Table 4 Quoted text excerpts from migration-related guidelines
Country | Document title | Theme | Quoted text excerpt (original language) | English translation |
|---|---|---|---|---|
Austria | Medical guideline for integrated care for dementia patients | Dementia diagnosis – Diagnostic tools | “Der Mini-Cog ist ein einfaches Testverfahren zur Früherkennung von Demenzerkrankungen, dessen Aussagekraft durch kulturelle und sprachliche Unterschiede sowie durch unterschiedliche Bildungsniveaus nicht beeinträchtigt wird.” | The Mini-Cog is a simple test procedure for the early detection of dementia diseases, whose significance is not affected by cultural and linguistic differences and different levels of education. |
Belgium (Flanders) | You and me, together we are human: a reference framework for quality of life, housing and care for people with dementia | Challenges of diversity for healthcare | “Our Western society is getting more colourful and diverse. This is enriching but it does make some things more challenging for carers.” | |
Denmark | National clinical guidelines on the examination and treatment of dementia | Dementia diagnosis – Diagnostic tools | “Der foreligger en dansk validering af RUDAS baseret på testning af 137 patienter (heraf 34 med indvandrerbaggrund) fra demensudredningsenheder.” | There is a Danish validation of RUDAS based on testing of 137 patients (including 34 with immigrant background) from dementia assessment units. |
England/Wales | Dementia: Assessment, management and support for people living with dementia and their carers | Dementia diagnosis – Diagnostic tools | “The committee agreed that some tests (e.g., MoCA) are less robust in certain population groups due to cultural differences (educational levels, language issues), and this can skew the resulting diagnosis of dementia/continued suspicion of dementia.” | |
Germany | S-3 guideline Dementias | Dementia diagnosis – Diagnostic tools -Recommendations | “Ausführliche neuropsychologische Tests sollten bei fraglicher oder leichtgradiger Demenz zur differenzialdiagnostischen Abklärung eingesetzt werden. […] Beeinflussende Variablen, wie z.B. […] soziokultureller Hintergrund oder Sprachkenntnisse, müssen berücksichtigt werden.” | Extensive neuropsychological tests should be used for differential diagnosis of questionable or mild dementia. [...] Influencing variables, such as […] socio-cultural background or language skills, must be taken into account. |
Ireland | Dementia: Diagnosis & Management in General Practice | Dementia diagnosis – Diagnostic tools | 1. “The MIS is especially appropriate for use with ethnic minorities, as it does not show educational or language bias.” 2. “The Mini-Cog is less affected by subject ethnicity, language, and education […].” | |
Northern Ireland | Dementia: A NICE–SCIE Guideline on supporting people with dementia and their carers in health and social care | Development and effects of Dementia - Vulnerability | “People from minority ethnic groups have special considerations. Increased incidence of hypertension and diabetes among African, Caribbean and Asian people increases the risk of developing vascular dementia in older age.” | |
Norway | National professional guidelines on dementia | Dementia diagnosis and Care - Validity and Access - Causes | 1. “Utredning av. demens hos personer med minoritetsbakgrunn kan være utfordrende fordi pasienten har en annen kultur- og språkbakgrunn som kan gi kommunikasjonsutfordringer i konsultasjonen.” 2. “Det kan også være et problem at kognitive tester som brukes er så kultur- og språkspesifikke at de ikke er egnet som utredningsverktøy I forskjellige innvandrergrupper.” | 1. Investigating dementia in people with minority backgrounds can be challenging because the patient has a different cultural and language background, which can present communication challenges in the consultation. 2. It can also be a problem that the cognitive tests used are so culture and language specific that they are not suitable as an assessment tool in different immigrant groups. |
Scotland | Standards of Care for Dementia in Scotland | Dementia diagnosis - Recommendations, | “People worried about their memory have timely access to services for assessment, including those who may be seldom heard, e.g., […] black and ethnic minority communities […].” | |
Spain | Clinical Practice Guideline on the Comprehensive Care of People with Alzheimer’s Disease and other Dementias | Care - Impact of Culture and Language | 1. “The cognitive assessment tests used have a low positive predictive value and the disadvantage of not being able to many patients due to the limitations of these tests, which may be influenced by the patient’s age, sex, culture and education.” 2. “The risk of abuse is multifactorial, combining personal, family, social and cultural elements.” | |
Sweden | Evaluated version of the policy: Health and social care at Dementia | Healthcare services - Availability | “Utvärderingen tyder på att det finns brister i vården och omsorgen för personer från andra länder – både när det gäller möjligheten till tidig upptäckt, adekvat läkemedelsbehandling och vilka insatser som ges när någon har fått en demensdiagnos.” | The evaluation indicates that there are deficiencies in health and social care for people from other countries - both in terms of opportunity for early detection, adequate drug treatment, and what efforts are made when someone has a dementia diagnosis. |