DECODE - Distant Evaluation of Cognitive Deficits

Introduction: The increasing global migrant population, currently estimated at 272 million with about 12% over the age of 60, has led to a rise in cognitive assessments needed across language and cultural barriers. In healthcare, older migrants face unique barriers to accessing accurate cognitive evaluations due to language limitations in the host country. While professional interpreters may occasionally assist, they often lack the specialised knowledge required for administering cognitive tests and can incur high costs.

Methods: To address these challenges, we developed an innovative, user-friendly digital platform connecting health professionals of diverse linguistic and cultural backgrounds. This network facilitates the referral and remote assessment of migrants with cognitive complaints, enabling evaluations to be conducted in the patient’s native language with culturally validated tools.

Migrants are referred by clinicians to network members proficient in their language and familiar with their cultural context. Cognitive assessments are conducted remotely, and findings are reported back to the referring clinician in the host country, allowing for informed and empathetic diagnostic decisions.

Results: Employing a design thinking framework, we defined the platform’s interface and features. A Pilot study has shown the system to be both feasible and well-received, with high levels of user satisfaction and support.

Conclusions This digital network addresses key challenges in migrant cognitive assessment, such as limited time, language-specific tools, and culturally appropriate normative data. By pairing patients with clinicians, who understand their cultural background, this approach enhances diagnostic accuracy and the detection of neurocognitive disorders. Empathy and cultural insight play a central role, as network clinicians are better equipped to identify subtle symptoms during assessment. This method offers substantial improvements in the quality of care for a diverse and underserved population, bridging gaps in current healthcare practice and enhancing diagnostic accuracy for migrant patients with cognitive issues.