Oanh Meyer was a postdoctoral fellow studying the experiences of caregivers for people with dementia in 2012, when her research took on a very personal turn.
That year, her mother, a Vietnamese immigrant, began showing signs of dementia and paranoia that seemed to be related to the trauma she suffered during the long Vietnam War, when bombings often pushed her to hide underground and she lived in fear. communist troops.
Growing up as an American of Vietnamese descent, Meyer had noticed a reluctance to address mental health issues in her community, an issue she pursued during her studies. She conducted her doctoral research at the University of California at Davis on the disparities in mental health care among Asian Americans.
Now an associate assistant professor at the Alzheimer’s Center at UC Davis Health, Meyer, 45, is investigating the link between trauma and dementia in the Vietnamese community. With a $ 7.2 million grant from the National Institute on Aging, the five-year study, which could start recruiting as early as this month, will follow more than 500 Vietnamese seniors in northern California, measuring the correlation between adversity, trauma and other factors. with memory and cognition.
When Vietnam’s 20-Year War ended with the fall of Saigon, now Ho Chi Minh City, in 1975, the United States began to evacuate the first of some 1.4 million Vietnamese immigrants. The links between post-traumatic stress disorder and dementia have been studied in other groups, but never in the Vietnamese American population, Meyer said.
Her mother, Anh Le, left the day before Saigon fell with her mother and several sisters. Meyer was born in New Jersey soon after, and the family then moved to Oklahoma and then to California. Le was 76 when she began to experience memory loss and paranoia. She was diagnosed with dementia in 2015.
KHN interviewed Meyer at his Davis home. The interview has been edited for length and clarity.
Q: How did you become interested in the link between trauma and dementia in the Vietnamese population?
A: In 2013, I did a small qualitative study in which I interviewed several Vietnamese family caregivers, and they were caring for a family member with dementia.
I started hearing all these stories about the trauma that a large percentage of them had experienced, or that their family members had experienced. At the same time, I remember when my mom was just starting out, she was always very paranoid, and that’s a symptom of dementia. She was particularly paranoid that the Communist Army was outside her home. She would close all the blinds and peek out the front door and make sure all the doors were locked.
It got me thinking: all this trauma these Vietnamese have been through throughout their lives, how does it influence them now? The more I started to research, the more I discovered this link between trauma, PTSD and dementia.
Q: Have there been any studies of dementia in Americans of Vietnamese descent?
A: We don’t know how many Vietnamese have dementia. This would be the first glimpse of what this population looks like.
Hopefully in the future we can look at the changes and demographic shifts and see if dementia has changed over time? We hope to begin to gain knowledge about this population and the prevalence of dementia and dementia.
Q: What makes this a good time to study this question?
A: Many Vietnamese who came to the United States are now becoming older adults. And so, these people are now at an age where they would likely have dementia if they had to.
Q: What do you find most interesting about this study?
A: Their trauma was related to the war and it lasted throughout their youth. So we can look at the timing of the trauma and also link it to dementia. And then we can look at the people who have gone through that trauma but don’t have cognitive impairments and what factors differentiate those groups of people who have virtually all experienced some type of trauma. There may be resilience factors.
Q: What do you think will be the impact of this study?
A: If we can find a connection between early life trauma for Vietnamese people and dementia, we can get some idea of who might be at risk. We can help these people and maybe their caregivers.
I think it can help us understand the health of refugees in general. There is such a growing refugee population that continues to flow into the United States – from Afghanistan, for example. Being able to understand the Vietnamese experience might help us understand other refugee experiences and some of the cognitive health issues that might arise for these populations in the future.
Q: Asian Americans face many barriers in accessing mental health services. Is this true of Vietnamese immigrants who need treatment for dementia?
A: With mental health and dementia there is this stigma. I worked with Vietnamese family members who were caregivers and they were like, no one wants to talk about it. There is this kind of unspoken rule that you just don’t talk about things that can bring shame on the family.
There’s this model minority stereotype that suggests Asian Americans came here, had nothing, worked really hard, and now they’re doing just fine. But there is a lot of heterogeneity even within what you consider to be an Asian American Pacific Islander. So I think what’s going on is that the groups that are not doing well are not getting the support they need, either in terms of funding or services.
Q: How did you see this unfold with your mother?
A: When she started showing the signs and symptoms, we tried to talk to her about it and she was just like, “Oh, that’s just a normal part of aging. It is nothing serious. And I remember talking to his doctor about it too. He was an old Vietnamese man and he didn’t really make a big deal of it.
Sometimes primary care physicians do not have training in Alzheimer’s disease and dementia. So either he didn’t recognize it or, culturally, he was trying to save face and not make her feel distress by giving her a diagnosis.
Q: It must be difficult to deal with the fact that your mother suffered a trauma and now has dementia.
A: It can certainly be difficult. But I think I just put on my scientist hat and I’m just trying to remember, “Oh, these are the behavioral manifestations of this disease. It’s very difficult and stressful, and that’s why caregivers need a lot of support. But I think having my research and just trying to remember what’s going on neurologically or biologically helps, for sure.
(KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the three main operational programs of the KFF (Kaiser Family Foundation). KFF is a nonprofit endowed organization providing information about health issues to the nation. This article was produced by KHN, which publishes California Healthline, an independent editorial service of the California Health Care Foundation.)