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Meta-Analysis
. 2021 Aug;51(11):1838-1845.
doi: 10.1017/S0033291720000586. Epub 2020 Apr 8.

Migration and dementia: a meta-analysis of epidemiological studies in Europe

Jean-Paul Selten  1   2 , Fabian Termorshuizen  1   2 , Maarten van Sonsbeek  1 , Jan Bogers  1 , Ben Schmand  3   4
Affiliations
Meta-Analysis

Migration and dementia: a meta-analysis of epidemiological studies in Europe

Jean-Paul Selten et al. Psychol Med. 2021 Aug.

Abstract

Background: To provide an overview of epidemiological studies of dementia among migrant groups in Europe and to estimate their pooled odds ratio (OR) v. the reference population.

Methods: Search for articles reporting on incidence or prevalence of dementia among ethnic minorities and migrants in Europe, published before 21 December 2018. We performed several meta-analyses, using a random-effects model, and, when there was no evidence of heterogeneity, a fixed-effects model. We distinguished between all migrants, African-Europeans and Asian-Europeans.

Results: We retrieved five population-based surveys and two health care record studies. The latter included one incidence study, the remainder were prevalence studies. The meta-analysis of all studies yielded a pooled OR, adjusted for age and sex, of 1.73 (95% CI 1.42-2.11) for dementia in all migrant groups. However, the pooled OR of population surveys (3.10; 95% CI 2.12-4.51) was significantly higher than that for the health care record studies (OR 0.94; 95% CI 0.80-1.11). The pooled ORs for African-Europeans and Asian-Europeans, based on population surveys, were 2.54 (95% CI 1.70-3.80) and 5.36 (95% CI 2.78-10.31), respectively.

Conclusions: The discrepancy between health care record studies and population surveys suggests that many migrants remain undiagnosed. Migrants from Asia and Africa seem to be at significantly increased risk of dementia in Europe. Since the prevalence rates in their countries of origin are generally not higher than those for natives in Europe, there may be a parallel with the epidemiology of schizophrenia.

Keywords: Claudin-5; dementia; epidemiology; ethnicity; migration; social exclusion; social status.

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Figures

Fig. 1.
Fig. 1.
Meta-analysis of studies on risk of dementia among migrants in Europe, forest plot. The figure shows ORs for migrants v. the native-born, by the first author and region of origin or ethnic background of the migrant group.
Fig. 2.
Fig. 2.
Funnel plot of studies examining the association between a history of migration to Europe and the OR (v. non-migrants) of dementia. The funnel plot shows:

  1. the standard error of ln OR against the logarithmically transformed odds ratio (lnOR). In the absence of publication bias and over-dispersion (i.e. heterogeneity), the points should resemble a symmetrical inverted funnel.

  2. Egger's regression (in red) showing the SE plotted against the ln RR. Egger's test for funnel plot was not significant (p =0 .75).

See this image and copyright information in PMC

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