Can Mild Cognitive Impairment Be Accurately Diagnosed in English Speakers From Linguistic Minorities? Results From the Sydney Memory and Ageing Study

• Published in: The American journal of geriatric psychiatry 2012-10, Vol.20 (10), p.866-877
• Main Authors: Low, Lee-Fay, Ph.D, Harrison, Fleur, G.Dip.Sc.(Psych), Kochan, Nicole A., Ph.D, Draper, Brian, M.D., F.R.A.N.Z.C.P, Slavin, Melissa J., Ph.D, Reppermund, Simone, Ph.D, Sachdev, Perminder S., M.D., Ph.D., F.R.A.N.Z.C.P, Brodaty, Henry, M.D., D.Sc., F.R.A.N.Z.C.P
• Format: Article
• Language: English
• Subjects: Acculturation; Aged; Aged, 80 and over; Australia; Cognitive Dysfunction - complications; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - epidemiology; Continental Population Groups - psychology; Cross-Sectional Studies; Dementia - complications; Dementia - epidemiology; diagnostic criteria; Disease Progression; Female; Geriatric Assessment - statistics & numerical data; Humans; Incidence; Internal Medicine; Language; linguistic minority; Longitudinal Studies; Male; Mild cognitive impairment; Neuropsychological Tests - statistics & numerical data; non–English-speaking background; Predictive Value of Tests; Prevalence; Residence Characteristics
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1097/JGP.0b013e31823e31e2

Objectives The aim of this article was to examine the prevalence and incidence over 2 years of mild cognitive impairment (MCI) in English speakers from linguistic minorities. Design Cross-sectional and longitudinal with 2-year follow-up. Setting Eastern suburbs of Sydney, New South Wales, Australia. Participants Eight hundred twenty-seven community-dwelling participants from English-speaking backgrounds (ESB) and 160 participants from non–English-speaking backgrounds (NESB) recruited through the electoral roll. Measurements Participants were assessed using 11 neuropsychological tests measuring memory, language, attention/processing speed, and executive function. Questionnaires measuring functional impairment and subjective cognitive complaints were completed by participants or informants. Results We found a two- to threefold higher prevalence of MCI in NESB participants than ESB participants depending on the impairment criterion applied. This difference was because of higher rates of objective cognitive impairment in NESB participants; rates of functional impairment and subjective cognitive complaints did not differ between the groups. This association between MCI prevalence and NESB status was accounted for by the proportion of time the participant spoke English and the proportion of life they had lived in Australia, but not by age, gender, and education. There were no differences between NESB and ESB groups in MCI incidence, dementia incidence, or rates of conversion from MCI to dementia. NESB participants had lower rates of reversion from MCI to normal. Conclusions It is difficult to accurately diagnose MCI in persons from linguistic minority groups, even when proficient in English as neuropsychological test scores may not be valid for these groups. English language ability and level of acculturation should be considered when assessing older persons from ethnic minority groups.