Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

A prototype rapid tool to enhance detection of dementia for Aboriginal and Torres Strait Islander peoples in primary care (120142)

Huong X. T. Nguyen 1 , Zoe Hyde 1 2 3 , Kate Smith 2 , Roslyn Malay 2 , Leon Flicker 3 , Kylie Radford 4 5 6 , Sarah Russell 7 8 , Rachel Quigley 7 8 , Betty Sagigi 7 9 , Edward Strivens 7 8 , Adrienne Withall 5 6 , Alison Timbery 4 , Terrence Donovan 4 , Brian Draper 10 , Kim Delbaere 11 12 , Louise Lavrencic 4 5 6 , Robert Cumming 13 , Jo-anne Hughson 1 , Rosie Watson 1 , Bridgette Mcnamara 14 15 , Dina LoGiudice 1
  1. Department of Medicine - Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
  2. Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australia, Perth, Australia
  3. Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
  4. Neuroscience Research Australia, Sydney, Australia
  5. School of Psychology, University of New South Wales, Sydney, Australia
  6. Ageing Futures Institute, University of New South Wales, Sydney, Australia
  7. College of Medicine and Dentistry, James Cook University, Cairns, Australia
  8. Cairns and Hinterland Hospital and Health Service, Cairns, Australia
  9. Torres and Cape Hospital and Health Service, Thursday Island, Australia
  10. Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
  11. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
  12. School of Health Sciences, University of New South Wales, Sydney, Australia
  13. School of Public Health, University of Sydney, Sydney, Australia
  14. Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia
  15. Barwon South-West Public Health Unit, Barwon Health, Geelong, Australia

Aims:  To develop a primary care rapid dementia screen through psychometric analysis of the 16-item Kimberley Indigenous Cognitive Assessment (KICA-Cog), a valid cognitive tool for Aboriginal and Torres Strait Islander peoples.

 

Methods:  We harmonised three cohort studies with KICA-Cog assessments of Aboriginal and Torres Strait Islander peoples aged ≥45 years. Logistic regression was used to evaluate the cross-sectional association between individual items of the KICA-Cog and presence of dementia and/or cognitive impairment not dementia (CIND) by independent consensus diagnoses, to identify candidate items for a rapid scale. Sensitivity, specificity and optimal cut-off scores were calculated through receiver operating characteristic (ROC) curve analysis. The resulting short scales were then validated in a separate cohort of Aboriginal and Torres Strait Islander peoples. 

 

Results:  113 (13%) of 898 participants (mean age 64.4 [SD 9.8] years, 60% female) had a consensus clinical diagnosis of dementia.  A combination of four items in the KICA-Cog (orientation to time, orientation to place, verbal fluency, and picture naming recall) demonstrated high sensitivity (82.6%), specificity (83.2%), and AUC of 0.90 (95% CI 0.87-0.94) for dementia. Validation of this prototype scale in a separate cohort of 84 individuals yielded good sensitivity (87.5%), specificity (80.9%), and discriminatory value for dementia (AUC of 0.92 95% CI 0.85-0.98) at the cut-off point of 7/8 out of 10. 

 

Conclusions:  The developed 4-item prototype scale based on the KICA-Cog is ready for community piloting and validation and may be useful in primary care for rapid cognitive screening as part of routine health care.