Uncovering accessibility gaps. Geospatial and diagnostic practices analysis of the Centres for Cognitive Disorders and Dementias (CCDD) in Apulia and Basilicata, Italy.

BACKGROUND: This study analysed accessibility, patient and healthcare professionals' characteristics, neuropsychological practices, and patient care gaps at Centres for Cognitive Disorders and Dementias (CCDD) in Apulia and Basilicata, Italy. METHODS: Geographic information systems (GIS) analysis and online survey were employed. CCDDs clinicians completed a self-report questionnaire covering "Characteristics of the CCDD" and "Neuropsychological assessment", from July 2021 to January 2023. Geographical coordinates were used to identify peripheral areas, based on the Italian strategy for Inner Areas. RESULTS: Thirty-three CCDDs were identified. Geospatial analysis revealed ultra-peripheral municipalities and inadequate public transport to CCDDs in several areas. Most patients were women aged 70-89. Neurologists played a key role in diagnosis and test administration. Diagnostic criteria and neuropsychological tools varied: international criteria were rarely applied, recommended tests were underutilised, and some cognitive domains undervalued. CONCLUSION: These findings highlight the need for effective healthcare interventions for cognitive disorders and the potential for teleneuropsychology to bridge care gaps.