Research advancing the goal of expanding the availability of valid and reliable diagnostic tools and assessments that can identify ethnic/racial minorities at high risk of developing Alzheimer’s Disease and Related Dementias (ADRD) is crucial. Achieving this goal will be impossible if enrollment in ADRD research is not expanded to include underrepresented populations, such as Chinese American older adults. Over 60% of older Chinese Americans are foreign-born (Budiman & Ruiz, 2022) and many of them have limited to no English language skills (US Census, 2021). Of those in the US, Mandarin and Cantonese are reported to be the most commonly spoken dialects (US Census, 2015). Even so, Mandarin and Cantonese are significantly different from one another both in spoken and written (i.e., traditional and simplified Chinese characters) forms. To best serve the diverse linguistic and cultural needs of older Chinese Americans, assessment tools with both written systems (Simplified and Traditional Chinese) and spoken dialects (Mandarin and Cantonese) should be made available. Moreover, it is essential to develop normative data utilizing linguistically and culturally appropriate assessment tools that are representative of the older Chinese American population to prevent inaccurate diagnosis of cognitive impairment and AD/ADRD.

We will review data from our existing cohort of over 300 Chinese American older adults recruited at Mount Sinai, New York. The cohort received a comprehensive dementia evaluation, which included a clinical interview/medical exam by our study physician, cognitive testing with our psychometrist, and an optional research blood draw.

From our experiences evaluating Chinese American older adults, we learned that testing items in many popular clinical assessment tools are culturally and linguistically inappropriate for use with Mandarin and/or Cantonese speaking older adults. Several cases will be used to illustrate challenges in evaluating Chinese American older adults using traditional cognitive testing tools that were developed for English speaking individuals who were born and raised in western cultures.

This presentation will discuss the current cultural and linguistic biases in neurocognitive assessment, interpretation, and diagnosis of Chinese American older adults. Discussion of available measures and normative data for this population will also be reviewed.