Wisconsin's only memory clinic targeting Latinos with dementia and Alzheimer's set to expand services
Latinos are 1.5 times more likely than non-Hispanic whites to be diagnosed with Alzheimer’s. They’re diagnosed, on average, at younger ages.
That’s a disparity that care teams are trying to address at the United Community Center in Milwaukee. UCC houses the only memory clinic in Wisconsin focused on testing patients for Alzheimer’s and dementia. The services are offered in Spanish to better reach native Spanish speakers and their families.
And, now the Wisconsin Partnership Program at the University of Wisconsin School of Medicine and Public Health is providing a grant to expand the UCC's Memory Clinic to service Milwaukee's surrounding counties as the Latino Dementia Health Regional Consortium.
Adriana Guevara describes her mom Leonelia as a people person. "She's a very social person, ... she loves everybody around her," she says. Leonelia is 93 years old, and 25 years ago, she immigrated to the U.S. from Colombia to be closer to her grandkids.
Guevara said about 10 years ago, her mom started showing symptoms of memory loss. "When she started repeating things in the order seem to forget things. And then she was doing things one, two, or three times," she explains.
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Leonelia was diagnosed with Alzheimer’s, the most common cause of dementia or “loss of cognitive ability” in older adults. Now, the native Spanish speaker spends her days at the Adult Day Center in the UCC’s Latino Geriatric Center on Milwaukee’s south side.
Guevara says Leonelia enjoys the activities like painting and the special events that celebrate the diversity of the Hispanic community. "I feel very comfortable because she's very happy. And she understands everybody. Everybody speaks Spanish to her. And she has her meals," Guevara says. "Everybody helps her [and] she has that interaction with everybody."
Dr. Piero Antuono says using the language patients and their families speak is key to figuring out if someone has Alzheimer’s. Antuono is a neurology professor at the Medical College of Wisconsin who volunteers at the Latino Geriatric Center.
“The assessments are done two ways, in parallel,” explains Antuono. “One asking the caregiver, the family, the people who know the patient what are the nature of the changes they have noticed, and these changes are behavior, they are personality changes. And you need to have this done in the mother tongue of the family and the patient to really get the nuances of these changes.”
Antuono says if there’s a basis, the patient then gets a memory test.
"We need to do a memory test in the mother tongue because, again, the subtleties of the memory tests are really based on their knowledge, their cultural background, which limits to some degree, some of the kinds of questions," he says. "For instance, giving an example, I asked them to interpret proverbs because if you can interpret proverbs, [it then] tells me how abstract you can reason or what's your judgment and explaining a certain context. But that is dependent if you ever knew these proverbs."
Antuono says a proverb in English translated into Spanish is not going to make any sense.
Language is only part of the picture when it comes to providing care for Latinos with dementia. So is culture, according to Maria Mora Pinzon, an assistant scientist at the Wisconsin Alzheimer's Institute at UW-Madison.
“I have heard many people who [were] able to get a diagnosis somewhere [say], ‘Ah, the doctor told me that I should put my mom in a home, I'm not doing that. We never went back to that doctor.’ Those cultural implications of how [to] take care of a family member are so important. It goes beyond just getting a diagnosis,” Mora Pinzon says.
Hispanic Americans have a variety of ethnic and racial background and experiences. Nine out of 10 Hispanics said that it is important for a dementia care provider to understand their unique racial and ethnic background and experiences.
That's why the UCC Latino Geriatric Center offers an on-site health clinic with medical professionals who speak Spanish. In addition, the facility provides exercises, arts and crafts, and other activities led by Spanish-speaking staff, and celebrations recognizing the diversity of the Hispanic community like Carnaval, Dias De Los Muertos and Puerto Rico Discovery Day.
The need for such services is already significant. Still, the U.S. Centers for Disease Control predicts that by 2060, the number of cases nationwide will rise to an estimated 14 million people. Again, Latino and Black populations are expected to be affected the hardest.
The CDC notes that health conditions such as heart disease and diabetes are more common among those populations, which could be contributing factors to a higher risk to Alzheimer’s disease, as well as greater exposure to adversity and discrimination.
That's why access to early diagnosis and resources, including medications that can potentially slow the spread of the illness, at places like the Latino Geriatric Center, is crucial.
And, Dr. Antuono says the aim is to be able to provide these services statewide eventually.