title: The Cross-Cultural Dementia Screening (CCD): A new neuropsychological screening instrument for dementia in elderly immigrants.
abstract: OBJECTIVE
  Currently, approximately 3.9% of the European population are non-EU citizens, and a large part of these people are from "non-Western" societies, such as Turkey and Morocco. For various reasons, the incidence of dementia in this group is expected to increase. However, cognitive testing is challenging due to language barriers and low education and/or illiteracy. The newly developed Cross-Cultural Dementia Screening (CCD) can be administered without an interpreter. It contains three subtests that assess memory, mental speed, and executive function. We hypothesized the CCD to be a culture-fair test that could discriminate between demented patients and cognitively healthy controls.
  
  
  METHODS
  To test this hypothesis, 54 patients who had probable dementia were recruited via memory clinics. Controls (N = 1625) were recruited via their general practitioners. All patients and controls were aged 55 years and older and of six different self-defined ethnicities (Dutch, Turkish, Moroccan-Arabic, Moroccan-Berber, Surinamese-Creole, and Surinamese-Hindustani). Exclusion criteria included current or previous conditions that affect cognitive functioning.
  
  
  RESULTS
  There were performance differences between the ethnic groups, but these disappeared after correcting for age and education differences between the groups, which supports our central hypothesis that the CCD is a culture-fair test. Receiver-operating characteristic (ROC) and logistic regression analyses showed that the CCD has high predictive validity for dementia (sensitivity: 85%; specificity: 89%).
  
  
  CONCLUSIONS
  The CCD is a sensitive and culture-fair neuropsychological instrument for dementia screening in low-educated immigrant populations.
authors: a Department of Medical Psychology/Hospital Psychiatry , Medical Centre Slotervaart , Amsterdam , The Netherlands.
authors: Miriam
authors: M
authors: Goudsmit
authors: b Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre , University of Amsterdam , Amsterdam , The Netherlands.
authors: Özgül
authors: Ö
authors: Uysal-Bozkir
authors: b Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre , University of Amsterdam , Amsterdam , The Netherlands.
authors: Juliette L
authors: JL
authors: Parlevliet
authors: c Department of Geriatrics , Medical Centre Slotervaart , Amsterdam , The Netherlands.
authors: Jos P C M
authors: JP
authors: van Campen
authors: b Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre , University of Amsterdam , Amsterdam , The Netherlands.|d University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine , Groningen , The Netherlands.
authors: Sophia E
authors: SE
authors: de Rooij
authors: e Department of Medical Psychology, Academic Medical Centre , University of Amsterdam , Amsterdam , The Netherlands.|f Faculty of Social and Behavioural Science, program group Brain and Cognition , University of Amsterdam , Amsterdam , The Netherlands.
authors: Ben
authors: B
authors: Schmand
mesh_terms: D000368:Aged; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003431:Cross-Cultural Comparison; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity
keywords: Cognition; Cross-cultural; Dementia; Neuropsychological tests; Sensitivity and specificity