Ethnic disparities in care needs among individuals with cognitive impairment.

Abstract

BackgroundAs more individuals with cognitive impairment and dementia (CID) remain at home, greater needs arise, necessitating additional support.ObjectiveTo examine ethnic differences in the needs of individuals with CID among Mexican American (MA) and non-Hispanic White (NHW) participants.MethodsAdults 65 + with possible cognitive impairment (Montreal Cognitive Assessment score < 26), and their caregivers living in Nueces County, Texas, were included. We used the Camberwell Assessment of Need for the Elderly (CANE) tool to study the needs (accommodations, self-care, continence, physical health, emotional well-being, social relationships, and availability of support networks) and their domains of individuals with CID including environmental, physical, psychological and social needs. Using negative binomial and Poisson regressions, ethnic differences were examined within each domain.ResultsA total of 473 participants were included. NHW participants (N = 150) were slightly older (75.5 versus 72.7 years) and had higher rates of MCI and dementia (55% versus 47%) compared to MA participants (N = 323). All participants reported high levels of needs (met or unmet). Furthermore, although NHW participants reported having fewer social needs (met or unmet) compared to MA participants (Incident Rate Ratio [IRR]=-0.79; 97.5%CI:0.63-0.98), NHW participants had a greater level of unmet needs when it came to social needs compared to MA participants (IRR = 1.85; 97.5%CI:1.33-2.57).ConclusionsFindings indicate high levels of needs among individuals with CID. There also exist ethnic differences, with NHW participants having greater unmet needs in social areas. Enhancing access to resources and support systems is essential for equitable support for individuals with CID across various ethnic backgrounds.