To date, international migrants (i.e., subjects born outside their current country of residence) account for 11.5% of overall European population. This immigrant population is steadily growing older, thus increasingly facing the burden of age-related chronic conditions. In particular, the occurrence of dementia and cognitive disorders in these individuals will likely assume (and is probably already assuming) a special relevance, for a number of reasons. In fact, it may pose important challenges in terms of diagnostic approach, provision of care and resources¿ utilization. It is to be noted that this phenomenon has already reached relevant dimensions with nearly 675,000 dementia cases estimated in the migrant populations living in the extended European Union in 2018. Nevertheless, this issue is still poorly investigated at the ¿real-world¿ level, at least in Italy. Specifically, the sociodemographic and clinical features of immigrant subjects attending Italian dementia services have been poorly characterized. Moreover, no screening or assessment tool for the culture-sensitive cognitive evaluation has so far been validated. Finally, the perceptions and knowledge of dementia among ethnically diverse groups living in Italy have not been explored and characterized.
The present project is therefore aimed at: 1) investigating and describing the demographic, sociocultural, and phenotypic characteristics of immigrants attending Italian centers for cognitive disturbances and dementia (CCDDs) due to cognitive disturbances; 2) validating a cognitive screening instrument supporting a culture-sensitive assessment of cognitive functions and dementia definition in migrants subjects referring to CCDDs; and 3) exploring the perception of dementia and dementia care among groups of older immigrants, relatives of immigrants living with dementia, and professional caregivers, health personnel and care workers dealing with this issue.
The present project constitutes the first attempt to achieve a better understanding of the issue of dementia in migrants from a clinical, neuropsychological, and ethno-cultural perspective. It represents the completion of other ongoing initiatives that are attempting to provide an epidemiological characterization of this emerging phenomenon (i.e., the ImmiDem project).
The project will consent to provide unique data concerning the demographic, socioeconomic, and clinical characteristics of immigrants with cognitive disturbances attending Italian CCDDs. The extensive and multidimensional collection of information should also allow to explore the accessibility to healthcare resources and to document eventual barriers and inadequacies in the provision of care. The validation of the MCE is a crucial step in the perspective of providing clinicians with a sensitive instrument for the culture-sensitive assessment of cognitive functioning. This objective seems of great relevance considering that the Italian population will increasingly be multiethnic and multicultural. The adoption of qualitative research methods (i.e., focus groups) will allow to culturally framing the phenomenon by capturing the attitudes, beliefs, and perceptions about dementia of individuals from diverse cultural groups. Moreover, the experiences of different professional figures already in contact with this issue will be valued. Overall, the findings coming from these different activities can inform and support the identification and implementation of tailored public health strategies.