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Panzavolta A, Cerami C, Caffarra P, De Vita D, Dodich A, Fonti C, L'Abbate F, Laganà V, Lavorgna L, Marra C, Papagno C, Pellegrini FF, Stracciari A, Trojano L, Iaquinta T, Ravizza A, Sternini F, Pandolfi R, Sanzone S, Calore M, Cappa SF. A digital teleneuropsychology platform for the diagnosis of mild cognitive impairment: from concept to certification as a medical device. Neurol Sci 2024; 45:3125-3135. [PMID: 38378904 DOI: 10.1007/s10072-024-07403-0] [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: 01/12/2024] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Innovative digital solutions are shaping a new concept of dementia care, opening additional venues for prevention, diagnosis, monitoring and treatment. Hereby, we report the development of a tablet-based teleneuropsychology platform (Tenèpsia®), from concept to certification as Medical Device (MD) Class IIA, as per new MD regulation 745/2017. METHODS The platform was designed for the remote cognitive evaluation and created thanks to the effort of a collaborative working group including experts from three Italian scientific societies and Biogen Italia S.r.l. (hereafter "Biogen"), and developers from Xenia Reply and Inside AI. The development strategy was guided by converting traditional paper-and-pencil tests into digital versions while maintaining comparable neuropsychological features and optimizing patient accessibility and user experience. The experts focused on the choice and adaptation of traditional neuropsychology measures for a 45-min teleneuropsychology assessment. RESULTS The developers created a web and a mobile interface, respectively, for the professional (neuropsychologist) and non-professional (patient and caregiver) use. Recording of voice, drawing and typing information was enabled. Instant dashboards provide a quick overview of the patient's condition. Simulation activities were performed to obtain MD certification, valid across Europe. CONCLUSION Neuropsychology services will benefit from the implementation in clinics of harmonized digital tools with adequate scientific and technological standards. The use of digital cognitive testing for the diagnosis of mild cognitive impairment is expected to enhance patient and clinician outcomes through simplified, digital objective data collection, sparing of time and resources, with a positive impact on healthcare costs and access to treatments, reducing inequalities and delays in diagnosis and cure.
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Affiliation(s)
- Andrea Panzavolta
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Di Studi Superiori IUSS, Piazza Della Vittoria 15, 27100, Pavia, Italy
| | - Chiara Cerami
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Di Studi Superiori IUSS, Piazza Della Vittoria 15, 27100, Pavia, Italy.
- Dementia Research Center, Mondino Foundation IRCCS, Pavia, Italy.
| | - Paolo Caffarra
- Membro esperto Tavolo permanente sulle demenze del Ministero della Salute, Rome, Italy
| | - Dalila De Vita
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - Cristina Fonti
- IRCCS, Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Federica L'Abbate
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Valentina Laganà
- Associazione Per La Ricerca Neurogenetica Odv, Lamezia Terme, Italy
| | - Luigi Lavorgna
- Clinica Neurologica I, Azienda Ospedaliera Universitaria, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Camillo Marra
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | | | - Andrea Stracciari
- Membro esperto Tavolo permanente sulle demenze del Ministero della Salute, Rome, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | | | - Federico Sternini
- InsideAI, Bologna, Italy
- PolitoBIOMed Lab, Politecnico Di Torino, Turin, Italy
| | | | | | | | - Stefano F Cappa
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Di Studi Superiori IUSS, Piazza Della Vittoria 15, 27100, Pavia, Italy
- Dementia Research Center, Mondino Foundation IRCCS, Pavia, Italy
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Bacigalupo I, Giaquinto F, Salvi E, Carnevale G, Vaccaro R, Matascioli F, Remoli G, Vanacore N, Lorenzini P. A new national survey of centers for cognitive disorders and dementias in Italy. Neurol Sci 2024; 45:525-538. [PMID: 37592124 PMCID: PMC10791890 DOI: 10.1007/s10072-023-06958-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/08/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION A new national survey has been carried out by the Italian Centers for Cognitive Disorders and Dementias (CCDDs). The aim of this new national survey is to provide a comprehensive description of the characteristics, organizational aspects of the CCDDs, and experiences during the COVID-19 pandemic. METHODS A list of all national CCDDs was requested from the delegates of each Italian region. The online questionnaire is divided in two main sections: a profile section, containing information on location and accessibility, and a data collection form covering organization, services, treatments, activities, and any service interruptions caused by the COVID-19 outbreak. RESULTS In total, 511 out of 534 (96%) facilities completed the profile section, while 450 out of 534 (84%) CCDDs also completed the data collection form. Almost half of the CCDDs (55.1%) operated for 3 or fewer days a week. About one-third of the facilities had at least two professional figures among neurologists, geriatricians and psychiatrists. In 2020, only a third of facilities were open all the time, but in 2021, two-thirds of the facilities were open. CONCLUSION This paper provides an update on the current status of CCDDs in Italy, which still shows considerable heterogeneity. The survey revealed a modest improvement in the functioning of CCDDs, although substantial efforts are still required to ensure the diagnosis and care of patients with dementia.
