Neuropsychological assessment of older Australian immigrant populations: considerations for clinical practice

ABSTRACT

Objective

By 2050, approximately one quarter of Australia’s ageing population will comprise culturally and linguistically diverse individuals. While a number of valid neuropsychological measures are available for use with English-speaking individuals, existing measures may not be appropriate for use with older immigrant populations. The purpose of this review is to highlight existing challenges facing the Australian neuropsychological community in the context of assessing older immigrant populations and offer suggestions to improve clinical practice.

Method

By conducting a review of existing research related to assessment of culturally and linguistically diverse populations, this paper provides a) a critical overview relating to factors known to impact on the validity of assessment outcomes, b) examines published Australian studies relating to neuropsychological test adaptation and the development of normative data for use with older immigrant populations, and c) offers recommendations to guide assessment and clinical practice.

Results

The use of existing English language test and norms has the potential to underestimate cognitive function in older immigrant populations, leading to erroneous diagnostic outcomes. These issues are related to a) level and quality of education, b) inappropriate test content, c) nonrepresentative normative data, and d) a lack of familiarity with test taking procedures.

Conclusion

Research addressing issues relating to cross-cultural assessment is gaining momentum within Australia, resulting in the development of demographically focused normative data and adapted tests to accommodate some cultural groups. Initial results have reported mixed success, indicating the need for further and carefully considered research.

KEY POINTS

What is already known about this topic:

1. The prevalence of age-related cognitive disorders in Australia is predicted to rise over the next 30 years.

2. A large number of elderly Australians represent culturally diverse older immigrant populations.

3. Neuropsychological tests and norms are influenced by age, education, language and culture.

What this topic adds:

1. An overview of research identifying limitations of neuropsychological assessment within culturally diverse older immigrant populations.

2. An overview of neuropsychological measures and norms that have been developed for use with culturally diverse older immigrant populations in Australia.

3. Recommendations and strategies to improve assessment of culturally diverse populations in Australia.

KEYWORDS:

• Older adults
• ethnic minority
• cross-cultural neuropsychology
• normative data

Acknowledgements

Thank you to Michal Boneh for assisting with critical feedback during the drafting process.

Disclosure statement

No potential conflict of interest was reported by the author(s).