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A Retrospective Study on Clinical Assessment of Cognitive Impairment in a Swedish Cohort : Is There Inequality Between Natives and Foreign-Born?

Nyholm, Ebba ; Torkpoor, Rozita LU orcid ; Frolich, Kristin LU orcid ; Londos, Elisabet LU and Cicognola, Claudia LU orcid (2022) In Journal of Alzheimer's disease : JAD 89(4). p.1403-1412
Abstract

BACKGROUND: People with a migration background are underrepresented in dementia research and disfavored in assessment and treatment, and many foreign-born individuals with dementia remain undiagnosed.

OBJECTIVE: The aim of this study was to examine whether there is inequality in the clinical assessment of dementia between native and foreign-born individuals in Sweden.

METHODS: Information was gathered retrospectively from a cohort of 91 native and 36 foreign-born patients attending four memory clinics in Skåne, Sweden. Data included information on cognitive test results, cerebrospinal fluid biomarkers, scores at structural imaging scales of global cortical atrophy (GCA), medial temporal lobe atrophy (MTA) and the Fazekas... (More)

BACKGROUND: People with a migration background are underrepresented in dementia research and disfavored in assessment and treatment, and many foreign-born individuals with dementia remain undiagnosed.

OBJECTIVE: The aim of this study was to examine whether there is inequality in the clinical assessment of dementia between native and foreign-born individuals in Sweden.

METHODS: Information was gathered retrospectively from a cohort of 91 native and 36 foreign-born patients attending four memory clinics in Skåne, Sweden. Data included information on cognitive test results, cerebrospinal fluid biomarkers, scores at structural imaging scales of global cortical atrophy (GCA), medial temporal lobe atrophy (MTA) and the Fazekas scale, laboratory measures of thyroid-stimulating hormone, calcium, albumin, homocysteine, hemoglobin, cobalamine (vitamin B12), and folate (vitamin B9), contact with health care, and treatment.

RESULTS: Foreign-born patients had lower educational level and scored lower on Mini-Mental State Examination and Clock Drawing Test (p <  0.001-0.011). Relatives initiated contact with health care to a higher extent in the foreign-born group (p = 0.031). Foreign-born patients had less white matter lesions (p = 0.018). Additionally, Alzheimer's disease (AD) biomarkers were significantly less used in foreign-born patients to support an AD diagnosis (p = 0.001). No significant differences were found for scores on GCA and MTA, laboratory measures, or initiated treatment.

CONCLUSION: Although native and foreign-born patients were predominantly homogenous regarding examined variables, differences in the diagnostic process and underlying biological correlates of dementia exist and need to be further investigated in a larger sample.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Alzheimer's disease : JAD
volume
89
issue
4
pages
1403 - 1412
publisher
IOS Press
external identifiers
  • scopus:85140144554
  • pmid:36057817
ISSN
1387-2877
DOI
10.3233/JAD-220177
language
English
LU publication?
yes
id
476f8e46-646e-463c-ad5b-66052a923058
date added to LUP
2022-09-11 12:30:35
date last changed
2024-04-04 11:48:21
@article{476f8e46-646e-463c-ad5b-66052a923058,
  abstract     = {{<p>BACKGROUND: People with a migration background are underrepresented in dementia research and disfavored in assessment and treatment, and many foreign-born individuals with dementia remain undiagnosed.</p><p>OBJECTIVE: The aim of this study was to examine whether there is inequality in the clinical assessment of dementia between native and foreign-born individuals in Sweden.</p><p>METHODS: Information was gathered retrospectively from a cohort of 91 native and 36 foreign-born patients attending four memory clinics in Skåne, Sweden. Data included information on cognitive test results, cerebrospinal fluid biomarkers, scores at structural imaging scales of global cortical atrophy (GCA), medial temporal lobe atrophy (MTA) and the Fazekas scale, laboratory measures of thyroid-stimulating hormone, calcium, albumin, homocysteine, hemoglobin, cobalamine (vitamin B12), and folate (vitamin B9), contact with health care, and treatment.</p><p>RESULTS: Foreign-born patients had lower educational level and scored lower on Mini-Mental State Examination and Clock Drawing Test (p &lt;  0.001-0.011). Relatives initiated contact with health care to a higher extent in the foreign-born group (p = 0.031). Foreign-born patients had less white matter lesions (p = 0.018). Additionally, Alzheimer's disease (AD) biomarkers were significantly less used in foreign-born patients to support an AD diagnosis (p = 0.001). No significant differences were found for scores on GCA and MTA, laboratory measures, or initiated treatment.</p><p>CONCLUSION: Although native and foreign-born patients were predominantly homogenous regarding examined variables, differences in the diagnostic process and underlying biological correlates of dementia exist and need to be further investigated in a larger sample.</p>}},
  author       = {{Nyholm, Ebba and Torkpoor, Rozita and Frolich, Kristin and Londos, Elisabet and Cicognola, Claudia}},
  issn         = {{1387-2877}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{4}},
  pages        = {{1403--1412}},
  publisher    = {{IOS Press}},
  series       = {{Journal of Alzheimer's disease : JAD}},
  title        = {{A Retrospective Study on Clinical Assessment of Cognitive Impairment in a Swedish Cohort : Is There Inequality Between Natives and Foreign-Born?}},
  url          = {{http://dx.doi.org/10.3233/JAD-220177}},
  doi          = {{10.3233/JAD-220177}},
  volume       = {{89}},
  year         = {{2022}},
}