Diagnosing foreign patients in Europe: An EADC‐ISTAART study

Background The detection rate of people with neurocognitive disorder is low (20-50%) even in highly developed countries. Early detection is a global priority (Aim 4 of WHO Global Action Plan on Dementia). Among the barriers to timely diagnosis in Europe is the migration status, which is currently increasing in prevalence, limiting access to specific assessments and care due to language barriers. Methods Within a wider European Alzheimer’s Disease Consortium (EADC) – ISTAART survey aimed at exploring the implementability of standard neuropsychological assessment in memory clinics, we examined the frequency and modality of assessments of foreign patients across tertiary memory clinics in Europe. Results Preliminary data show that in over 50% of EADC memory clinics, for which we have survey returns, foreign patients are assessed frequently (3 of 49 responding sites report daily, and 24/49 report monthly foreign assessments). Countries with more frequent requests are Belgium (4/4 Belgium responders report assessing foreign patients often, i.e. daily or monthly), Croatia (1/1), Czech Republic (1/1), Denmark (1/1), France (3/5), Germany (7/8), Sweden (2/2), Switzerland (4/4), and the United Kingdom (1/2). Only 9/49 centers reported using an interpreter often (>60% of assessed foreign cases). The majority (33/49) translate local tests; however, as many as 19 centers do use culture- and language-specific tests for foreign patients. Discussion: In tertiary European memory clinics, requests for assessments in a foreign language are very frequent, but the testing practices used for this purpose vary across sites. Our survey was conducted in centers of excellence and may not be fully representative: non-academic centers are expected to be even more heterogeneous in their practices. This survey allows us to define more specific investigations, and to devise interventions to improve detection of neurocognitive disorders among foreign patients. Conclusion Actions specifically dedicated to proper assessment of foreign people may contribute to improve early detection of neurocognitive disorders.