Telephone cognitive screening with older Aboriginal Australians: A preliminary study

Area of Science:

• Gerontology
• Neuroscience
• Public Health

Background:

• Telehealth cognitive screening is vital, especially post-COVID-19.
• Validating telephone adaptations of cognitive tests across diverse populations is crucial.
• Older Aboriginal Australians require culturally appropriate and validated cognitive assessment tools.

Purpose of the Study:

• To evaluate the telephone adaptation of the Mini-Mental State Examination (tMMSE) in older Aboriginal Australians.
• To assess the telephone adaptation of the Kimberley Indigenous Cognitive Assessment short-form (tKICA screen) in the same population.
• To determine the validity and reliability of these telephone cognitive screening tools compared to in-person assessments.

Main Methods:

• A sub-sample of 20 older Aboriginal Australians (aged 55-69) with recent in-person cognitive assessments (MMSE and KICA screen) participated.
• Participants underwent telephone-based cognitive testing without an assistant.
• Data from telephone and in-person assessments were compared for correlation and agreement.

Main Results:

• The telephone Mini-Mental State Examination (tMMSE) showed moderate correlation but unacceptably wide agreement limits with the in-person version.
• The telephone Kimberley Indigenous Cognitive Assessment short-form (tKICA screen) demonstrated poor correlation and significantly lower scores compared to face-to-face testing.
• Hearing impairment was linked to poorer tKICA screen performance, but age and education were not significant factors for either telephone test.

Conclusions:

• Telephone administration of the MMSE and KICA screen is not equivalent to in-person cognitive testing for older Aboriginal people.
• Current telephone adaptations require significant revision and further evaluation before widespread use.
• Ensuring accurate and equitable cognitive screening for Indigenous elders via telehealth remains a challenge.