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Nielsen TR, Franzen S, Watermeyer T, Jiang J, Calia C, Kjærgaard D, Bothe S, Mukadam N. Interpreter-mediated neuropsychological assessment: Clinical considerations and recommendations from the European Consortium on Cross-Cultural Neuropsychology (ECCroN). Clin Neuropsychol 2024; 38:1775-1805. [PMID: 38588670 DOI: 10.1080/13854046.2024.2335113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/19/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE With increasing international migration, societies have become increasingly diverse worldwide. Although neuropsychological assessment is influenced by several diversity characteristics, language barriers have repeatedly been identified as one of the main challenges to cross-cultural neuropsychological assessment in migrant populations. Importantly, neuropsychologists are often required to conduct interpreter-mediated neuropsychological assessments without any graduate training or continuing education on the topic. To address this gap, the objective of this paper is to provide guidelines for interpreter-mediated neuropsychological assessment. METHOD A European Consortium on Cross-Cultural Neuropsychology (ECCroN) task force conducted a conceptual literature review and provided recommendations for good practice and working principles to inform the preparation and administration of interpreter-mediated assessments. RESULTS ECCroN takes the position that it is the responsibility of neuropsychologists, as well as the institutions or organizations that employ them, to ensure effective communication between themselves and their patients. This may be accomplished by preparing for an interpreter-mediated assessment by engaging an appropriate interpreter, which in most circumstances will be a professional in-person interpreter speaking the same language(s) or dialect(s) as the patient, and considering practical, language, and cross-cultural issues. During the assessment, reasonable steps should be taken to proactively manage the proceedings and adopt a communication style that facilitates effective patient-directed communication, and when interpreting test data and determining formulations and diagnoses, the limitations of interpreter-mediated assessment should be carefully considered. CONCLUSION Adhering to the provided recommendations and working principles may help neuropsychologists provide competent interpreter-mediated neuropsychological assessments to linguistically diverse patients.
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Affiliation(s)
- T Rune Nielsen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Sanne Franzen
- Department of Neurology & Alzheimer Center, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tamlyn Watermeyer
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Jessica Jiang
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Clara Calia
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Daniel Kjærgaard
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Søren Bothe
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- DIGNITY - Danish Institute Against Torture, Copenhagen, Denmark
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Achaa-Amankwaa P, Kushnereva E, Miksch H, Stumme J, Heim S, Ebersbach M. Multilingualism is associated with small task-specific advantages in cognitive performance of older adults. Sci Rep 2023; 13:16912. [PMID: 37805638 PMCID: PMC10560281 DOI: 10.1038/s41598-023-43961-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/30/2023] [Indexed: 10/09/2023] Open
Abstract
The protective effects of multiple language knowledge on the maintenance of cognitive functions in older adults have been discussed controversially, among others, because of methodological inconsistencies between studies. In a sample of N = 528 German monolinguals and multilinguals (speaking two or more languages) older than 60 years, this study examined (1) whether speaking multiple languages is positively related to performance on tasks of interference suppression, working memory, concept shifting, and phonemic and semantic fluency, and (2) whether language proficiency and age of second language acquisition (AoA) are associated with cognitive performance of multilinguals. Controlling for education and daily activity, we found small cognitive benefits of speaking multiple languages on interference suppression, working memory, and phonemic fluency, but not on concept shifting and semantic fluency. Furthermore, no substantive correlations were found between language proficiency or AoA and cognitive performance. In conclusion, multilingualism appears to have small incremental effects on cognitive performance beyond education and daily activity in older age that are task-specific and widely independent of proficiency and AoA.
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Affiliation(s)
- Priscilla Achaa-Amankwaa
- Institute of Psychology, University of Kassel, Holländische Strasse 36-38, 34127, Kassel, Germany.
| | - Ekaterina Kushnereva
- Institute of Psychology, University of Kassel, Holländische Strasse 36-38, 34127, Kassel, Germany
| | - Hanna Miksch
- Institute of Psychology, University of Kassel, Holländische Strasse 36-38, 34127, Kassel, Germany
| | - Johanna Stumme
- Institute of Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Stefan Heim
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Mirjam Ebersbach
- Institute of Psychology, University of Kassel, Holländische Strasse 36-38, 34127, Kassel, Germany
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Tolchinsky Wiesen G, Calvo Escalona R, Inzitari M. [Medical attention in bilingual territories]. Med Clin (Barc) 2023; 160:39-43. [PMID: 36253207 DOI: 10.1016/j.medcli.2022.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Gustavo Tolchinsky Wiesen
- Servicio de Medicina Interna, Hospital Municipal, Badalona Serveis Assistencials, Badalona, España; Junta de Gobierno, Colegio Oficial de Médicos de Barcelona, Barcelona, España.
