Symposia 14 Program Schedule
02/17/2024
09:00 am - 10:30 am
Room: West Side Ballroom - Salon 1
Symposia 14: Advances in cognitive screening and neuropsychological assessment of cognitive decline and dementia in individuals with low education/low literacy levels
Simposium #1
Establishing a framework for neuropsychological assessment of cognitive decline and dementia for low literacy, marginalized communities such as the Travelling Community in Ireland: insights from clinicians and target individuals.
Dawn Higgins, Maynooth University, Ireland, Maynooth, Ireland
Category: Assessment/Psychometrics/Methods (Adult)
Keyword 1: academic achievement
Keyword 2: assessment
Keyword 3: ethnicity
Objective:
Current neuropsychological assessments for the screening and diagnosis of dementia rely heavily on literacy and cultural awareness to complete, making them unsuitable for use with individuals with low literacy and from different ethnic backgrounds such as the Travelling Community of Ireland. Therefore, the goal of this research is to establish a framework for neuropsychological assessment of cognitive decline and dementia for low literacy, marginalized communities such as these.
Participants and Methods:
14 clinicians who give neuropsychological assessments as part of their daily duties, and 20 members of the Travelling Community. Semi-structured focus groups were conducted with both clinicians and Travellers. The questions posed to clinicians focused on (1) any current issues occurring when assessing members of the Travelling Community and (2) any modifications they make to standardised assessments, while questions asked of the Travellers centred on (1) their impressions of current assessments (2) any potential barriers to help seeking behaviours on this issue, and (3) perceptions of dementia within their community and any stigma which might be attached to such a diagnosis. A review into individual cognitive deficits measured by current neuropsychological assessments, as well as those deficits which are currently not included (e.g. visual memory), was also conducted.
Results:
Several key points were raised by the clinicians which indicate ways standardized assessments could be updated to be more inclusive. Interviews conducted with Travellers revealed several themes (such as barriers to help seeking, the cultural implications of a diagnosis of dementia, and a lack of awareness around dementia in general within the community) which have serious implications for health care providers working with or trying to diagnose members of the Travelling community. Suggestions for improving engagement with the community as well as minimizing barriers to help seeking behaviours were also made.
Conclusions:
Several key issues were raised by both Travellers and clinicians that suggest a need to review the way cognitive assessment is performed with these populations. Using a broader range of measurements may be beneficial when assessing individuals with low literacy as the detection of certain deficits would not require literacy skills and would therefore be more accurate when used with this population. Findings also suggest that current traditional assessments are not suitable for all, and that changes and additional efforts are required to guarantee access of marginalized communities to adapted literacy level-appropriate cognitive assessments and resources.
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