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Affiliation(s)
- Ilaria Bacigalupo
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Via Giano Della Bella 34, 00161, Rome, Italy.
| | - Francesco Giaquinto
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Emanuela Salvi
- National Center for Drug Research and Evaluation, Italian National Institute of Health, Rome, Italy
| | - Giulia Carnevale
- Italian National Institute of Health FONDEM Study Group, Rome, Italy
| | - Roberta Vaccaro
- Italian National Institute of Health FONDEM Study Group, Rome, Italy
- GINCO, Aware Aging Group, Como, Italy
| | - Fabio Matascioli
- Italian National Institute of Health FONDEM Study Group, Rome, Italy
- TAM Onlus, Social Cooperative, Naples, Italy
| | - Giulia Remoli
- Neurology Section, University of Milano-Bicocca, Milan, Italy
| | - Nicola Vanacore
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Via Giano Della Bella 34, 00161, Rome, Italy
| | - Patrizia Lorenzini
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Via Giano Della Bella 34, 00161, Rome, Italy
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Bellelli G, Zucchelli A, Benussi A, Pinardi E, Caratozzolo S, Ornago AM, Cosseddu M, Stella V, Turrone R, Massariello F, Marengoni A, Padovani A. Assessing frailty at the centers for dementia and cognitive decline in Italy: potential implications for improving care of older people living with dementia. Neurol Sci 2023; 44:3509-3514. [PMID: 37280476 PMCID: PMC10495473 DOI: 10.1007/s10072-023-06885-8] [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: 03/03/2023] [Accepted: 05/29/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Frailty is strongly associated with the clinical course of cognitive impairment and dementia, thus arguing for the need of its assessment in individuals affected by cognitive deficits. This study aimed to retrospectively evaluate frailty in patients aged 65 years and older referred to two Centers for Cognitive Decline and Dementia (CCDDs). METHODS A total of 1256 patients consecutively referred for a first visit to two CCDDs in Lombardy (Italy) between January 2021 to July 2022 were included. All patients were evaluated by an expert physician in diagnosis and care of dementia according to a standardized clinical protocol. Frailty was assessed using a 24-items Frailty Index (FI) based on routinely collected health records, excluding cognitive decline or dementia, and categorized as mild, moderate, and severe. RESULTS Overall, 40% of patients were affected by mild frailty and 25% of the sample has moderate to severe frailty. The prevalence and severity of frailty increased with decreasing Mini Mental State Examination (MMSE) score and advancing age. Frailty was also detected in 60% of patients with mild cognitive impairment. CONCLUSION Frailty is common in patients referring to CCDDs for cognitive deficits. Its systematic assessment using a FI generated with readily available medical information could help develop appropriate models of assistance and guide personalization of care.
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Affiliation(s)
- G Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
- Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, Italy.
| | - A Zucchelli
- Department of Clinical and Experimental Sciences, Geriatric Unit, University of Brescia, Brescia, Italy
| | - A Benussi
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - E Pinardi
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - S Caratozzolo
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - A M Ornago
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - M Cosseddu
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - V Stella
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - R Turrone
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - F Massariello
- Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, Italy
| | - A Marengoni
- Department of Clinical and Experimental Sciences, Geriatric Unit, University of Brescia, Brescia, Italy
| | - A Padovani
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
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Fania A, Monaco A, Amoroso N, Bellantuono L, Cazzolla Gatti R, Firza N, Lacalamita A, Pantaleo E, Tangaro S, Velichevskaya A, Bellotti R. A Dementia mortality rates dataset in Italy (2012-2019). Sci Data 2023; 10:564. [PMID: 37626087 PMCID: PMC10457292 DOI: 10.1038/s41597-023-02461-z] [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: 04/21/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Dementia is on the rise in the world population and has been defined by the World Health Organization as a global public health priority. In Italy, according to demographic projections, in 2051 there will be 280 elderly people for every 100 young people, with an increase in all age-related chronic diseases, including dementia. Currently the total number of patients with dementia is estimated to be over 1 million (mainly with Alzheimer's disease (AD) and Parkinson's disease (PD)). In-depth studies of the etiology and physiology of dementia are complicated due to the complexity of these diseases and their long duration. In this work we present a dataset on mortality rates (in the form of Standardized Mortality Ratios, SMR) for AD e PD in Italy at provincial level over a period of 8 years (2012-2019). Access to long-term, spatially detailed and ready-to-use data could favor both health monitoring and the research of new treatments and new drugs as well as innovative methodologies for early diagnosis of dementia.