| | - Rosa Calvo Escalona
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Hospital Clinic de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, España; Institut d'Investigacións Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Departamento de Medicina, Universitat de Barcelona, Barcelona, España
| | - Marco Inzitari
- RE-FiT Barcelona Research Group, Vall d'Hebrón Institute of Research (VHIR), Barcelona, España; Facultad de Ciencias de la Salud, Universitat Oberta de Catalunya, Barcelona, España
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Temple J, Wilson T, Brijnath B, Radford K, LoGiudice D, Utomo A, Anstey KJ. The role of demographic change in explaining the growth of Australia's older migrant population living with dementia, 2016-2051. Aust N Z J Public Health 2022; 46:661-667. [PMID: 36047851 DOI: 10.1111/1753-6405.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine the demographic drivers contributing to the future growth in the population of older migrants in Australia living with dementia. METHODS Using birthplace-specific cohort-component projection models, we projected the number of older migrants living with dementia. ABS data on births, deaths, migration and birthplace were used, alongside Australian Institute of Health and Welfare (AIHW) estimates of dementia prevalence with birthplace dementia weights calculated from administrative data. RESULTS The number of older migrants living with dementia is projected to increase from about 134,423 in 2016 to 378,724 by 2051. Increases in populations with dementia varied considerably, from a slight decrease for those born in Southern & Eastern Europe to over 600% increases amongst the South-East Asia, Southern & Central Asia, and Sub-Saharan Africa-born populations. CONCLUSIONS Cohort flow is the primary driver increasing the number of older migrants living with dementia. This growth is largely inevitable because the cohorts are already living in Australia as part of the migrant population, but currently at ages below 60 years. IMPLICATIONS FOR PUBLIC HEALTH High relative growth and shifting birthplace composition in the number of migrants living with dementia poses implications for culturally appropriate care, health care access and workforce needs to support migrant families, carers and their communities.
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Affiliation(s)
- Jeromey Temple
- Melbourne School of Population and Global Health, University of Melbourne, Victoria
| | - Tom Wilson
- Melbourne School of Population and Global Health, University of Melbourne, Victoria
| | | | - Kylie Radford
- Neuroscience Research Australia, University of New South Wales
| | - Dina LoGiudice
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria
| | - Ariane Utomo
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Victoria
| | - Kaarin J Anstey
- Neuroscience Research Australia, University of New South Wales
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Temple J, Wilson T, Brijnath B, Utomo A, McDonald P. English Language Proficiency Among Older Migrants in Australia, 2016-2046. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2021; 23:403-429. [PMID: 34131412 PMCID: PMC8193169 DOI: 10.1007/s12134-021-00836-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 01/10/2023]
Abstract
Australia’s population is growing, ageing and exhibiting increasing heterogeneity with respect to birthplace and ethnic composition. Yet, little is understood about the levels of English language proficiency among the next generation of older migrants in Australia. Utilising a modified cohort-component model incorporating detailed language proficiency transition probabilities, we project birthplace populations by levels of English language proficiency to mid-century. Our results show that although Asian-born migrants tend to have lower levels of English proficiency, the majority of older migrants with poor proficiency are currently from a predominantly European background. In the future, we project a strong shift in the population of poor English speakers toward an Asian-born dominance as some European-born migrant groups dwindle in size and cohort flow increases population growth among older Asian migrants. Specifically, most of the population growth among older migrants with poor English proficiency occurs among Chinese and Mainland Southeast Asian migrants. However, we demonstrate that population growth among the total migrant population with poor proficiency is considerably lower than populations with good proficiency or from English-speaking households. Over the projection horizon, the total older migrant population with poor English proficiency increases by under 80,000 compared with an increase of 726,000 with good levels of proficiency and 518,000 in English-speaking households. However, we caution against conflating improved English language proficiency with a policy shift away from ethno-specific aged care services as culture, which is more than language, strongly influences perceptions of quality of aged care.
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Affiliation(s)
- Jeromey Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Tom Wilson
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Melbourne, Australia
| | - Ariane Utomo
- School of Geography, Faculty of Science, University of Melbourne, Melbourne, Australia
| | - Peter McDonald
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
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Cong L, Miyaguchi H, Ishizuki C. Comparison of Activation in the Prefrontal Cortex of Native Speakers of Mandarin by Ability of Japanese as a Second Language Using a Novel Speaking Task. Healthcare (Basel) 2021; 9:healthcare9040412. [PMID: 33918495 PMCID: PMC8065755 DOI: 10.3390/healthcare9040412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022] Open
Abstract
Evidence shows that second language (L2) learning affects cognitive function. Here in this work, we compared brain activation in native speakers of Mandarin (L1) who speak Japanese (L2) between and within two groups (high and low L2 ability) to determine the effect of L2 ability in L1 and L2 speaking tasks, and to map brain regions involved in both tasks. The brain activation during task performance was determined using prefrontal cortex blood flow as a proxy, measured by functional near-infrared spectroscopy (fNIRS). People with low L2 ability showed much more brain activation when speaking L2 than when speaking L1. People with high L2 ability showed high-level brain activation when speaking either L2 or L1. Almost the same high-level brain activation was observed in both ability groups when speaking L2. The high level of activation in people with high L2 ability when speaking either L2 or L1 suggested strong inhibition of the non-spoken language. A wider area of brain activation in people with low compared with high L2 ability when speaking L2 is considered to be attributed to the cognitive load involved in code-switching L1 to L2 with strong inhibition of L1 and the cognitive load involved in using L2.
