Neuropsychological assessment in the multicultural memory clinic: Development and feasibility of the TULIPA battery

Sanne Franzen*, Esther van den Berg, Willemijn Bossenbroek, Judi Kranenburg, Esther A. Scheffers, Moniek van Hout, Lotte van de Wiel, Miriam Goudsmit, Rozemarijn L. van Bruchem-Visser, Judy van Hemmen, Lize C. Jiskoot, Janne M. Papma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective: Neuropsychological assessment of culturally diverse populations is hindered by barriers in language, culture, education, and a lack of suitable tests. Furthermore, individuals from diverse backgrounds are often unfamiliar with being cognitively tested. The aim of this study was to develop a new neuropsychological test battery and study its feasibility in multicultural memory clinics. Method: Composition of the TULIPA battery (Towards a Universal Language: Intervention and Psychodiagnostic Assessment) entailed a literature review and consultation with experts and individuals from diverse backgrounds. Feasibility was investigated by examining administration and completion rates and the frequency of factors complicating neuropsychological assessment in 345 patients from 37 countries visiting four multicultural memory clinics in the Netherlands. Results: The test battery included existing tests such as the Cross-Cultural Dementia screening (CCD), Rowland Universal Dementia Assessment Scale (RUDAS), tests from the European Cross-Cultural Neuropsychological Test Battery, and newly developed tests. Completion rates for the test battery were generally high (82%–100%), except for CCD Dots subtest B (58%). Although tests of the “core” TULIPA battery were administered often (median: 6 of 7, IQR: 5–7), supplementary tests were administered less frequently (median: 1 of 9; IQR: 0–3). The number of administered tests correlated with disease severity (RUDAS, ρ=.33, adjusted p <.001), but not with other patient characteristics. Complicating factors were observed frequently, e.g. suboptimal effort (29%–50%), fatigue (29%), depression (37%–57%). Conclusions: The TULIPA test battery is a promising new battery to assess culturally diverse populations in a feasible way, provided that complicating factors are taken into account.

Original languageEnglish
Pages (from-to)60-80
Number of pages21
JournalClinical Neuropsychologist
Issue number1
Publication statusPublished - 2023

Bibliographical note

Funding Information:
This work was supported by the Netherlands Organisation for Health Research and Development (grant number: 733050834). The authors would like to thank Caroline Jurgens, Wilma Smith-Spijkerboer, Lothar van Hoogdalem, Özgül Uysal-Bozkir, Charlotte Schreuder, Jennifer van den Broeke, Yuled Kalkisim, Swastie Doekhie, and Bregje Appels for their contributions to the focus groups. In addition, we would like to thank the geriatricians and neurologists in all the participating centers for their contribution to the TULIPA-project.

Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


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