Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy.
Department of Human Neuroscience, "Sapienza" University, Rome, Italy.
J Alzheimers Dis. 2023;92(3):843-852. doi: 10.3233/JAD-221146.
A crucial step for planning effective public health policies for migrants with dementia is the collection of data on the local dimensions of the phenomenon and patients' characteristics.
This study aimed to identify and characterize migrants with dementia in the Lazio region using health administrative databases.
Residents with dementia aged 50 years or older, living in the Lazio region as of December 31, 2018, were identified using a validated algorithm based on hospital discharge(s), claims for antidementia drugs, and co-payment exemption for dementia. Migrants were defined as people born abroad and grouped in migrants from High Migratory Pressure Countries (HMPCs) and Highly Developed Countries (HDCs). Overall and age-specific prevalence rates were estimated in native- and foreign-born patients.
Dementia was ascertained in 38,460 residents. Among them, 37,280 (96.9%) were born in Italy, 337 (0.9%) were migrants from HDCs, and 843 (2.2%) from HMPCs. Dementia prevalence was higher among natives (1.15%, 95% CI 1.14-1.16) relative to migrants from HDCs (0.60%, 95% CI 0.54-0.67) and HMPCs (0.29%, 95% CI 0.27-0.31). The prevalence of comorbidities did not differ between groups. Migrants with dementia had a lower likelihood of receiving antidementia treatments compared with natives (51.6% in migrants from HDCs, 49.3% in migrants from HMPCs, and 53.5% among Italians).
Routinely collected data in healthcare administrative databases can support the identification of migrants with dementia. Migrants exhibited a lower age-standardized prevalence of registered dementia and lower access to dedicated treatments than Italians. These findings are suggestive of underdiagnosis and undertreatment of dementia in migrants.
为移民痴呆症制定有效公共卫生政策的关键步骤是收集有关该现象的地方维度和患者特征的数据。
本研究旨在使用健康管理数据库确定和描述拉齐奥地区的移民痴呆症患者。
使用基于医院出院记录、抗痴呆药物报销和痴呆症共同支付豁免的经过验证的算法，确定截至 2018 年 12 月 31 日居住在拉齐奥地区、年龄在 50 岁及以上的痴呆症患者。移民被定义为出生在国外的人，并分为来自高移民压力国家（HMPCs）和高发达国家（HDCs）的移民。在本地出生和外国出生的患者中估计了总体和年龄特异性患病率。
确定了 38460 名居民患有痴呆症。其中，37280 人（96.9%）出生在意大利，337 人（0.9%）是来自 HDCs 的移民，843 人（2.2%）是来自 HMPCs 的移民。与来自 HDCs 的移民（0.60%，95%CI0.54-0.67）和 HMPCs（0.29%，95%CI0.27-0.31）相比，本地出生的患者痴呆症患病率更高（1.15%，95%CI1.14-1.16）。两组之间的合并症患病率没有差异。与本地出生者相比，痴呆症移民接受抗痴呆治疗的可能性较低（来自 HDCs 的移民为 51.6%，来自 HMPCs 的移民为 49.3%，意大利人为 53.5%）。
在医疗保健管理数据库中收集的常规数据可以支持移民痴呆症患者的识别。与意大利人相比，移民的登记痴呆症标准化患病率较低，获得专门治疗的机会也较少。这些发现表明移民的痴呆症诊断和治疗不足。
