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Vol. 61 No. 3 (2025)
DOI: 10.4415/ANN_25_03_04
Original Articles
2025-09-16
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Uncovering accessibility gaps. Geospatial and diagnostic practices analysis of the Centres for Cognitive Disorders and Dementias (CCDD) in Apulia and Basilicata, Italy

Authors

Ezia Rizzi , Francesco Giaquinto , Marika Iaia , Michele Dell’Abate , Luigi Macchitella , Giorgia Tosi , Daniele Luigi Romano , Nicola Vanacore , Paola Angelelli

Abstract

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.

Keywords: nequalities in healthcare, geographical accessibility, Centres for Cognitive Disorders and Dementia, neuropsychological assessment, accessibility

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Authors

Ezia Rizzi - Dipartimento di Psicologia e Milano Centro per le Neuroscienze (NeuroMi), Università di Milano-Bicocca, Milan, Italy

Francesco Giaquinto - Dipartimento di Medicina Sperimentale, Lab di Psicologia Applicata e Intervento, Università del Salento, Lecce, Italy

Marika Iaia - Dipartimento di Medicina Sperimentale, Lab di Psicologia Applicata e Intervento, Università del Salento, Lecce, Italy

Michele Dell’Abate - Dipartimento di Scienze Umane e Sociali, Università del Salento, Lecce, Italy

Luigi Macchitella - Associazione “La Nostra Famiglia” – IRCCS “E. Medea”, Ospedale Scientifico per la Neuroriabilitazione. Unità per le Disabilità Severe dell'Età Evolutiva e Giovane Adulta (Neurologia dello Sviluppo e Neuroriabilitazione), Brindisi, Italy

Giorgia Tosi - Dipartimento di Psicologia e Milano Centro per le Neuroscienze (NeuroMi), Università di Milano-Bicocca, Milan, Italy

Daniele Luigi Romano - Dipartimento di Psicologia e Milano Centro per le Neuroscienze (NeuroMi), Università di Milano-Bicocca, Milan, Italy

Nicola Vanacore - Centro Nazionale per la Prevenzione e il Controllo delle Malattie, Istituto Superiore di Sanità, Rome, Italy

Paola Angelelli - Dipartimento di Medicina Sperimentale, Lab di Psicologia Applicata e Intervento, Università del Salento, Lecce, Italy

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Copyright (c) 2025 Istituto Superiore di Sanità

How to Cite
Rizzi, E., Giaquinto, F., Iaia, M., Dell’Abate, M., Macchitella, L., Tosi, G., Romano, D. L., Vanacore , N., & Angelelli, P. (2025). Uncovering accessibility gaps. Geospatial and diagnostic practices analysis of the Centres for Cognitive Disorders and Dementias (CCDD) in Apulia and Basilicata, Italy. Annali dell’Istituto Superiore Di Sanità, 61(3), 180–190. https://doi.org/10.4415/ANN_25_03_04
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