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Affiliation(s)
- Li Cong
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima City 734-8551, Japan;
- Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima City 739-2695, Japan
| | - Hideki Miyaguchi
- Department of Human Behavior Science of Occupational Therapy, Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City 734-8551, Japan;
- Correspondence: ; Tel.: +81-82-257-5440
| | - Chinami Ishizuki
- Department of Human Behavior Science of Occupational Therapy, Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City 734-8551, Japan;
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Wilson T, McDonald P, Temple J, Brijnath B, Utomo A. Past and projected growth of Australia's older migrant populations. GENUS 2020; 76:20. [PMID: 32834077 PMCID: PMC7403568 DOI: 10.1186/s41118-020-00091-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/20/2020] [Indexed: 01/05/2023] Open
Abstract
In recent years, Australia’s older population (aged 65 and over) has been growing rapidly, accompanied by a shift in its country of birth composition. Although a great deal of research has been undertaken on past and current aspects of Australia’s migrant groups, little attention has been paid to future demographic trends in older populations. The aim of this paper is to examine recent and possible future demographic trends of Australia’s migrant populations at the older ages. We present population estimates by country and broad global region of birth from 1996 to 2016, and then new birthplace-specific population projections for the 2016 to 2056 period. Our findings show that substantial growth of the 65+ population will occur in the coming decades, and that the overseas-born will shift from a Europe-born dominance to an Asia-born dominance. Cohort flow (the effect of varying sizes of cohorts moving into the 65+ age group over time) will be the main driver of growth for most older birthplace populations. The shifting demography of Australia’s older population signals many policy, planning, service delivery and funding challenges for government and private sector providers. We discuss those related to aged care, health care, language services, the aged care workforce, regulatory frameworks and future research needs in demography and gerontology.
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Affiliation(s)
- Tom Wilson
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Peter McDonald
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Jeromey Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Parkville, Australia
| | - Ariane Utomo
- School of Geography, University of Melbourne, Melbourne, Australia
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Hwang K, De Silva A, Simpson JA, LoGiudice D, Engel L, Gilbert AS, Croy S, Haralambous B. Video-interpreting for cognitive assessments: An intervention study and micro-costing analysis. J Telemed Telecare 2020; 28:58-67. [PMID: 32228142 DOI: 10.1177/1357633x20914445] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Evidence in the literature demonstrates the reliability of cognitive screening assessments using video technology in English-speaking older populations. However, this has not been tested in older culturally and linguistically diverse (CALD) populations who require an interpreter, and what the associated costs would be. The aim was to determine if the Rowland Universal Dementia Assessment Scale (RUDAS) and the Geriatric Depression Scale (GDS) could be reliably administered over video-interpreting methods compared with face-to-face interpreting. In addition, the study aims to compare the costs of video-interpreting with the costs of face-to-face interpreting. METHODS We compared similarity of the RUDAS and GDS scores when administered face-to-face and via video-interpreting. The similarity of scores between methods was analysed using paired t-tests and Bland-Altman plots. A costing analysis was done using a micro-costing approach to estimate the costs of video-interpreting compared with face-to-face, extrapolated to a national level. RESULTS Analysis found no significant differences in the mean assessment scores between video-interpreting and face-to-face (RUDAS mean difference: -0.36; 95% confidence interval (CI): -1.09, 0.38, GDS mean difference: 0.22; 95% CI: -0.38, 0.83). Bland-Altman plots demonstrated that 71% of RUDAS scores and 82% of GDS scores were within the maximum allowed difference of ±2 units. Costing analysis showed a A$7 saving per assessment when using video-interpreting compared with face-to-face, with a total national saving of A$247,350. DISCUSSION Video-interpreting was found to be as reliable as face-to-face interpreting for both RUDAS and GDS assessments. Cost analysis indicates that video-interpreting is cheaper than face-to-face interpreting.
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Affiliation(s)
- Kerry Hwang
- National Ageing Research Institute, Parkville, Australia
| | - Anurika De Silva
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Julie A Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Dina LoGiudice
- National Ageing Research Institute, Parkville, Australia.,Melbourne Health, Melbourne, Australia
| | - Lidia Engel
- Deakin Health Economics, School of Health and Social Development, Deakin University, Melbourne, Australia
| | - Andrew S Gilbert
- National Ageing Research Institute, Parkville, Australia.,Department of Social Inquiry, La Trobe University, Melbourne, Australia
| | - Samantha Croy
- National Ageing Research Institute, Parkville, Australia
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