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. 2022 Jul;29(7):1892-1902.
doi: 10.1111/ene.15297. Epub 2022 Mar 10.

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

Marco Canevelli  1   2 , Ilaria Cova  3 , Giulia Remoli  2 , Ilaria Bacigalupo  2 , Emanuela Salvi  4 , Giorgia Maestri  3 , Alessia Nicotra  3 , Martina Valletta  1 , Antonio Ancidoni  2 , Francesco Sciancalepore  2 , Silvia Cascini  5 , Anna Maria Bargagli  5 , Simone Pomati  3 , Leonardo Pantoni  6 , Nicola Vanacore  2 ; ImmiDem Study Network; ImmiDem Study Group
Collaborators, Affiliations

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

Marco Canevelli et al. Eur J Neurol. 2022 Jul.

Abstract

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.

Keywords: culture-sensitivity; dementia; diversity; migration.

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Conflict of interest statement

The authors have no competing interests to disclose.

Figures

FIGURE 1
FIGURE 1
Centers for Cognitive Disorders and Dementia (CCDDs) that completed the survey questionnaire (a). Survey response rate in each Italian region (b) [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Boxplots depicting the distribution, at the national level and by geographic macro‐area, of the number of migrants referred to Centers for Cognitive Disorders and Dementia (CCDDs) (a), the number of migrants subjected to neuropsychological assessment (b), the proportion of visits (c), and neuropsychological assessments (d) applied to migrants in 2019. *p < 0.001 (Kruskal–Wallis test) [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Available resources for migrants with cognitive disturbances at the surveyed Centers for Cognitive Disorders and Dementia (CCDDs) (n = 343), by geographic macro‐area. *p < 0.001 (Chi‐square test) [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 4
FIGURE 4
Challenges encountered in the provision of care for migrants with cognitive disturbances based on the experience of the surveyed Centers for Cognitive Disorders and Dementia (CCDDs) (n = 343). BPSD, behavioral and psychological symptoms of dementia [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 5
FIGURE 5
Results of two logistic regression models exploring the factors associated with (a) ≥1 migrant referred to the Centers for Cognitive Disorders and Dementia (CCDDs) in 2019 (vs. no migrants) and (b) a sufficient quality of the cognitive assessment of migrants (vs. insufficient/very poor quality) (bivariate dependent variables of interest). CA: cognitive assessment; NP, neuropsychological. * p < 0.05; ** p < 0.001
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References

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