Cognitive screening of low educated and illiterate older minority ethnic patients in a memory clinic setting

Dementia is one of the main health problems of our time. Also, the number of older people with a migration background in the Netherlands and in Europe increases. The incidence of dementia in this group will also increase due to aging and specific risk factors. Language differences, cultural differences and the often low level of education or illiteracy form the biggest barriers to an accurate dementia diagnosis. The first aim of this thesis was to improve diagnostic accuracy of cognitive screening tests for (low-educated) older people with a migration background. We found that the Dutch version of the RUDAS and the IQCODE are reliable and valid screening tests for dementia. The newly developed CCD is promising. The MMSE is less suitable for this group.
A second aim was to investigate the symptoms and clinical characteristics of older people with a migration background and to compare these with those of originally Dutch patients of the memory clinic. We found that people with a migration background were on average six years younger and had complaints about six months longer before presenting at the memory clinic. In addition, they had slightly more neuropsychiatric symptoms, they reported much more depressive symptoms and they were more likely to have diabetes mellitus.
The results of this thesis can contribute to timely and accurate dementia diagnosis in older people with a migration background, and thus to better advanced care planning. We also make recommendations for improving access to dementia diagnostic facilities and aftercare.