Introduction People from minoritised ethnic groups are diagnosed with dementia later in the disease. We explored pathways that may determine the timing of diagnoses in a UK ethnically diverse, urban area. Methods We conducted 61 semi-structured interviews: 10 community-dwelling older people from minoritised ethnic backgrounds with diagnosed and undiagnosed dementia (mean age = 72 years; males = 5/10), 30 family members (51; 10/30), 16 health or social care professionals (42; 3/15), 3 paid carers and 2 interpreters for people with dementia. We used reflexive thematic analysis and the Model of Pathways to Treatment to consider diagnostic delay. Findings We identified three themes: (1) Cultural identity and practices shape responses: gendered expectations that families relieve elders of household roles reduce awareness or concern when functioning declines; expectations that religious practices are maintained mean problems doing so triggers help-seeking. Second-generation family members often held insider and outsider identities, balancing traditional and Western perspectives. (2) Becoming like a tourist: daily experiences became unfamiliar for people developing dementia in an adopted country, sometimes engendering a need to reconnect with a home country. For professionals and interpreters, translating meanings faithfully, and balancing relatives’ and clients’ voices, were challenging. (3) Naming and conceptualising dementia: the term dementia was stigmatised, with cultural nuances in how it was understood; initial presentations often included physical symptoms with cognitive concerns. Conclusion Greater understanding of dilemmas faced by minoritised ethnic communities, closer collaboration with interpreters and workforce diversity could reduce time from symptom appraisal to diagnosis, and support culturally competent diagnostic assessments.

中文翻译：

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及时诊断痴呆的机会均等 （EQUATED）：一项关于少数民族如何经历痴呆早期症状并寻求帮助的定性研究


简介 少数民族的人在疾病后期被诊断出患有痴呆。我们探索了可能决定英国种族多元化城市地区诊断时间的途径。方法 我们进行了 61 次半结构化访谈：10 名来自少数民族背景的社区老年人，患有已诊断和未确诊的痴呆症（平均年龄 = 72 岁;男性 = 5/10），30 名家庭成员（51;10/30），16 名健康或社会护理专业人员（42;3/15），3 名有偿护理人员和 2 名痴呆患者的口译员。我们使用反射性主题分析和治疗途径模型来考虑诊断延迟。研究结果 我们确定了三个主题： （1） 文化认同和习俗塑造了反应：家庭减轻老年人家庭角色的性别期望降低了功能下降时的认识或担忧;期望维持宗教活动意味着这样做会引发寻求帮助的问题。第二代家庭成员通常拥有局内人和局外人的身份，平衡了传统和西方的观点。（2）变得像游客一样：对于在收养国患痴呆症的人来说，日常经历变得陌生，有时会产生与祖国重新建立联系的需要。对于专业人士和口译员来说，忠实地翻译含义以及平衡亲属和客户的声音是具有挑战性的。（3） 命名和概念化痴呆症：痴呆一词被污名化，在如何理解它方面存在文化上的细微差别;最初的表现通常包括躯体症状和认知问题。 结论 更深入地了解少数族裔社区面临的困境、与口译员的更密切合作以及劳动力的多样性可以减少从症状评估到诊断的时间，并支持具有文化能力的诊断评估。