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Research article
Tim Schmachtenberg
Deutsches Zentrum fur Neurodegenerative Erkrankungen
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4232-5095
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Background People with a migration background are a vulnerable group regarding dementia. Providing care for this group is a public health challenge in Europe. Many countries are issuing care guidelines, but a systematic overview of their references to migration is lacking. This study aims to determine the extent to which care guidelines take people with a migration background into account, which migration-related content focuses are set and to what extent specific actions are considered or recommendations are made to ensure their care.
Methods This study is a systematic analysis of national dementia care guidelines of the EU and EFTA (European Free Trade Association) countries. Using the discourse analysis model by Rainer Keller (2011), n=43 documents from n= 24 EU and n=3 EFTA countries were systematically screened for migration references via keyword and context analysis. The content of the migration-related section was paraphrased, memos and comments were added and the individual text passages were coded using the strategy of open coding.
Results 27 of the 35 EU- and EFTA countries have guidelines or similar documents on care for people with dementia and twelve refer to migration. Norway, Sweden, and Northern Ireland refer to this topic in detail. The focus of the migration-related documents is on the early detection and diagnosis of dementia. The main message is that standardized diagnostic tools such as the Mini-Mental State Examination (MMSE) or the clock test are not suitable for linguistic minorities. Nine countries make recommendations for the care of people with a migration background and dementia but only Norway, Sweden, and Denmark point to available healthcare services. A key recommendation is that the linguistic and cultural background of people should be taken into account when selecting diagnostic tests. Several countries refer to the validity of the RUDAS (Rowland Universal Dementia Assessment Scale) for migrants.
Conclusions The topic of migration plays a subordinate role in the care guidelines of European countries. Almost all countries lack appropriate diagnostic tools and healthcare services for people with a migration background. Consequently, people with a migration background are a risk group for underdiagnosis and a lower level of care.
Keywords
dementia, migration, care, healthcare services, Europe, guidelines, policies, recommendations
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On 08 Oct, 2020
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Posted 03 Oct, 2020
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On 01 Oct, 2020
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On 30 Sep, 2020
Editor invited
On 30 Sep, 2020
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Posted 19 Feb, 2020
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Review #2 received
Received 11 May, 2020
Editorial decision: Major revision
On 11 May, 2020
Review #3 received
Received 08 May, 2020
Reviewer #3 agreed
On 18 Apr, 2020
Reviewer #2 agreed
On 15 Apr, 2020
Review #1 received
Received 07 Apr, 2020
Reviewer #1 agreed
On 19 Feb, 2020
Reviewers invited
Invitations sent on 18 Feb, 2020
Editor assigned
On 18 Feb, 2020
Submission checks complete
On 17 Feb, 2020
Editor invited
On 17 Feb, 2020
First submitted
On 06 Feb, 2020
Version (no preprint)
Posted 19 Feb, 2020
Editorial decision: Major revision
On 23 Sep, 2020
Review #2 received
Received 11 Sep, 2020
Reviewer #2 agreed
On 02 Sep, 2020
Review #1 received
Received 31 Jul, 2020
Reviewer #1 agreed
On 25 Jun, 2020
Reviewers invited
Invitations sent on 22 Jun, 2020
Editor assigned
On 21 Jun, 2020
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On 20 Jun, 2020
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tim Schmachtenberg
Deutsches Zentrum fur Neurodegenerative Erkrankungen
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4232-5095
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Submission checks complete
On 10 Oct, 2020
Editorial decision: Accept
On 08 Oct, 2020
Version (no preprint)
Posted 03 Oct, 2020
Editor assigned
On 01 Oct, 2020
Submission checks complete
On 30 Sep, 2020
Editor invited
On 30 Sep, 2020
This version was not preprinted
Version 1
Posted 19 Feb, 2020
No comments provided
Review #2 received
Received 11 May, 2020
Editorial decision: Major revision
On 11 May, 2020
Review #3 received
Received 08 May, 2020
Reviewer #3 agreed
On 18 Apr, 2020
Reviewer #2 agreed
On 15 Apr, 2020
Review #1 received
Received 07 Apr, 2020
Reviewer #1 agreed
On 19 Feb, 2020
Reviewers invited
Invitations sent on 18 Feb, 2020
Editor assigned
On 18 Feb, 2020
Submission checks complete
On 17 Feb, 2020
Editor invited
On 17 Feb, 2020
First submitted
On 06 Feb, 2020
Version (no preprint)
Posted 19 Feb, 2020
Editorial decision: Major revision
On 23 Sep, 2020
Review #2 received
Received 11 Sep, 2020
Reviewer #2 agreed
On 02 Sep, 2020
Review #1 received
Received 31 Jul, 2020
Reviewer #1 agreed
On 25 Jun, 2020
Reviewers invited
Invitations sent on 22 Jun, 2020
Editor assigned
On 21 Jun, 2020
Submission checks complete
On 20 Jun, 2020
Editor invited
On 20 Jun, 2020
This version was not preprinted
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background People with a migration background are a vulnerable group regarding dementia. Providing care for this group is a public health challenge in Europe. Many countries are issuing care guidelines, but a systematic overview of their references to migration is lacking. This study aims to determine the extent to which care guidelines take people with a migration background into account, which migration-related content focuses are set and to what extent specific actions are considered or recommendations are made to ensure their care.
Methods This study is a systematic analysis of national dementia care guidelines of the EU and EFTA (European Free Trade Association) countries. Using the discourse analysis model by Rainer Keller (2011), n=43 documents from n= 24 EU and n=3 EFTA countries were systematically screened for migration references via keyword and context analysis. The content of the migration-related section was paraphrased, memos and comments were added and the individual text passages were coded using the strategy of open coding.
Results 27 of the 35 EU- and EFTA countries have guidelines or similar documents on care for people with dementia and twelve refer to migration. Norway, Sweden, and Northern Ireland refer to this topic in detail. The focus of the migration-related documents is on the early detection and diagnosis of dementia. The main message is that standardized diagnostic tools such as the Mini-Mental State Examination (MMSE) or the clock test are not suitable for linguistic minorities. Nine countries make recommendations for the care of people with a migration background and dementia but only Norway, Sweden, and Denmark point to available healthcare services. A key recommendation is that the linguistic and cultural background of people should be taken into account when selecting diagnostic tests. Several countries refer to the validity of the RUDAS (Rowland Universal Dementia Assessment Scale) for migrants.
Conclusions The topic of migration plays a subordinate role in the care guidelines of European countries. Almost all countries lack appropriate diagnostic tools and healthcare services for people with a migration background. Consequently, people with a migration background are a risk group for underdiagnosis and a lower level of care.
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