PhD defence S. (Sanne) Franzen

Dissertation in short:

The culturally, educationally, and linguistically diverse population of Europe is aging rapidly. Many diverse elderly are at risk of developing dementia due to a higher prevalence of risk factors such as cardiovascular disease and diabetes, resulting in an increase in the number of patients with a diverse background visiting memory clinics. Memory clinic staff members are faced with diagnostic challenges, such as barriers in language and culture, as well as a lack of suitable tests and norms for this (often low-educated) population. These barriers can result in misdiagnoses, with potentially severe consequences. This PhD dissertation demonstrated the lack of appropriate neuropsychological tests that can measure aspects other than memory in diverse populations, such as tests of language, executive functioning, and social cognition (recognition of emotions, knowledge of social norms). Furthermore, this dissertation presents the multicenter development of the TULIPA test battery, the first test battery in the Netherlands that can be used to properly examine cognitive impairment in diverse populations. Several newly developed tests are included in this test battery, such as a new test to measure word finding difficulties in Alzheimer's disease and an adapted test for memory. The research in this dissertation was based on strong international collaboration, ultimately resulting in a newly formed consortium to address issues in neuropsychology: the European Consortium on Cross-Cultural Neuropsychology (ECCroN). Last, this dissertation addresses next steps for clinical practice and research, providing recommendations for the design of inclusive drug trials and providing advice to clinicians in the Netherlands.