A comparison of cognitive and health assessment tools used in a dementia prevention and risk management program for urban-dwelling older aboriginal Australians (DAMPAA)

Background: In partnership with Aboriginal Elders and Aboriginal community-controlled organisations, we developed a dementia risk management and prevention program for Aboriginal Australians aged ≥45 years. In this study, we report neuropsychological assessment data for people who underwent eligibility screening and baseline assessment and explore associations between the cognitive assessment tools used. Methods: Fifty Aboriginal people living in metropolitan Perth, Western Australia without known dementia were assessed with the Kimberley Indigenous Cognitive Assessment dementia screening tool (KICA-Cog) and a battery of standard neuropsychological tests. Results: Participants were aged 45–80 years (mean 63.5; standard deviation [SD] 9.4 years). Eleven participants (22.0 %) were male and 39 (78.0 %) were female. Of 49 participants with complete data, 13 (26.5 %) had a GAD-7 score indicating a possible anxiety disorder and 20 (40.8 %) had a KICA-Dep score indicating possible depression. All participants were screened with the KICA-Cog and 44–49 were screened with the other tests. The mean KICA-Cog score was 37.2 (SD 1.7; range: 33–39) and the mean Montreal Cognitive Assessment (MoCA) score was 22.2 (SD 4.5; range: 13–30). There were moderate correlations between the KICA-Cog and MoCA, Symbol Digit Modalities Test (oral version), and Hopkins Verbal Learning Test total immediate recall and delayed recall scores. There were weak or no correlations between the KICA-Cog and other cognitive assessment tools. Four participants had previously been told they had cognitive impairment. The KICA-Cog and MoCA scores for these participants were 37.0 (SD 2.2; range: 34–39) and 18.8 (SD 1.5; range: 17–20), respectively. Discussion: A high prevalence of possible depression and anxiety suggest mental health support may be required for people participating in dementia prevention programs. The KICA-Cog is the only valid screening tool for dementia in Aboriginal and Torres Strait Islander people, but its clinical utility could potentially be improved to better detect mild neurocognitive disorder.