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Assessing cognitive impairment in Indigenous Australians: Re‐evaluation of the Kimberley Indigenous Cognitive Assessment in Western Australia and the Northern Territory
Authors:KATE SMITH  LEON FLICKER  ANNA DWYER  GAIL MARSH  SADHANA MAHAJANI  OSVALDO ALMEIDA  NICOLA LAUTENSCHLAGER  DAVID ATKINSON  DINA LOGIUDICE
Affiliation:1. Western Australian Centre for Health and Ageing;2. Schools of Medicine and Pharmacology;3. Alzheimer's Australia (Northern Territory);4. Aged Care Assessment Team, Darwin, Northern Territory;5. Psychiatry and Clinical Neurosciences;6. Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne;7. Kimberley Aboriginal Medical Services Council and Rural Clinical School, University of Western Australia, Broome, Western Australia;8. Royal Park, Melbourne Health and National Ageing Research Institute, Melbourne, Victoria, Australia
Abstract:The Kimberley Indigenous Cognitive Assessment (KICA) was initially developed and validated as a culturally appropriate dementia screening tool for older Indigenous people living in the Kimberley. This paper describes the re‐evaluation of the psychometric properties of the cognitive section (KICA‐Cog) of this tool in two different populations, including a Northern Territory sample, and a larger population‐based cohort from the Kimberley. In both populations, participants were evaluated on the KICA‐Cog tool, and independently assessed by expert clinical raters blinded to the KICA scores, to determine validity and reliability of dementia diagnosis for both groups. Community consultation, feedback and education were integral parts of the research. for the Northern Territory sample, 52 participants were selected primarily through health services. Sensitivity was 82.4% and specificity was 87.5% for diagnosis of dementia, with area under the curve (AUC) of .95, based on a cut‐off score of 31/32 of a possible 39. for the Kimberley sample, 363 participants from multiple communities formed part of a prevalence study of dementia. Sensitivity was 93.3% and specificity was 98.4% for a cut‐off score of 33/34, with AUC = .98 (95% confidence interval: 0.97–0.99). There was no education bias found. The KICA‐Cog appears to be most reliable at a cut‐off of 33/39.
Keywords:Aboriginal  cognitive assessment  cross‐cultural  dementia
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