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Clinical Manifestations.

Rachel W Maina1,2, Wambui Karanja1, Chinedu Udeh-Momoh3,4

  • 1Brain and Mind Institute, Aga Khan University, Nairobi, Nairobi, Kenya.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
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Summary
This summary is machine-generated.

Cognitive tests adapted for Kenyan adults show construct validity, but semantic fluency needs improvement for this multilingual population. Further validation of cognitive assessment tools is crucial for cross-cultural use.

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Area of Science:

  • Neuroscience
  • Psychology
  • Cognitive Science

Background:

  • Transcultural adaptation and psychometric validation of cognitive assessment tools are essential for equitable use in low- and middle-income countries (LMICs).
  • Cognitive assessment tools developed in high-income countries (HICs) require validation for use in diverse populations.
  • This study addresses the need for culturally relevant cognitive assessments in LMICs.

Purpose of the Study:

  • To evaluate the factor structure of a multi-domain, multi-modal cognitive test battery in cognitively unimpaired (CU) multilingual Kenyan adults.
  • To determine if the test battery conforms to globally recognized neuropsychological domains.
  • To assess the psychometric properties of both paper/pencil and digital cognitive tests.

Main Methods:

  • Administered a neuropsychological test battery to two independent samples of CU Kenyan adults (N=135 and N=218).
  • