Cognitive disorders in migrants: retrospective analysis in a Center for Cognitive Disorders and Dementia in Milan

Cova, Ilaria; Tedesco, F.; Maggiore, Laura; Pantoni, Leonardo; Pomati, Simone

doi:10.1007/s40520-019-01224-4

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…The facts and figures emerging from the survey are not representative of the entire population of migrants with cognitive disorders living in Italy. Indeed, as stated above, only regular migrants have access to CCDDs [34,35]. Moreover, the survey did not focus on other health and social care settings (e.g., primary care, emergency departments, reception centers) where migrants with cognitive problems may seek medical help.…”

Section: Discussionmentioning

confidence: 99%

A nationwide survey of Italian Centers for Cognitive Disorders and Dementia on the provision of care for international migrants

Canevelli

Cova

Remoli

et al. 2022

Euro J of Neurology

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Background More than 500,000 dementia cases can be estimated among migrants living in Europe. There is the need to collect “real world” data on the preparedness of healthcare services to support the inclusion of migrants in the public health response to dementia. The present study aimed (i) to estimate the number of migrants referred to Italian memory clinics (Centers for Cognitive Disorders and Dementia [CCDDs]) and (ii) to identify possible barriers and resources for the provision of diversity‐sensitive care. Methods A survey of all Italian CCDDs was conducted between December 2020 and April 2021. An online questionnaire was developed to obtain information on the number of migrants referred to Italian CCDDs in 2019, the challenges encountered in the diagnostic approach, and possible facilitators in the provision of care. Results Overall, 343 of the 570 contacted CCDDs completed the survey questionnaire (response rate: 60.2%). Nearly 4527 migrants were referred to these services in 2019. Migrants accounted for a median 1.1% (IQR: 0.9%–2.8%) of overall CCDD referrals. More than one‐third of respondents reported that the number of migrants referred to their facilities had increased in the last 5 years. The overall quality of the migrants' cognitive assessment was deemed to be very poor or insufficient in most cases. A minority of CCDDs had translated information material on dementia and reported the possibility to contact cultural mediators and interpreters. Conclusions A relevant number of migrants are being referred to Italian CCDDs that are still not adequately prepared to deliver diversity‐sensitive care and support.

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Section: Discussionmentioning

confidence: 99%

A nationwide survey of Italian Centers for Cognitive Disorders and Dementia on the provision of care for international migrants

Canevelli

Cova

Remoli

et al. 2022

Euro J of Neurology

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“…Moreover, in order to enhance participation, the project will be presented and disseminated in scientific and social manifestations. Second, exploratory data suggest that the issue of dementia among migrants is still under-represented in Italian dementia services 31 32. It could be expected that only a limited proportion of individuals with a migration background and belonging to minority groups might seek help for cognitive disturbances and that diverse barriers and inadequacies, both at the service and community level, might limit their access to our memory clinics.…”

Section: Discussionmentioning

confidence: 99%

Dementia among migrants and ethnic minorities in Italy: rationale and study protocol of the ImmiDem project

et al. 2020

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IntroductionDue to the ongoing demographic and epidemiological transitions, estimating the phenomenon of dementia in migrants and minority groups, exploring its characteristics and challenges and implementing dedicated healthcare policies, constitute emerging and urgent matters for Western countries. In the present paper we describe the rationale and design of the ‘Dementia in immigrants and ethnic minorities living in Italy: clinical-epidemiological aspects and public health perspectives” (ImmiDem) project.Methods and analysisThree main aims will be pursued by the ImmiDem project. First, a survey of all Italian dementia services will be conducted with dedicated questionnaires in order to estimate and describe the proportion and characteristics of migrants seeking help for cognitive disturbances. The different clinical approaches for diagnosing dementia and the challenges encountered in the assessment of cognitive functioning and in the provision of care in these groups of individuals will also be investigated. Second, record linkage procedures of data routinely collected in regional Health Information Systems will be conducted in order to identify and monitor migrant individuals with dementia living in the Lazio region. Third, tailored national and local care-coordination pathways and/or good practices dedicated to migrants affected by dementia and cognitive disorders will be identified and promoted.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Italian National Institute of Health (protocol 10749; 5 April 2018). The project was launched in November 2018 and will end in November 2021. The findings of the project will be disseminated through scientific peer-reviewed journals as well as to the public via the Dementia Observatory website (https://demenze.iss.it).

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“…More than one million dementia and mild cognitive impairment cases can be estimated among migrants living in Europe by applying age-standardized prevalence rates [ 6, 7 ]. An increase in the number of migrants with cognitive disturbances referred to dedicated healthcare facilities (e.g., memory clinics) has been documented in some European countries [ 8–10 ]. However, recent surveys have shown that these services are still only partially prepared to manage dementia in patients with a history of migration and that several gaps and barriers (e.g., low health literacy of migrants, poor adoption of cross-cultural cognitive assessment tools, lack of specific training for healthcare professionals, absence of dedicated referral pathways) still challenge a diversity-sensitive provision of care and support [ 11–13 ].…”

Section: Introductionmentioning

confidence: 99%

Case Identification and Characterization of Migrants with Dementia in the Lazio Region Using Health Administrative Data

Cascini

Canevelli

Agabiti

et al. 2023

JAD

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Background: A crucial step for planning effective public health policies for migrants with dementia is the collection of data on the local dimensions of the phenomenon and patients’ characteristics. Objective: This study aimed to identify and characterize migrants with dementia in the Lazio region using health administrative databases. Methods: Residents with dementia aged 50 years or older, living in the Lazio region as of December 31, 2018, were identified using a validated algorithm based on hospital discharge(s), claims for antidementia drugs, and co-payment exemption for dementia. Migrants were defined as people born abroad and grouped in migrants from High Migratory Pressure Countries (HMPCs) and Highly Developed Countries (HDCs). Overall and age-specific prevalence rates were estimated in native- and foreign-born patients. Results: Dementia was ascertained in 38,460 residents. Among them, 37,280 (96.9%) were born in Italy, 337 (0.9%) were migrants from HDCs, and 843 (2.2%) from HMPCs. Dementia prevalence was higher among natives (1.15%, 95% CI 1.14–1.16) relative to migrants from HDCs (0.60%, 95% CI 0.54–0.67) and HMPCs (0.29%, 95% CI 0.27–0.31). The prevalence of comorbidities did not differ between groups. Migrants with dementia had a lower likelihood of receiving antidementia treatments compared with natives (51.6% in migrants from HDCs, 49.3% in migrants from HMPCs, and 53.5% among Italians). Conclusion: Routinely collected data in healthcare administrative databases can support the identification of migrants with dementia. Migrants exhibited a lower age-standardized prevalence of registered dementia and lower access to dedicated treatments than Italians. These findings are suggestive of underdiagnosis and undertreatment of dementia in migrants.

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Cognitive disorders in migrants: retrospective analysis in a Center for Cognitive Disorders and Dementia in Milan

Cited by 7 publications

References 8 publications

A nationwide survey of Italian Centers for Cognitive Disorders and Dementia on the provision of care for international migrants

A nationwide survey of Italian Centers for Cognitive Disorders and Dementia on the provision of care for international migrants

Dementia among migrants and ethnic minorities in Italy: rationale and study protocol of the ImmiDem project

Case Identification and Characterization of Migrants with Dementia in the Lazio Region Using Health Administrative Data

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