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Kota KJ, Dawson A, Papas J, Sotelo V, Su G, Li M, Lee W, Estervil J, Marquez M, Sarkar S, Lopez LL, Hu WT. Factors associated with attitudes toward research MRI in older Asian Americans. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12449. [PMID: 38356478 PMCID: PMC10865479 DOI: 10.1002/trc2.12449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/14/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION South Asian (SA) and East Asian (EA) older adults represent the fastest-growing racial/ethnic groups of Americans at risk for dementia. While recruiting older SA adults into a brain health study, we encountered unexpected hesitancy toward structural brain magnetic resonance imaging (MRI) analysis and stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as personal MRI experience, perceived MRI safety, and concerns for personal risk for future dementia/stroke. METHODS We developed a brief cross-sectional survey to assess older adults' MRI experiences and perceptions, desire to learn of six incidental findings of increasing impact on health, and attitudes related to dementia (including LoC) and research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey (offered in English, Chinese, Korean, and Spanish) and modeled the proportional odds (PO) for favorable attitudes toward research activities. RESULTS Seventy-seven SA and 84 EA respondents were analyzed alongside 95 White, Black, or Hispanic adults. White (PO = 2.54, p = 0.013) and EA (PO = 2.14, p = 0.019) respondents were both more likely than SA respondents to endorse healthy volunteers' participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p = 0.006) but still shared SA respondents' lower wish (measured by proportion of total) to learn of incidental MRI findings. DISCUSSION SA-and EA compared to SA-older adults had low desire to learn of incidental MRI findings but had different attitudes toward future dementia/stroke risks. A culturally appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research. Highlights Older Asian Americans have limited interest in incidental findings on research MRISouth Asians are most likely to attribute dementia to people's own behaviorsSouth Asians' attitudes mediate lower support for healthy volunteers in researchSouth and East Asians differ in dementia worries and research-related attitudes.
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Affiliation(s)
- Karthik J Kota
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Departments of MedicineRutgers‐Robert Wood Johnson Medical SchoolInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Alice Dawson
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Julia Papas
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Victor Sotelo
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Guibin Su
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Mei‐Ling Li
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Woowon Lee
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Jaunis Estervil
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Melissa Marquez
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Shromona Sarkar
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Lisa Lanza Lopez
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - William T. Hu
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
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Kota K, Dawson A, Papas J, Sotelo V, Su G, Li ML, Lee W, Estervil J, Marquez M, Sarkar S, Lopez LL, Hu WT. Too much information? Asian Americans' preferences for incidental brain MRI findings. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.17.23288629. [PMID: 37162874 PMCID: PMC10168418 DOI: 10.1101/2023.04.17.23288629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
INTRODUCTION South Asian (SA) and East Asian (EA) older adults represent the fastest growing group of Americans at risk for dementia, but their participation in aging and dementia research has been limited. While recruiting healthy SA older adults into a brain health study, we encountered unexpected hesitancy towards structural brain MRI analysis along with some stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as one's own MRI experience, perceived MRI safety, and concerns for one's own risks for future dementia/stroke. METHODS We developed a brief cross-sectional survey to assess older adults' MRI experiences and perceptions, desire to learn of six incidental findings of increasing health implications, and attitudes related to dementia as well as research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey, and modeled the proportional odds (P.O.) for pro-research attitudes. RESULTS 77 SA and 84 EA respondents were analyzed with 95 non-Asian adults. White (P.O.=2.54, p=0.013) and EA (P.O.=2.14, p=0.019) respondents were both more likely than SA respondents to endorse healthy volunteers' participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p=0.006), but still shared SA respondents' low desire to learn of incidental MRI findings. DISCUSSION SA and EA older adults had different attitudes towards future dementia/stroke risks, but shared a low desire to learn of incidental MRI findings. A culturally-appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research.
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Affiliation(s)
- Karthik Kota
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Alice Dawson
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Julia Papas
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Victor Sotelo
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Guibin Su
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Mei-Ling Li
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Woowon Lee
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Jaunis Estervil
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Melissa Marquez
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Shromona Sarkar
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Lisa Lanza Lopez
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - William T. Hu
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
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