Diaz Esperanza, Kumar Bernadette N, Engedal Knut
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Dement Geriatr Cogn Disord. 2015;39(5-6):321-31. doi: 10.1159/000375526. Epub 2015 Mar 19.
Immigrants comprise a growing proportion of the elderly population. However, knowledge about the diagnosis and management of dementia and memory impairment among immigrants is scarce in Norway and elsewhere.
To compare proportions of Norwegians and immigrants aged ≥50 years with a diagnosis of dementia or memory impairment in primary health care and to study the demographic characteristics, utilization of primary health care services and pharmacological treatment of Norwegians and immigrants with either of the two diagnoses in 2008.
This is a registry-based study using linked data at the individual level from 4 national Norwegian registers.
A significantly lower proportion of immigrants, especially those from other than high-income countries, had a diagnosis of dementia or memory impairment. Among patients with such diagnoses, anti-dementia medication was purchased 20-50% more often by Norwegians than by immigrants, although the differences remained significant only for immigrants from other than high-income countries after adjustment for several variables.
The lower proportions of immigrants with a dementia diagnosis and lower proportions of patients receiving treatment might indicate a lower prevalence or milder forms of dementia among immigrants. However, the cultural validity of the assessment tools, linguistic barriers and challenges for general practitioners should be further investigated.
移民在老年人口中所占比例日益增加。然而,在挪威及其他地区,关于移民中痴呆症和记忆障碍的诊断与管理的知识却很匮乏。
比较在初级卫生保健中被诊断患有痴呆症或记忆障碍的50岁及以上挪威人和移民的比例,并研究2008年患有这两种诊断之一的挪威人和移民的人口统计学特征、初级卫生保健服务的利用情况以及药物治疗情况。
这是一项基于登记处的研究,使用了来自挪威4个国家登记处的个体层面的关联数据。
移民中,尤其是来自非高收入国家的移民,被诊断患有痴呆症或记忆障碍的比例显著较低。在患有此类诊断的患者中,挪威人购买抗痴呆药物的频率比移民高20%至50%,不过在对多个变量进行调整后,差异仅在来自非高收入国家的移民中仍然显著。
被诊断患有痴呆症的移民比例较低以及接受治疗的患者比例较低,可能表明移民中痴呆症的患病率较低或病情较轻。然而,评估工具的文化有效性、语言障碍以及全科医生面临的挑战仍需进一步研究。