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Affiliation(s)
- Alessandro Fania
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, Via G. Amendola 173, Bari, 70125, Italy
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy
| | - Alfonso Monaco
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, Via G. Amendola 173, Bari, 70125, Italy.
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy.
| | - Nicola Amoroso
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy
- Dipartimento di Farmacia - Scienze del Farmaco, Universitá degli Studi di Bari Aldo Moro, Via A. Orabona 4, Bari, 70125, Italy
| | - Loredana Bellantuono
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy
- Dipartimento di Biomedicina Traslazionale e Neuroscienze (DiBraiN), Universitá degli Studi di Bari Aldo Moro, Piazza G. Cesare 11, Bari, 70124, Italy
| | - Roberto Cazzolla Gatti
- Department of Biological Sciences, Geological and Environmental (BiGeA), Alma Mater Studiorum - University of Bologna, Piazza Porta S. Donato 1, Bologna, 40126, Italy
| | - Najada Firza
- Dipartimento di Economia e Finanza, Universitá degli Studi di Bari Aldo Moro, Largo Abbazia S. Scolastica, Bari, 70124, Italy
- Catholic University Our Lady of Good Counsel, Rr. Dritan Hoxha 123, Laprake, Tirana, 1031, Albania
| | - Antonio Lacalamita
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, Via G. Amendola 173, Bari, 70125, Italy
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy
| | - Ester Pantaleo
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, Via G. Amendola 173, Bari, 70125, Italy
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy
| | - Sabina Tangaro
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy
- Dipartimento di Scienze del Suolo, della Pianta e degli Alimenti, Universitá degli Studi di Bari Aldo Moro, Via G. Amendola 165/a, Bari, 70126, Italy
| | - Alena Velichevskaya
- Biological Institute, Tomsk State University, Lenin Ave., 36, Tomsk, 634050, Russia
| | - Roberto Bellotti
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, Via G. Amendola 173, Bari, 70125, Italy
- Sezione di Bari, Istituto Nazionale di Fisica Nucleare (INFN), Via A. Orabona 4, Bari, 70125, Italy
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Redefinition of dementia care in Italy in the era of amyloid-lowering agents for the treatment of Alzheimer's disease: an expert opinion and practical guideline. J Neurol 2023; 270:3159-3170. [PMID: 36892630 DOI: 10.1007/s00415-023-11642-0] [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: 01/12/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/10/2023]
Abstract
No disease-modifying therapies are currently available for Alzheimer's disease (AD) in Europe. Current evidence from clinical trials testing anti-beta amyloid (Aβ) monoclonal antibodies (mAbs) in patients with early AD, though, suggests a likely marketing authorization in the next years. Since the implementation of disease-modifying therapies for AD in the clinical practice will evidently require a huge change of dementia care in all countries, a group of prominent AD clinical experts in Italy met to discuss patients' selection and management strategies. The current diagnostic-therapeutic standard of care in Italy was taken as the starting point. The prescription of new therapies cannot ignore the definition of a biological diagnosis through the assessment of both amyloid- and tau-related biomarkers. The high risk/benefit ratio of anti-Aβ immunotherapies, moreover, needs a highly specialized diagnostic work-up and a thorough exclusion criteria assessment, which should be provided by a neurology specialist. The Expert Panel also suggests a reorganization of the Centers for dementia and cognitive decline in Italy into 3 levels of increasing complexity: community center, first- and second-level center. Tasks and requirements for each level were defined. Finally, specific characteristics of a center deputed to prescribe anti-Aβ mAbs were discussed.
