The Cross-Cultural Dementia Screening (CCD): A new neuropsychological screening instrument for dementia in elderly immigrants

摘要

Currently, approximately 3.9% of the European population are non-EU citi- ' zens, and a large part of these people are from "non-Western" societies, such as Turkey and Morocco. For various reasons, the incidence of dementia in this group is expected to increase. However, cognitive testing is challenging due to language barriers and low i education and/or illiteracy. The newly developed Cross-Cultural Dementia Screening < (CCD) can be administered without an interpreter. It contains three subtests that assess I memory, mental speed, and executive function. We hypothesized the CCD to be a ' culture-fair test that could discriminate between demented patients and cognitively ! healthy controls. Method: To test this hypothesis, 54 patients who had probable dementia were recruited via memory clinics. Controls (A/ = 1625) were recruited via their general practitioners. All patients and controls were aged 55 years and older and of six different self-defined ethnicities (Dutch, Turkish, Moroccan-Arabic, Moroccan-Berber, Surinamese-Creole, and Surinamese-Hindustani). Exclusion criteria included current or previous conditions that affect cognitive functioning. Results: There were performance differences between the ethnic groups, but these disappeared after correcting for age and education differences between the groups, which supports our central hypothesis that the CCD is a culture-fair test. Receiver-operating characteristic (ROC) and logistic regression analyses showed that the CCD has high predictive validity for dementia (sensitivity: 85%; specificity: 89%). Discussion: The CCD is a sensitive and culture-fair neuropsychological instrument for dementia screening in low-educated immigrant populations.