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

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. 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. 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. 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. • The KICA-Cog is a valid dementia cognitive assessment tool but it has limited ability to detect mild neurocognitive disorder. • Incorporating more items that assess executive function abilities could enhance the utility of the KICA-Cog. • The KICA package is currently being reviewed to determine how its utility can be enhanced. • Culturally responsive cognitive assessments must be co-designed and validated with the population in which they will be used.