Researchers from the University of Sydney have recently found evidence that culturally diverse people might resist symptoms for frontotemporal dementia, for longer.
Calling for more in-depth diagnostic criteria in dementia cases, the researchers have found that people born overseas with a different native tongue to English, can tolerate the disease for longer before symptoms begin to take a toll.
Published in the Journal of Neurology and led by Ms Amira Skeggs, a clinical researcher at the School of Psychology, the study focuses on one of three types of the dementia known as behavioural variant frontotemporal dementia (bvFTD). BvFTD is a progressive neurodegenerative disease that affects areas in the brain responsible for behaviour, personality, language and emotions.
In this case, the study was carried out in Australia with English as a geographical example and despite results suggesting clear outcomes in this case, it has been acknowledged that this study focuses on Western samples.
“Currently, all the diagnostic criteria are based off Western samples, which means that it can be difficult to diagnose the diseases in non-Western people because they may not have the same symptoms,” Ms Skeggs said.
In February, actor Bruce Willis announced he had been diagnosed with frontotemporal dementia – raising awareness on the disease.
Ms Skeggs further explained “Frontotemporal dementia refers to a set of younger-onset dementia syndromes, which are typically diagnosed before the age of 65. Our findings suggest that current diagnostic methods might be less accurate at identifying symptoms in Australians from culturally diverse backgrounds.”
She added, “When it comes to neurodegenerative syndromes like bvFTD, culturally diverse people can have a later onset of the disease compared to monolingual Australians because they have other factors which could increase their resilience or cognitive reserve.”
The term ‘cognitive reserve’ refers to a kind of fortification that helps the brain navigate and resist the progression of neurodegeneration, before more classic symptoms of mental decline emerge. According to the University of Sydney’s School of Psychology, this reserve is “built up over an active lifetime and is influenced by a range of factors.”
In Australia, it has been noted that culturally diverse patients, including those who have moved to Australia, tend to have higher levels of cognitive reserve.
In this study, researchers compared clinical symptoms of people with bvFTD based on culture and language for the first time.107 participants were separated into three groups: monolingual Australians who speak only English, and a further two groups of culturally diverse people: one with English as their first language and another with a different mother tongue and English as a second or additional language.
Findings revealed that the group who spoke a non-English first language performed worse than the other groups on verbal tests but better on non-verbal tests, something researchers attest to potential clinical biases within current healthcare frameworks.
“The poor verbal performance in the non-English speaking group is probably influenced by cultural biases within current clinical tests, so the reason they are showing decline may not actually be because they are declining,” added Skeggs.
An unexpected finding also emerged, whereby bilingual patients with a good-fluent proficiency in English had lost their second language abilities with the onset of dementia.
In conclusion, researchers agreed that clinics should actively collect information about a patient’s cultural background, bilingualism, and education – offering alternatives during diagnosis such as a translator or image-based testing.