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Anti-dementia drugs: a descriptive study of the prescription pattern in Italy. Neurol Sci 2023; 44:1587-1595. [PMID: 36595207 PMCID: PMC9807981 DOI: 10.1007/s10072-022-06586-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/24/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Acetylcholinesterase inhibitors (AChEIs) and memantine are currently the only anti-dementia drugs (ADDs) approved for treating Alzheimer's disease (AD) in Italy. This nationwide study aims to characterize dementia drug utilization in a population > 65 years, during 2018-2020. METHODS Different administrative healthcare databases were queried to collect both aggregate and individual data. RESULTS ADD consumption remained stable throughout the study period (~ 9 DDD/1000 inhabitants per day). AChEI consumption was over 5 DDD/1000 inhabitants per day. Memantine consumption was nearly 4 DDD/1000 inhabitants per day, representing 40% of ADD consumption. The prevalence of use of memantine represented nearly half of ADD consumption, substantially unchanged over the 3 years. Comparing the AD prevalence with the prevalence of ADDs use, the gap becomes wider as age increases. In 2019, the proportion of private purchases of ADDs was 38%, mostly represented by donepezil and rivastigmine. In 2020, memantine was the only ADD with an increase in consumption (Δ% 19-20, 1.3%). DISCUSSION To our knowledge, this study represents the first attempt to investigate the ADD prescription pattern in Italy with a Public Health approach. In 2019, the proportion of ADD private purchases point out several issues concerning the reimbursability of ADDs. From a regulatory perspective, ADDs can be reimbursed by the National Health System only to patients diagnosed with AD; therefore, the off-label use of ADDs in patients with mild cognitive impairment may partially explain this phenomenon. The study extends knowledge on the use of ADDs, providing comparisons with studies from other countries that investigate the prescription pattern of ADDs.
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Bacigalupo I, Lombardo FL, Bargagli AM, Cascini S, Agabiti N, Davoli M, Scalmana S, Palma AD, Greco A, Rinaldi M, Giordana R, Imperiale D, Secreto P, Golini N, Gnavi R, Lovaldi F, Biagini CA, Gualdani E, Francesconi P, Magliocchetti N, Fiandra TD, Vanacore N. Identification of dementia and MCI cases in health information systems: An Italian validation study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12327. [PMID: 36320346 PMCID: PMC9617569 DOI: 10.1002/trc2.12327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 11/06/2022]
Abstract
Introduction The identification of dementia cases through routinely collected health data represents an easily accessible and inexpensive method to estimate the prevalence of dementia. In Italy, a project aimed at the validation of an algorithm was conducted. Methods The project included cases (patients with dementia or mild cognitive impairment [MCI]) recruited in centers for cognitive disorders and dementias and controls recruited in outpatient units of geriatrics and neurology. The algorithm based on pharmaceutical prescriptions, hospital discharge records, residential long-term care records, and information on exemption from health-care co-payment, was applied to the validation population. Results The main analysis was conducted on 1110 cases and 1114 controls. The sensitivity, specificity, and positive and negative predictive values in discerning cases of dementia were 74.5%, 96.0%, 94.9%, and 79.1%, respectively, whereas in detecting cases of MCI these values were 29.7%, 97.5%, 92.2%, and 58.1%, respectively. The variables associated with misclassification of cases were also identified. Discussion This study provided a validated algorithm, based on administrative data, which can be used to identify cases with dementia and, with lower sensitivity, also early onset dementia but not cases with MCI.
