogle ScholarPubMed
Lawton, MP and Brody, EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist 9, 179–186.CrossRefGoogle ScholarPubMed
Li, X, Wang, H, Williams, A and He, G (2009) Stigma reported by people living with HIV in south central China. Journal of the Association of Nurses in AIDS Care 20, 22–30.CrossRefGoogle ScholarPubMed
Liu, D, Hinton, L, Tran, C, Hinton, D and Barker, JC (2008) Reexamining the relationships among dementia, stigma, and ageing in immigrant Chinese and Vietnamese family caregivers. Journal of Cross-cultural Gerontology 23, 283–299.CrossRefGoogle ScholarPubMed
Lubben, J, Blozik, E, Gillmann, G, Iliffe, S, Kruse, W, Beck, JC and Stuck, AE (2006) Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. The Gerontologist 46, 503–513.CrossRefGoogle ScholarPubMed
Luo, JD and Yeh, YC (2012) Neither collectivism nor individualism: trust in the Chinese guanxi circle. Journal of Trust Research 2, 53–70.CrossRefGoogle Scholar
Mak, WW, Cheung, R, Law, RW, Woo, J, Li, P and Chung, R (2007) Examining attribution model of self-stigma on social support and psychological well-being among people with HIV+/AIDS. Social Science and Medicine 64, 1549–1559.CrossRefGoogle ScholarPubMed
Markowitz, FE (1998) The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness. Journal of Health and Social Behavior 39, 335–347.CrossRefGoogle ScholarPubMed
Nasreddine, ZS, Phillips, NA, Bédirian, V, Charbonneau, S, Whitehead, V, Collin, I, Cummings, JL and Chertkow, H (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society 53, 695–699.CrossRefGoogle ScholarPubMed
Penn, DL, Guynan, K, Daily, T, Spaulding, WD, Garbin, CP and Sullivan, M (1994) Dispelling the stigma of schizophrenia: what sort of information is best? Schizophrenia Bulletin 20, 567–578.CrossRefGoogle ScholarPubMed
Pescosolido, BA, Martin, JK, Lang, A and Olafsdottir, S (2008) Rethinking theoretical approaches to stigma: a framework integrating normative influences on stigma (FINIS). Social Science and Medicine 67, 431–440.CrossRefGoogle Scholar
Phillipson, L, Magee, CA, Jones, SC and Skladzien, E (2014) Correlates of dementia attitudes in a sample of middle-aged Australian adults. Australasian Journal on Ageing 33, 158–163.CrossRefGoogle Scholar
Piver, LC, Nubukpo, P, Faure, A, Dumoitier, N, Couratier, P and Clément, J (2013) Describing perceived stigma against Alzheimer's disease in a general population in France: the STIG-MA survey. International Journal of Geriatric Psychiatry 28, 933–938.CrossRefGoogle Scholar
Prince, M, Wimo, A, Guerchet, M, Ali, G, Wu, Y and Prina, M (2015) World Alzheimer Report 2015: The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. London: Alzheimer's Disease International .Google Scholar
Roberts, JS, Connell, CM, Cisewski, D, Hipps, YG, Demissie, S and Green, RC (2003) Differences between African Americans and whites in their perceptions of Alzheimer disease. Alzheimer Disease and Associated Disorders 17, 19–26.CrossRefGoogle ScholarPubMed
Shi, Y, Sun, F, Liu, Y and Marsiglia, FF (in press) Perceived threat of Alzheimer's disease and related dementias among older Chinese Americans in subsidized housing: through a cultural lens. Dementia. Available online doi:10.1177/1471301218805901.Google Scholar
Sun, F, Gao, X and Coon, DW (2015) Perceived threat of Alzheimer's disease among Chinese American older adults: the role of Alzheimer's disease literacy. Journals of Gerontology: Psychological Sciences and Social Sciences 70B, 245–255.CrossRefGoogle Scholar
Tsui, AS and Farh, JLL (1997) Where guanxi matters: relational demography and guanxi in the Chinese context. Work and Occupations 24, 56–79.CrossRefGoogle Scholar
US Department of Health and Human Services (1999) Mental Health: A Report of the Surgeon General. Bethesda, MD: US Department of Health and Human Services.Google Scholar
Werner, P (2005) Social distance towards a person with Alzheimer's disease. International Journal of Geriatric Psychiatry 20, 182–188.CrossRefGoogle ScholarPubMed
Werner, P (2006) Lay perceptions regarding the competence of persons with Alzheimer's disease. International Journal of Geriatric Psychiatry 21, 674–680.CrossRefGoogle ScholarPubMed
Werner, P and Davidson, M (2004) Emotional reactions of lay persons to someone with Alzheimer's disease. International Journal of Geriatric Psychiatry 19, 391–397.CrossRefGoogle ScholarPubMed
Werner, P, Mittelman, MS, Goldstein, D and Heinik, J (2011) Family stigma and caregiver burden in Alzheimer's disease. The Gerontologist 52, 89–97.CrossRefGoogle ScholarPubMed
Woo, BK (2017) Family history and its relationship with dementia stigma beliefs among Chinese Americans. Geriatrics and Gerontology International 17, 122–125.CrossRefGoogle ScholarPubMed
Woo, BK and Chung, JO (2013) Public stigma associated with dementia in a Chinese-American immigrant population. Journal of the American Geriatrics Society 61, 1832–1833.CrossRefGoogle Scholar
Woo, BK and Mehta, P (2017) Examining the differences in the stigma of dementia and diabetes among Chinese Americans. Geriatrics and Gerontology International 17, 760–764.CrossRefGoogle ScholarPubMed
Woo, BK, Chung, S, Woo, G and Chung, JO (2019) Mitigating stigma of Alzheimer's disease dementia among Chinese Americans. Alzheimer's and Dementia: The Journal of the Alzheimer's Association 15, 1006–1007.CrossRefGoogle ScholarPubMed
Yang, LH and Kleinman, A (2008) ‘Face’ and the embodiment of stigma in China: the cases of schizophrenia and AIDS. Social Science and Medicine 67, 398–408.CrossRefGoogle ScholarPubMed
Zhou, Y (2012) Study on Social Discrimination and Perceived Stigma and Its Influencing Factors of Patients with Mental Disorders (Doctoral dissertation). Available at http://www.wanfangdata.com.cn/details/detail.do?_type=degreeandid=Y2257211. (In Chinese)Google Scholar
Zhou, Y, Pan, SM, Zhao, CY, Lin, JK, Li, YJ, Zhang, JP and Liu, LQ (2015) Influence of stigma on QOL of patients with mental disorders. Chongqing Medicine 44, 1349–1351. (In Chinese)Google Scholar