Mental Status and Dementia

New Mexico: A battery of neuropsychological tests was used to compare performances in the Hispanics and non-Hispanic whites in the New Mexico Elder Health Survey (LaRue, Romero, Ortiz, Liang, & Lindeman, 1999). Considering the educational, language fluency, socioeconomic, and cultural differences between the elderly of these two ethnicities, it was expected that the Hispanics would perform less well compared to the non-Hispanic whites. After adjusting for the effects of age, education, gender, depressive symptoms, and a global measure of medical illness, statistically significant ethnic differences remained.

New York: The largest prevalence research on dementia including Hispanic populations was part of the North Manhattan Study which surveyed Medicare beneficiaries in 13 adjacent census tracts in New York City plus cases in nursing homes in the area (Gurland, Wilder, Lantigua, Mayeaux, Stern, Chen, Cross, & Killeffer, 1997).

The 685 subjects who classified themselves as “Hispanic” were primarily from the Dominican Republic with smaller proportions from Puerto Rican and Cuban backgrounds; none were identified as Mexican or Mexican American. Authors in the North Manhattan project found “dramatically” lower rates of dementia in their non-Hispanic white than their Hispanic sample as well as in their African American subjects. Among Hispanics, 12% of those aged 65–74, 29% of those 75–84, and 60% of those 85 and over were classified as having dementia. However, as in some prior studies, they found a major effect of education; in their Hispanic sample over 40% had less than five years of school. In fact the authors state, “With age and education controlled, ethno-racial membership loses its association with rates of dementia” (Gurland et al, 1997).

California: Contrary to the finding in a Los Angeles area study that equal percentages (38.5%) of their Hispanic sample were diagnosed as having Alzheimer’s Disease and vascular dementia (Fitten, Ortiz, Ponton, 2001), in an analysis of statewide data for over 5000 assessments performed in the nine California Alzheimer’s Disease Diagnostic and Treatment Centers (ADDTC), Yeo et al. (1996) found that only 18% of patients identified as Hispanic were diagnosed as having vascular dementia compared to 47% with Alzheimer’s Disease. This was a slightly smaller percentage with vascular dementia than among non-Hispanic whites (20%) and considerably less than among those identified as Black (31%) or Asian (26%). Higher rates of diabetes among Hispanic elders in that study did not seem to predispose them to higher rates of vascular dementia, as might be expected.

Southwest: Data from the Hispanic EPESE survey of older Mexican Americans living in Texas, California, Colorado, Arizona, and New Mexico found illiteracy, marital status, advanced age (over 80), levels of depressive symptoms and history of stroke as significant predictors of severe cognitive impairment (Black & Markides, 1998).