A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care

Abstract

INTRODUCTION: Dementia is prevalent within Aboriginal and Torres Strait Islander communities but clients attending primary care often remain undiagnosed. This project aimed to develop a rapid dementia screen for primary care. METHODS: Logistic regression was used to identify candidate items from the Kimberley Indigenous Cognitive Assessment (KICA-Cog). The psychometric properties of different scales were assessed using receiver operating characteristic curve analysis and validated in a separate cohort. RESULTS: Four items in the KICA-Cog demonstrated high sensitivity (82.6%), specificity (83.2%) and area under the curve (AUC = 0.90; 95% CI: 0.87-0.94) for dementia at a cut-off point of 7/8 out of 10. This scale has favourable psychometrics (sensitivity 87.5%, specificity 80.9%, AUC = 0.92; 95% CI: 0.85-0.98) when validated in separate cohort. DISCUSSION: The proposed prototype tool, ready for community piloting and validation, may be useful in primary care to enable rapid cognitive screening as part of routine health care.