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Affiliation(s)
- Ilaria Bacigalupo
- National Center for Disease Prevention and Health PromotionItalian NationalInstitute of HealthRomeItaly
| | - Flavia L. Lombardo
- National Center for Disease Prevention and Health PromotionItalian NationalInstitute of HealthRomeItaly
| | | | - Silvia Cascini
- Department of EpidemiologyLazio Regional Health ServiceRomeItaly
| | - Nera Agabiti
- Department of EpidemiologyLazio Regional Health ServiceRomeItaly
| | - Marina Davoli
- Department of EpidemiologyLazio Regional Health ServiceRomeItaly
| | | | | | | | | | | | | | - Piero Secreto
- Geriatric unitLocal Health Authority TO3Piemonte RegionTurinItaly
| | - Natalia Golini
- Epidemiology UnitLocal Health Authority TO3Piemonte RegionGrugliascoItaly
| | - Roberto Gnavi
- Epidemiology UnitLocal Health Authority TO3Piemonte RegionGrugliascoItaly
| | | | | | - Elisa Gualdani
- Epidemiology UnitToscana Regional Health AgencyFlorenceItaly
| | | | | | - Teresa Di Fiandra
- General Directorate for Health PreventionMinistry of HealthRomeItaly
| | - Nicola Vanacore
- National Center for Disease Prevention and Health PromotionItalian NationalInstitute of HealthRomeItaly
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Mehrani I, Sachdev PS. The role of Memory Clinics in the assessment and management of dementia, now and into the future. Curr Opin Psychiatry 2022; 35:118-122. [PMID: 35026801 DOI: 10.1097/yco.0000000000000777] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The diagnosis of dementia is often delayed and many individuals with the disorder go undiagnosed or receive an inadequate assessment. Specialist Memory Clinics have long been at the centre of such assessments. Recent developments in biomarkers and disease-modifying treatments are likely increase the need for specialist assessments. It is therefore timely to review the role of Memory Clinics internationally. RECENT FINDINGS The timely diagnosis of dementia and cognitive decline is the main responsibility of Memory Clinics. These clinics can diagnose dementia up to 4 years earlier than primary care services, but their low numbers and capacity of leads to long waiting times and a focus on complex cases. Few clinics are resourced to offer specific postdiagnostic support services, and their roles in clinical trials and research have not been realised. They are often well integrated with primary care and aged care services. SUMMARY Memory Clinics play an important role in bridging the gap between research and clinical practice and providing high-quality assessment and care. Additional Memory Clinic services and greater harmonisation of their responsibilities and procedures are needed to exploit their full potential.
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Affiliation(s)
- Inga Mehrani
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine and Health, The University of New South Wales
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine and Health, The University of New South Wales
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
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Canevelli M, Cova I, Remoli G, Bacigalupo I, Salvi E, Maestri G, Nicotra A, Valletta M, Ancidoni A, Sciancalepore F, Cascini S, Bargagli AM, Pomati S, Pantoni L, Vanacore N. A nationwide survey of Italian centers for cognitive disorders and dementia on the provision of care for international migrants. Eur J Neurol 2022; 29:1892-1902. [PMID: 35189011 PMCID: PMC9314112 DOI: 10.1111/ene.15297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
Background More than 500,000 dementia cases can be estimated among migrants living in Europe. There is the need to collect “real world” data on the preparedness of healthcare services to support the inclusion of migrants in the public health response to dementia. The present study aimed (i) to estimate the number of migrants referred to Italian memory clinics (Centers for Cognitive Disorders and Dementia [CCDDs]) and (ii) to identify possible barriers and resources for the provision of diversity‐sensitive care. Methods A survey of all Italian CCDDs was conducted between December 2020 and April 2021. An online questionnaire was developed to obtain information on the number of migrants referred to Italian CCDDs in 2019, the challenges encountered in the diagnostic approach, and possible facilitators in the provision of care. Results Overall, 343 of the 570 contacted CCDDs completed the survey questionnaire (response rate: 60.2%). Nearly 4527 migrants were referred to these services in 2019. Migrants accounted for a median 1.1% (IQR: 0.9%–2.8%) of overall CCDD referrals. More than one‐third of respondents reported that the number of migrants referred to their facilities had increased in the last 5 years. The overall quality of the migrants' cognitive assessment was deemed to be very poor or insufficient in most cases. A minority of CCDDs had translated information material on dementia and reported the possibility to contact cultural mediators and interpreters. Conclusions A relevant number of migrants are being referred to Italian CCDDs that are still not adequately prepared to deliver diversity‐sensitive care and support.
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Affiliation(s)
- Marco Canevelli
- Department of Human Neuroscience, "Sapienza" University, Rome, Italy.,National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Ilaria Cova
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Giulia Remoli
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Ilaria Bacigalupo
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Emanuela Salvi
- National Center for Drug Research and Evaluation, Italian National Institute of Health, Rome, Italy
| | - Giorgia Maestri
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Alessia Nicotra
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Martina Valletta
- Department of Human Neuroscience, "Sapienza" University, Rome, Italy
| | - Antonio Ancidoni
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Francesco Sciancalepore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Silvia Cascini
- Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy
| | - Anna Maria Bargagli
- Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy
| | - Simone Pomati
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Leonardo Pantoni
- Stroke and Dementia Lab, "Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
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