Cultural issues related to diagnosis
| ISSUE | EXPLANATION | ACTION |
|---|---|---|
| Language barriers and low education can lead to diagnostic errors | Low education among ethnic elderly can result in inappropriate responses from these patients due to educational misinterpretation as opposed to cognitive dysfunction2 | Health professionals should identify the first language, including the dialect, used by the patient and caregiver |
| When untrained translators are used, there is a possibility of translator bias, poor understanding of terminology, and inaccurate paraphrasing3 | Access appropriately trained translators | |
| Studies have shown diagnosis is difficult among ethnic groups, even after accounting for age and education; health care professionals should be aware that measures of cognitive testing, such as the Mini-Mental State Examination, can often overestimate cognitive impairment in many cultural and linguistic groups4 | The Mini-Mental State Examination is available in different languages, thus the appropriate language should be used, with the help of language interpreters, when assessing ethnic patients | |
| Cultural beliefs about dementia are a barrier to its acceptance and diagnosis | Dementia or memory changes are considered among various cultures to be a normal part of aging5 | In-depth discussion about dementia is required in order for it to be recognized and accepted; to achieve this goal, it is important to identify the primary caregiver and decision maker in the family |
| Some ethnic families often avoid sharing members’ cognitive disturbances and behavioural problems with outsiders, including health care professionals; these families view dementia as taboo and fear it will bring shame to their families6 |