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Wiley, Alzheimer's & Dementia: The Journal of the Alzheimer's Association, S6(17), 2021

DOI: 10.1002/alz.055849

Wiley, Australasian Journal on Ageing, 2(42), p. 311-316, 2022

DOI: 10.1111/ajag.13147

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Telephone cognitive screening with older Aboriginal Australians: A preliminary study

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

AbstractObjectivesCognitive screening via telehealth is increasingly employed, particularly during the COVID‐19 pandemic. Telephone adaptations of existing cognitive screening tests must be validated across diverse populations. The present study sought to evaluate an existing 26‐point telephone adaptation of the Mini‐Mental State Examination (tMMSE) in a sample of older Aboriginal Australians. Additionally, we aimed to evaluate a telephone adaptation of the urban version of the Kimberley Indigenous Cognitive Assessment short‐form (tKICA screen).MethodsA sub‐sample (n = 20) of participants (aged 55–69 years; 11 women) who had completed an in‐person cognitive assessment (MMSE and KICA screen) within the past 6 months as part of the Koori Growing Old Well Study completed telephone‐based cognitive testing without an assistant.ResultsThere was moderate correlation and reasonable agreement between MMSE versions (rs = 0.33; p = 0.2), although the limits of agreement were unacceptably wide (−4.1 and 4.8 points difference). Poorer performance was seen on the tMMSE for Season (p = 0.02) and Phrase (p = 0.02) items, and better performance for three‐word Recall (p = 0.03). KICA‐screen versions were poorly correlated (rs = 0.20; p = 0.4) with telephone scoring a mean of 2.17 points below the face‐to‐face score, greater bias observed at the lower end of the performance and worse scores for Season (p = 0.02) and Recall (p = 0.001) items. Age and education were not associated with telephone screening performance. Hearing impairment was associated with poorer performance on the tKICA screen (p = 0.04) but not the tMMSE (p = 0.6).ConclusionsResults indicate that telephone administration of the MMSE and/or KICA screen is not equivalent to in‐person testing for older Aboriginal people, and further revision and evaluation are required.