Equity of access to a memory clinic in Melbourne? Non‐English speaking background attenders are more severely demented and have increased rates of psychiatric disorders

Abstract

The clinical and demographic features of people of NESB referred to a memory clinic in Melbourne, Australia, differ from their ESB counterparts, with specific groups being under represented. This has implications for equity of assessment, service provision and utilisation for those of ethnically diverse backgrounds.

Non-English speaking background patients in a predominantly English-speaking region may be more likely to present with a dementia other than Alzheimer’s disease

“…Baseline demographic findings are similar to previous reports [1,2]. NESB patients experienced symptoms 18 months longer on average before receiving a formal diagnosis, supporting a previous report of increased symptom severity at presentation [2].…”

“…The aim of this study was to explore presentation and diagnostic trends of NESB and English speaking background (ESB) patients attending an Australian memory clinic service in Melbourne that extensively uses FDG PET in the diagnostic work-up process, and to see if these trends match those previously reported [2].…”

“…The AMS is located in the north-eastern suburbs of Melbourne Australia and is widely regarded as a centre of excellence, providing assessments of predominantly local residents but also those from further away who pose diagnostic difficulties. Unlike other memory clinics [2], there is onsite access to FDG PET. In addition, one of the clinical staff is both a neurologist with a special interest in dementia as well as a nuclear medicine specialist with a special interest in PET neuroimaging.…”

“…The client pathway through the AMS is similar to that described previously [2]. However, instead of using the Cambridge Examination for Mental Disorders in the Elderly [5], initial cognitive examination of those sufficiently proficient in English is mainly performed using the Addenbrooke's Cognitive Examination Revised (ACER) [6] as well as the Geriatric Depression Scale [7].…”

“…One study that focused on equity of access to a memory clinic service serving the north-western suburbs of Melbourne Australia noted that non-English speaking background (NESB) patients were under represented [2]. Furthermore, NESB patients were more likely to be diagnosed with a psychiatric disorder, and present in the later stages of dementia, though they present with similar rates of dementia subtypes, compared to English speaking background (ESB) patients.…”