AAR  Vol.2 No.3 , August 2013
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
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.

Cite this paper
Ong, K. and Woodward, M. (2013) 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. Advances in Aging Research, 2, 94-99. doi: 10.4236/aar.2013.23013.
References
[1]   Woodward, M.C. and Woodward, E. (2009) A national survey of memory clinics in Australia. International Psychogeriatrics, 21, 696-702. doi:10.1017/S1041610209009156

[2]   LoGiudice, D., Hassett, A., Cook, R., et al. (2001) Equity of access to a memory clinic in Melbourne? Non-English speaking background attenders are more severely demented and have increased rates of psychiatric disorders. International Journal of Geriatric Psychiatry, 16, 327-334. doi:10.1002/gps.346

[3]   Bohnen, N.I., Djang, D.S., Herholz, K., et al. (2012) Effectiveness and safety of 18F-FDG PET in the evaluation of dementia: A review of the recent literature. Journal of Nuclear Medicine, 53, 59-71. doi:10.2967/jnumed.111.096578

[4]   Shaffer, J.L., Petrella, J.R., Sheldon, F.C., et al. (2013) Predicting cognitive decline in subjects at risk for Alzheimer disease by using combined cerebrospinal fluid, MR imaging, and PET biomarkers. Radiology, 266, 583-591. doi:10.1148/radiol.12120010

[5]   Roth, M., Tym, E., Mountjoy, C.Q., et al. (1986) CAMDEX: A standardised instrument for the diagnosis for mental disorder in the elderly with a special reference to early detection of dementia. British Journal of Psychiatry, 149, 698-709. doi:10.1192/bjp.149.6.698

[6]   Mioshi, E., Dawson, K., Mitchell, J., et al. (2006) The Addenbrooke’s Cognitive Examination Revised (ACE-R): A brief cognitive test battery for dementia screening. International Journal of Geriatric Psychiatry, 21, 10781085. doi:10.1002/gps.1610

[7]   Koenig, H.G., Meador, K.G., Cohen, H.J., et al. (1988) Self-rated depression scales and screening for major depression in the older hospitalized patient with medical illness. Journal of the American Geriatrics Society, 36, 699-706.

[8]   Folstein, M.F., Folstein, S.E. and McHugh, P.R. (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198. doi:10.1016/0022-3956(75)90026-6

[9]   Petersen, R.C. (2004) Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183194. doi:10.1111/j.1365-2796.2004.01388.x

[10]   Hou, C.E., Carlin, D. and Miller, B.L. (2004) Non-Alzheimer’s disease dementias: Anatomic, clinical, and molecular correlates. Canadian Journal of Psychiatry, 49, 164-171.

[11]   Zhou, J., Greicius, M.D., Gennatas, E.D., et al. (2010) Divergent network connectivity changes in behavioural variant frontotemporal dementia and Alzheimer’s disease. Brain, 133, 1352-1367. doi:10.1093/brain/awq075

[12]   Snowden, J.S., Neary, D. and Mann, D.M.A. (2002) Frontotemporal dementia. British Journal of Psychiatry, 180, 140-143. doi:10.1192/bjp.180.2.140

[13]   McKeith, I.G. (2002) Dementia with Lewy Bodies. British Journal of Psychiatry, 180, 144-147. doi:10.1192/bjp.180.2.144

[14]   Banerjee, S. and Wittenberg, R. (2009) Clinical and cost effectiveness of services for early diagnosis and intervention in dementia. International Journal of Geriatric Psychiatry, 24, 48-54. doi:10.1002/gps.2191

[15]   Prince, M., Bryce, R. and Ferri, C. (2011) Alzheimer’s Disease International World Alzheimer Report 2011. The benefits of early diagnosis and intervention. Alzheimer’s Disease International.

[16]   Moise, P., Schwarzinger, M. and Um, M.-Y. (2004) Demetia Expert’s Group. Dementia Care in 9 OECD Countries: A comparative analysis. OECD Health Working Papers, 13.

[17]   Seltzer, B. (2007) Donepezil: An update. Expert Opinion on Pharmacotherapy, 8, 1011-1023. doi:10.1517/14656566.8.7.1011

[18]   Mendez, M.F., Shapira, J.S., McMurtray, A., et al. (2001) Preliminary findings: Behavioral worsening on donepezil in patients with frontotemporal dementia. American Journal of Geriatric Psychiatry, 15, 84-87. doi:10.1097/01.JGP.0000231744.69631.33

[19]   Lopez, O.L., Litvan, I., Catt, K.E., et al. (1999) Accuracy of four clinical diagnostic criteria for the diagnosis of neurodegenerative dementias. Neurology, 53, 1292. doi:10.1212/WNL.53.6.1292

[20]   Albert, M.S., DeKosky, S.T., Dickson, D., et al. (2011) The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers & Dementia, 7, 270-279. doi:10.1016/j.jalz.2011.03.008

 
 
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