Objectives: Racially minoritized populations are vulnerable to suffer from dementia, aside from experiencing health and resource disparities. However, research about dementia literacy of minoritized people in Chinese society is scarce, while dementia cases have been escalating. This study aimed to explore how minoritized groups understand dementia and its causal attributions, and what actions they intend to take if their family members are suspected of having dementia.

Methods: Qualitative-descriptive study design was used to delineate the understanding and beliefs about dementia from three minoritized groups (Indians, Pakistanis, and Nepalis) in Hong Kong. Focus group and individual interviews were conducted with a sample of 38 participants from December 2019 to February 2020. Thematic analysis was used to categorize the data and identify themes from the transcribed interviews.

Results: Five key themes were identified: normalization versus stigmatization of dementia; socio-spiritual versus biomedical attributions of dementia; familial responsibility versus potential caregiving burden; uncertainties versus openness to professional care; and barriers versus opportunities in dementia literacy. Minoritized people recognized dementia either as a disease of normal aging or a stigmatizing mental disorder. Spiritual and psychosocial factors were perceived as key causes of cognitive decline, although health education influenced perceptions of dementia as a medical condition. Participants stressed that families were the first point of help-seeking because of their filial responsibilities, but they also expressed the potential burden of dementia caregiving. Contrasting feelings of confidence or doubt towards professional services also surfaced. While information and language barriers existed in promoting dementia literacy, various strategies could be utilized to address these concerns.

Conclusion: Racially minoritized people in Hong Kong encountered difficulties to understand dementia and how to seek community services. While culture influenced their beliefs, health education was a potential buffer to correct their misperceptions and help-seeking behaviors. Support strategies could address family concerns in providing care to older people who may experience cognitive impairments. There is also a need to develop culture- and language-specific programs to improve their knowledge about dementia and health service access.

Funding: Hong Kong Polytechnic University - Faculty of Health and Social Sciences Collaborative Research Fund (Project No.: P0031062)