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

Abstract

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. 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. 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. 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.