Non-English speaking background patients in a predominantly English-speaking region may be more likely to present with a dementia other than Alzheimer’s disease

Kevin Ong,Michael Woodward

doi:10.4236/aar.2013.23013

Abstract

Information on 54 patients was retrospectively collected to compare the presentation trends of cognitive disorders in those of non-English speaking background (NESB)to English speaking background(ESB)attending an Australian memory clinic that extensively uses fluorodeoxyglucose positron emission tomography(FDG PET) in the diagnosis of cognitive concerns. NESB patients were less likely to be diagnosed with Alzheimer’s disease(AD)as the sole neurodegenerative diagnosis (Fisher exact test, p = 0.08), and NESB patients with dementia were more likely to have non-AD dementia (Fisher exact test, p = 0.06). They experienced symptoms 18 months longer before receiving a formal diagnosis (t(46) = 2.2, p = 0.03). Older elderly NESB females were under represented in those presenting to the clinic (Fisher exact test, p = 0.04). The clinical work-up of NESB patients as opposed to those of ESB relied more heavily on FDG PET (Fisher exact test, p = 0.04). ESB and NESB patients may have different attitudes towards dementia, affecting how they present, and biomarkers may be more heavily relied on when language affects history taking and neuropsychological testing.

Highlights

Memory clinics are increasingly being established as centres of diagnostic excellence [1]
One study that focused on equity of access to a memory clinic service serving the north-western suburbs of Melbourne Australia noted that non-English speaking background (NESB) patients were under represented [2]
NESB patients were more likely to be diagnosed with a psychiatric disorder, and present in the later stages of dementia, though they present with similar rates of dementia subtypes, compared to English speaking background (ESB) patients

Summary

Introduction

Memory clinics are increasingly being established as centres of diagnostic excellence [1]. One study that focused on equity of access to a memory clinic service serving the north-western suburbs of Melbourne Australia noted that non-English speaking background (NESB) patients were under represented [2]. NESB patients were more likely to be diagnosed with a psychiatric disorder, and present in the later stages of dementia, though they present with similar rates of dementia subtypes, compared to English speaking background (ESB) patients. Rapid progress in the last few years in the dementia field includes translational studies promoting the integration into routine clinical practice of biomarkers like fluorodeoxyglucose positron emission tomography (FDG PET), which has been consistently demonstrated to have far greater sensitivity and specificity in discriminating between neurodegenerative subtypes, compared to clinical diagnostic criteria [3]. Memory clinics that incorporate FDG PET as part of the diagnostic work-up may further improve diagnostic accuracy

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