What do Korean American immigrants know about Alzheimer’s disease (AD)? The impact of acculturation and exposure to the disease on AD knowledge Sang E. Lee 1 , Hee Yun Lee 2 and Sadhna Diwan 1 1 San Jose State University, USA 2 University Of Minnesota, USA Correspondence to: S. E. Lee, E-mail: sangL@casa.sjsu.edu Objective: The present study examined knowledge of Alzheimer’s disease (AD) and factors related to the disease knowledge among Korean American immigrants. Methods: Two-hundred and nine middle-aged and older Korean American immigrants completed a self- administered questionnaire. Results: Korean American immigrants had strong stigma about AD and interpreted the disease as a form of insanity. They considered memory loss and AD as a part of the aging process. They seriously lacked knowledge about the treatment, diagnosis and cause of AD. Those who were less acculturated and less exposed to AD were likely to have poorer AD knowledge. Conclusions: There is a need to expand AD education efforts among Korean American immigrants because the views of stigmatization and normalization of AD combined with certain Asian cultural norms can be barriers to early recognition and intervention. Our study suggests knowledge areas of concentration in AD education and a segment of the population that AD education should target. Further research on symptom knowledge by the disease stages and causal beliefs is needed to better understand the existing views about AD in Korean American immigrants. Copyright # 2009 John Wiley & Sons, Ltd. Key words: Alzheimer’s disease; knowledge; Korean Americans; acculturation; exposure; immigrants; ethnic minority; dementia History: Received 9 October 2008; Accepted 18 March 2009; Published online 23 June 2009 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/gps.2299 Introduction Individuals’ knowledge about an illness is generally linked to their illness-related behaviors. Models explaining health behaviors, such as illness repres- entation (Leventhal et al., 1984) and mental health literacy (Jorm et al., 1997), suggest that individuals attempt to understand their symptoms based on their knowledge about an illness, which in turn affects their illness-related behaviors such as recognition, help- seeking, management and prevention (Jorm, 2000; Jorm et al., 2000; Werner, 2003 and 2004). Thus, as a first step in a process of promoting appropriate illness- related behaviors, it is crucial to assess individuals’ knowledge about an illness and to integrate it into educational materials for the general public and intervention strategies for health care professionals. Prior research on assessing knowledge about mental illness in the general public has predominantly focused on depression and schizophrenia (Werner, 2005). Attention to knowledge of Alzheimer’s disease (AD) has been growing due to the expected dramatic increase in AD in the next decades (Herbert et al., 2003). However, despite AD being primarily an older adult’s disease, most research on AD knowledge has rarely included older adults (Werner, 2005). Prior studies mainly focused on Whites, African Americans, and/or Hispanics and relatively limited attention has RESEARCH ARTICLE Copyright # 2009 John Wiley & Sons, Ltd. Int J Geriatr Psychiatry 2010; 25: 66–73.