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      Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies

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          Abstract

          Background

          It is estimated that there are about 25,000 people from UK ethnic minority groups with dementia. It is clear that there is an increasing need to improve access to dementia services for all ethnic groups to ensure that everyone has access to the same potential health benefits. The aim was to systematically review qualitative studies and to perform a meta-synthesis around barriers and facilitators to accessing care for dementia in ethnic minorities.

          Methods

          Databases were searched to capture studies on barriers and facilitators to accessing care for dementia in ethnic minorities. Analysis followed the guidelines for meta-ethnography. All interpretations of data as presented by the authors of the included papers were extracted and grouped into new themes.

          Results

          Six hundred and eighty four papers were identified and screened. Twenty eight studies were included in the meta-synthesis. The analysis developed a number of themes and these were incorporated into two overarching themes: ‘inadequacies’ and ‘cultural habitus’.

          Conclusions

          The two overarching themes lend themselves to interventions at a service level and a community level which need to happen in synergy.

          Trial registration

          The review was registered with PROSPERO: CRD42016049326.

          Electronic supplementary material

          The online version of this article (10.1186/s12888-017-1474-0) contains supplementary material, which is available to authorized users.

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          Most cited references46

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          The global prevalence of dementia: a systematic review and metaanalysis.

          The evidence base on the prevalence of dementia is expanding rapidly, particularly in countries with low and middle incomes. A reappraisal of global prevalence and numbers is due, given the significant implications for social and public policy and planning. In this study we provide a systematic review of the global literature on the prevalence of dementia (1980-2009) and metaanalysis to estimate the prevalence and numbers of those affected, aged ≥60 years in 21 Global Burden of Disease regions. Age-standardized prevalence for those aged ≥60 years varied in a narrow band, 5%-7% in most world regions, with a higher prevalence in Latin America (8.5%), and a distinctively lower prevalence in the four sub-Saharan African regions (2%-4%). It was estimated that 35.6 million people lived with dementia worldwide in 2010, with numbers expected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. In 2010, 58% of all people with dementia lived in countries with low or middle incomes, with this proportion anticipated to rise to 63% in 2030 and 71% in 2050. The detailed estimates in this study constitute the best current basis for policymaking, planning, and allocation of health and welfare resources in dementia care. The age-specific prevalence of dementia varies little between world regions, and may converge further. Future projections of numbers of people with dementia may be modified substantially by preventive interventions (lowering incidence), improvements in treatment and care (prolonging survival), and disease-modifying interventions (preventing or slowing progression). All countries need to commission nationally representative surveys that are repeated regularly to monitor trends. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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            Meta-Ethnography

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              A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012

              The aging of the US population is expected to lead to a large increase in the number of adults with dementia, but some recent studies in the United States and other high-income countries suggest that the age-specific risk of dementia may have declined over the past 25 years. Clarifying current and future population trends in dementia prevalence and risk has important implications for patients, families, and government programs.
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                Author and article information

                Contributors
                Cassandra.kenning@manchester.ac.uk
                gavin.daker-white@manchester.ac.uk
                amy.blakemore@manchester.ac.uk
                maria.panagioti@manchester.ac.uk
                Waquas.waheed@manchester.ac.uk
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                30 August 2017
                30 August 2017
                2017
                : 17
                : 316
                Affiliations
                ISNI 0000000121662407, GRID grid.5379.8, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, , The University of Manchester, ; 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
                Author information
                http://orcid.org/0000-0001-6041-4051
                Article
                1474
                10.1186/s12888-017-1474-0
                5577676
                28854922
                cb00efab-d1ec-4d75-b0b2-11b8c4070f48
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 April 2017
                : 22 August 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000272, National Institute for Health Research;
                Award ID: SPCR 300
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Clinical Psychology & Psychiatry
                dementia,barriers,facilitators,access,review,meta-ethnography,ethnicity,minority

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