Browsing by Author "Garcia, Joshua M"
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Item COGNITIVE SCREENING INSTRUMENTS AND FUNCTIONING OF VIETNAMESE CARE RECIPIENTS IN THE UNITED STATES(2023-12) Garcia, Joshua M; Medina, Luis D.; Woods, Steven P.; Miyawaki, Christina E.; Gallagher, Matthew W.Background: Cognitive assessment of Vietnamese Americans is distinct from assessment of other cultural groups in the United States given the historical context of Vietnamese immigration patterns and associated hardships, in addition to aspects of language and culture that potentially influence difficulties in assessment. Reliability and validity evidence, in addition to data on normative standards for cognitive testing, are limited in this population in comparison to non-Hispanic White Americans. The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool translated to Vietnamese, with limited evidence of reliability and validity due to few appearances in the literature. Objectives: The first aim was to demonstrate evidence of validity and reliability of the Vietnamese MoCA compared to other objective and subjective measures of functioning and memory. The second aim was to examine statistical agreement between care recipient and care giver reported functioning and memory. The third aim was to characterize cognitive functioning with consideration of both objective and subjective measurements across relevant sociodemographic factors. Methods: Dyadic data from the second wave of the Vietnamese Aging and Care Survey (VACS, n=102) were used. VACS includes demographic and comprehensive physical, mental and cognitive health data on Vietnamese older adult care recipients and their family caregivers. A multitrait-multimethod (MTMM) approach was used to demonstrate evidence of validity for the Vietnamese MoCA, while estimates of internal consistency were used to demonstrate evidence of reliability. Statistical agreement between subjective self- and informant-reported functioning and memory of care recipients were estimated. Clinically relevant descriptive and inferential statistics were used to examine the relationships of cognitive and functioning variables with sociodemographic variables. Results: Ninety-three care recipients completed cognitive screeners and were included in the present analysis. Apart from a lack of significant association between informant-rated instrumental activities of daily living and subjective cognitive concerns, results of the MTMM matrix indicated that cognitive and functioning variables were associated in expected directions ranging from small to large effect sizes. Interrater reliability ranged from moderate to very good with the highest agreement between care recipients and their caregivers on basic activities of daily living and subjective memory concerns followed by instrumental activities of daily living. Younger age and higher education were consistently associated with higher cognition and daily functioning. Neuropsychiatric symptoms were associated with higher subjective memory concerns and lower independence in instrumental activities of daily functioning. Conclusions: The present study demonstrated a nomological network of the relationships between cognitive and functioning variables measured in a Vietnamese sample of community-dwelling care recipients in the Houston area with various methods (objective, self-, and informant-report). This demonstrated relationships between cognitive screening instruments and functional outcomes perceived by care recipients and their caregivers. Age and education were the most consistently associated variables with cognitive and functional status. The present study advanced evidence of measurement validity of cognitive and functional instruments pertinent to Vietnamese-speaking populations for researchers and clinicians to aid in interpretation of clinical information, as well as guide future research endeavors.