New neuropsychological test battery shows promise in multicultural memory clinics
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SAN DIEGO — A new neuropsychological test battery may be valuable for assessment of culturally diverse populations if barriers for testing are considered, according to an expert at the Alzheimer’s Association International Conference.
“What we know about the diverse populations of Europe is that there are many different levels of language proficiency, and both bilingualism and multilingualism are very common,” Sanne Franzen, MSc, a neuropsychologist and researcher at the Alzheimer Center of the Erasmus Medical Center in Rotterdam, the Netherlands, said during her presentation. “What we also know is that no education and illiteracy happen often.”
Franzen and fellow researchers sought to develop a new neuropsychological test battery and study its feasibility in multicultural memory clinics in the Netherlands.
They conducted a literature review and consulted with experts and individuals from diverse backgrounds to create the TULIPA (Towards a Universal Language: Intervention and Psychodiagnostic Assessment) battery, which includes the existing Cross-Cultural Dementia screening (CCD), the Rowland Universal Dementia Assessment Scale (RUDAS), tests from the European Cross-Cultural Neuropsychological Test Battery and other novel tests. Researchers assessed the battery’s feasibility by examining administration and completion rates and the frequency of factors complicating neuropsychological assessment.
The study included 345 participants from 37 countries who visited four multicultural memory clinics in the Netherlands.
Results showed completion rates for the test battery were generally high (82%-100%), except for CCD Dots subtest B (58%). Although tests of the core TULIPA battery were administered often (median: 6 of 7, IQR: 5-7), supplementary tests were administered less frequently (median: 1 of 9; IQR: 0-3). The number of administered tests correlated with disease severity (RUDAS, P = .33, adjusted P < .001) but not with other patient characteristics.
Researchers frequently observed complicating factors, which included suboptimal effort (29%-50%), fatigue (29%), depression (37%-57%) and refusal to finish the battery.
“Administering the selection of tests from our TULIPA battery is feasible, but we have to be selective about which tests we select for which patients,” Franzen said. “We need to do a lot more research before the battery is complete.”