A new study conducted by Edith Cowan University (ECU) in partnership with The Dementia Centre, HammondCare, discovered that immigrants with dementia were more likely to exhibit agitation and hostility than their non-immigrant counterparts.
Researchers from ECU’s Centre for Research in Aged Care and HammondCare’s The Dementia Centre reported that behaviors and psychological symptoms of dementia (BPSD), such as agitation and hostility, are prevalent; however, their presentation may be altered by the person’s cultural background.
A study looked at disparities in clinical and demographic variables, as well as BPSD, among immigrants and non-immigrants living with dementia in residential aged care facilities who were referred to Dementia Support Australia (DSA) programs. The study discovered that immigrants were more likely to appear with agitation or violence, whereas non-immigrants were more likely to report hallucinations or delusions.
Since 2016, DSA, a free, Australian Government-funded dementia behavior support program, has helped over 60,000 clients and 98% of aged care institutions across all states and territories. BPSD was common throughout the groups, with immigrants typically experiencing language problems and cultural issues, which added to the contributing variables.
Our study calls for increased awareness and education on the impact of culture and language for people receiving residential care and exhibiting BPSD. Future research should explore related factors such as length of stay in Australia and English language proficiency to learn more about BPSD presentations for different immigrant groups. By doing so, we can better manage these symptoms.
Pelden Chejor
“In Australia, over 400,000 people are living with dementia, a number projected to double by 2058, At least 54% of people living in residential aged care homes (RACHs) in 2019 – 2020 had a dementia diagnosis,” said lead researcher Pelden Chejor.
“More than 31% of aged care residents were born abroad, and 9.2% preferred a language other than English.” Between 2019 and 2020, 21% of people living with dementia in RACHs were immigrants from non-English speaking countries. According to international studies, immigrants have a greater prevalence of dementia due to their diverse life experiences, including trauma, low literacy, and socioeconomic level.”
Chejor and his colleagues found that loneliness, boredom, language barriers, and cultural considerations all contributed significantly to BPSD in non-English-speaking immigrants compared to non-immigrants, with language barriers and cultural considerations having the greatest impact. There were no differences in the prevalence of contributing factors among English-speaking immigrants and non-immigrants.
“Our findings indicated a significantly lower rate of hallucinations for immigrants and non-English-speaking immigrants compared to non-immigrants. Additionally, non-English-speaking immigrants were significantly lower on delusions and disinhibition than non-immigrants.
“The higher severity of agitation or aggression was most likely caused by communication issues, as there was no difference among English-speaking immigrants. Cognitive decline can impair both the ability to express and comprehend spoken language, and people living with dementia who speak English as an additional language may lose the ability to communicate in English and instead use their first language as their primary language of communication, according to Chejor.
“Our study calls for increased awareness and education on the impact of culture and language for people receiving residential care and exhibiting BPSD. Future research should explore related factors such as length of stay in Australia and English language proficiency to learn more about BPSD presentations for different immigrant groups. By doing so, we can better manage these symptoms.”
Marie Alford, Head of DSA, stated that the study reaffirmed the need to understand the individual living with dementia, including their cultural background and experiences, likes, dislikes, and routines while reacting to BPSDs.
“Communicating effectively with the person living with dementia, and taking the time to know them, including their language background and culture, is essential,” he said. “In many cases, this can mean responding with support without the need for a pharmacological intervention.”
