Cultural factors in dementia: perspectives from the anthropology of aging.

The plasticity of cultural constructs of dementia is shown in two societies: Japan, and an American Indian nation. By demedicalizing the analysis of dementia, the social and cultural factors that influence recognition of symptoms, help-seeking strategies, caregiving behaviors, and adherence to biomedical and sociocultural coping advice become more obvious. Notably in the Japanese example, motivation toward primary prevention behavior is clear in the context of boke since it is an undesirable condition of frailty and cognitive decline considered to be preventable by remaining active. In the American Indian example, the hallucinatory symptoms are positively valued communications with the "other side" rather than pathologically defined. The findings show the need to extend dementia models beyond the biomedical in order to optimize prevention and management of this complex, chronic condition.