Background: As the economic impact of dementia on health and social care increases, governments require disease‐specific epidemiological data that will help inform spending and policy decisions. The aim of this study is to examine predictors of mortality in dementia in consecutive referrals to a New Zealand (NZ) memory service that includes Māori, Pacific Islander, and NZ European patients.Methods: Date of birth, sex, ethnicity, living situation, cognitive function, dementia subtype, dementia severity, physical comorbidity, and medication data were collected from electronic health records. The resulting data set was linked to administrative data on mortality and last hospital contact dates to allow time‐dependent survival analyses.Results: The risk of death in people with dementia was increased by age (adjusted HR per year 1.08, 95%CI:1.05‐1.12) and lower cognitive score at baseline (adjusted HR for severe impairment:2.54, 95% CI:1.25‐5.16), and was reduced by cholinesterase inhibitors (adjusted HR:0.54, 95% CI:0.34‐0.88). Compared to NZ Europeans (HR:1.19, 95% CI:0.63‐2.25), antipsychotics increased the risk of death three‐fold in Māori (adjusted HR:3.62, 95% CI:0.79‐16.7) and Pacific Islanders (adjusted HR:2.54, 95%CI:1.10‐5.85).Conclusions: Further research is required to elucidate the mechanisms underlying the survival rates in Māori and Pacific Islanders living with dementia in NZ,and their increased risk of death if antipsychotics are used.

Currently, there are estimated to be 70,000 people living with dementia in Aotearoa, New Zealand (NZ). This figure is projected to more than double by 2040, but due to the more rapid growth of older age groups in non-European populations, prevalence will at least triple amongst the NZ Indian population. The impact of dementia in the NZ Indian community is currently unknown. The aim of this study was to explore the lived experiences of NZ Indians living with dementia and their caregivers. Ten caregivers (age range: 41–81) and five people living with mild dementia (age range: 65–77) were recruited from a hospital memory service and two not-for-profit community organisations in Auckland, Aotearoa, NZ. Semi-structured interviews were conducted by bilingual/bicultural researchers and transcribed for thematic analysis in the original languages. Dementia was predominantly thought of as being part of normal ageing. Getting a timely diagnosis was reported as difficult, with long waiting times. Cultural practices and religion played a large part in how both the diagnosis and ongoing care were managed. Caregivers expressed concerns about societal stigma and about managing their own health issues, but the majority also expressed a sense of duty in caring for their loved ones. Services were generally well-received, but gaps were identified in the provision of culturally appropriate services. Future health services should prioritise a timely diagnosis, and dementia care services should consider specific cultural needs to maximise uptake and benefit for Indian families living with dementia.

Little is known about the lived experience of dementia in the New Zealand Chinese community. This study aims to explore the understanding and experiences of living with dementia in Chinese New Zealanders. Participants were recruited from a memory service and a community dementia day programme. In-depth interviews were conducted by bilingual and bicultural researchers. The recorded interviews were transcribed and thematically analysed. Sixteen people living with dementia and family carers participated in this study. The first theme revealed the lack of understanding of dementia prior to diagnosis, the commonly used term of “brain shrinkage” and that dementia is associated with getting older. The second theme covered the symptoms experienced by people with dementia and how family carers found anhedonia and apathy particularly concerning. The third theme highlighted the tension between cultural obligation and carer stress. The fourth theme is about the stigma attached to dementia. Our results provide some insight into ways to improve dementia care for Chinese New Zealanders, including targeted psychoeducation in the Chinese community to improve awareness and to reduce stigma, access to person-centred interventions, and learning about strategies for healthy ageing to live well with dementia, and emotional support and psychoeducation for family carers to reduce carer stress.

Introduction: The World Health Organisation (WHO) has developed iSupport for Dementia, a self-paced online training programme for caregivers of people with dementia which is adaptable to different cultural contexts. This scoping review aims to understand the iSupport adaptation process in different countries and provide recommendations for future adaptations. Methods: A systematic search was done in electronic databases such as Pubmed, MEDLINE, APA PsycINFO, and EMBASE to obtain relevant publications up to 18 February 2024. Only full-text publications describing iSupport cultural adaptation process were included. The publications obtained were reviewed using the Cultural Adaptation Process framework. Results: Thirteen publications from ten studies were eligible for inclusion. Based on the Cultural Adaptation Process framework, the steps undertaken in the studies were grouped into: (i) setting the stage, (ii) initial adaptation, and (iii) adaptation iterations. The three significant players in this process are the intervention developer (researchers), the cultural adaptation specialist (researchers, caregivers, and dementia care professionals), and the target community (caregivers). In the publications reviewed, cultural adaptation was mostly undertaken using a co-design process between researchers, caregivers, and dementia care professionals deciding on necessary modifications. Conclusion: iSupport for Dementia is a versatile programme to support caregivers and is readily available for adaptation to different cultural settings. It is essential to engage caregivers early in co-designing its cultural adaptations to ensure their needs can be met by this online tool.

Objective. Perinatal outcomes in the United States are poor among Hispanics, the country's fastest-growing population. Hispanics experience higher rates of obesity, diabetes, gestational diabetes, preterm birth, and pregnancy-related hypertension, as well as 20% of infant deaths. StartSmart^tm, an mHealth app, screens for risk and protective factors. This project translated and culturally adapted StartSmart^tm for Spanish-speaking pregnant women. Methods. Using the Beaton process for translation and cultural adaptation, we completed a six-stage process. Stage I: Translation into Spanish, Stage II: Synthesis of the translations, Stage III: Back-translation, Stage IV: Expert committee review, Stage V: Pretesting with Spanish-speaking pregnant women, Stage VI: Appraisal of process. Results. StartSmart^tm was acceptable and feasible for use during prenatal visits. Participants reported ease of use and understanding the material. No issues regarding literacy were identified, and participants provided helpful feedback for refining StartSmart^tm for Spanish-speaking women. Conclusions. The Beaton process ensures culturally appropriate translation.