Second phase of the project
The first three years of the Immidem project confirmed the initial clinical observation- shared among Italian and European healthcare staff- on the increasing number of patients with a migration background who visit specialised clinics to address cognitive disorders. The survey, conducted across more than 340 CDCDs (Centres for Cognitive Disorders and Dementia) in Italy during the first phase of the project, revealed that in 2019 over 4,000 migrants attended at least one visit at a CDCD for cognitive disorders, and more than 2,000 underwent neuropsychological assessments.
The specific objectives of the second phase of the project will aim to address some of the gaps and challenges identified during the first three years of research: the limited use of cross-cultural cognitive tests, the shortage of key personnel such as interpreters and cultural mediators in services, inadequate training for healthcare professionals, and the lack of dementia information materials for patients and caregivers in languages other than Italian.
Objective 1
To investigate the demographic, sociocultural, and clinical characteristics as well as the use of healthcare resources of migrants with cognitive disorders living in Italy
The first initiative of the second phase of the project will involve collecting clinical and socio-demographic data from a representative sample of Italian CDCDs to better understand the specific healthcare needs of migrant population with cognitive disorders. The same data will also be gathered for a control group of Italian patients with cognitive disorders from the same CDCDs.
Additionally, a longitudinal study will be conducted using health registry data from the Lazio region. Migrants with cognitive disorders and dementia will be monitored over time to gather information on health outcomes such as mortality, hospitalisation, and institutionalisation.
Objective 2
To provide healthcare professionals with cross-cultural assessment tools for the cognitive evaluation of individuals with a migration background
Immidem aims to translate and adapt into Italian cross-cultural tests that were proven useful for an accurate and reliable cognitive assessment of all patients, including people from diverse backgrounds. The availability of such cross-cultural tools plays a pivotal role in a correct diagnostic approach.
Objective 3
To raise awareness and health literacy, fight stigma and negative stereotypes about dementia in culturally diverse individuals, and specifically train healthcare professionals about cognitive disorders in these population groups
Another key objective will be to train and raise awareness on the topic: training will be delivered to healthcare staff because many professionals lack specialised training on this topic. For this reason, residential courses will be held annually at the Italian National Institute of Health on how to implement diversity-sensitive care pathways and models of care for dementia. The content of these residential courses will then be converted into distance learning (e-learning) and made available online. Finally, an informational chapter will be directed specifically at migrants and their families: the goal is to produce culturally adapted informational materials on dementia, as well as on the resources and services provided by the National Health Service for citizens, along with practical advice for supporting dementia patients, particularly aimed at their caregivers.
Phase One of the Project
introduction
The Immidem project aims to study and describe the phenomenon of dementia in the migrant population, estimating its prevalence, identifying critical issues and barriers, as well as resources to address it. At the same time, it seeks to explore the healthcare provision available to this segment of the population and the availability of appropriate clinical approaches and diagnostic tools. Lastly, it aims to identify and promote dedicated healthcare pathways and good clinical practices, at both national and local levels, for migrants affected by dementia and cognitive disorders.
Objective 1
Estimate the characteristics of dementia in migrants living in Italy
Describe the migrant population seeking assistance for cognitive disorders at dedicated services in Italy.Systematically explore differences in clinical approaches and tools used for diagnosing dementia in migrants and ethnic minority groups at Italian Cognitive Disorders and Dementia Centres (CDCDs), with a particular focus on cognitive/neuropsychological tests. Identify the main challenges encountered during cognitive assessments, dementia diagnosis processes, and post-diagnostic care and support for these specific populations.
Objective 2
Define the characteristics and extent of the phenomenon at the regional level
Identify individuals with a migrant background affected by dementia living in the Lazio Region, through routinely collected clinical data in healthcare information systems and statistical procedures. This region is taken as an example to characterise the phenomenon at the regional level and to determine whether the process can be replicated in other regions.
Objective 3
Identify and promote the implementation of coordinated care pathways and good clinical practices
Improve the quality of care for migrants with dementia and optimise the allocation of healthcare resources dedicated to this phenomenon. Provide practical tools and useful information to migrants with dementia, their caregivers, and healthcare professionals- such as general practitioners, neurologists, psychiatrists, neuropsychologists, cultural mediators, interpreters, and others- who assist them. Create a platform for reflection to disseminate a culturally informed and guided approach. Establish a meeting and dialogue point for an international research network.