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. 2023;92(3):843-852.
doi: 10.3233/JAD-221146.

Case Identification and Characterization of Migrants with Dementia in the Lazio Region Using Health Administrative Data

Silvia Cascini  1 , Marco Canevelli  2   3   4 , Nera Agabiti  1 , Laura Angelici  1 , Marina Davoli  1 , Ilaria Bacigalupo  3 , Ilaria Cova  5 , Nicola Vanacore  3 , Simone Pomati  5 , Leonardo Pantoni  6 , Anna Acampora  1 , Anna Maria Bargagli  1 ; ImmiDem Study Group
Collaborators, Affiliations

Case Identification and Characterization of Migrants with Dementia in the Lazio Region Using Health Administrative Data

Silvia Cascini et al. J Alzheimers Dis. 2023.

Abstract

Background: A crucial step for planning effective public health policies for migrants with dementia is the collection of data on the local dimensions of the phenomenon and patients' characteristics.

Objective: This study aimed to identify and characterize migrants with dementia in the Lazio region using health administrative databases.

Methods: Residents with dementia aged 50 years or older, living in the Lazio region as of December 31, 2018, were identified using a validated algorithm based on hospital discharge(s), claims for antidementia drugs, and co-payment exemption for dementia. Migrants were defined as people born abroad and grouped in migrants from High Migratory Pressure Countries (HMPCs) and Highly Developed Countries (HDCs). Overall and age-specific prevalence rates were estimated in native- and foreign-born patients.

Results: Dementia was ascertained in 38,460 residents. Among them, 37,280 (96.9%) were born in Italy, 337 (0.9%) were migrants from HDCs, and 843 (2.2%) from HMPCs. Dementia prevalence was higher among natives (1.15%, 95% CI 1.14-1.16) relative to migrants from HDCs (0.60%, 95% CI 0.54-0.67) and HMPCs (0.29%, 95% CI 0.27-0.31). The prevalence of comorbidities did not differ between groups. Migrants with dementia had a lower likelihood of receiving antidementia treatments compared with natives (51.6% in migrants from HDCs, 49.3% in migrants from HMPCs, and 53.5% among Italians).

Conclusion: Routinely collected data in healthcare administrative databases can support the identification of migrants with dementia. Migrants exhibited a lower age-standardized prevalence of registered dementia and lower access to dedicated treatments than Italians. These findings are suggestive of underdiagnosis and undertreatment of dementia in migrants.

Keywords: Access to care; dementia; diversity; migrants; record linkage.

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Conflict of interest statement

The authors have no conflict of interest to report.

Marco Canevelli is an Editorial Board Member of this journal but was not involved in the peer-review process nor had access to any information regarding its peer-review.

Figures

Fig. 1
Fig. 1
Study population. HDCs, highly developed countries; HMPCs, high migratory pressure countries.
Fig. 2
Fig. 2
Venn diagrams showing the number of dementia cases identified in each of the three healthcare and administrative datasets by migrant status and the intersects of these three data sources. HDCs, highly developed countries; HMPCs, high migratory pressurecountries.
Fig. 3
Fig. 3
Countries of birth of migrants with dementia living in the Lazio region.
Fig. 4
Fig. 4
Dementia prevalence (A) and case distribution (B) by age class in among Italians and migrants from highly developed countries (HDCs) and high migratory pressure countries (HMPCs).
See this image and copyright information in PMC

References

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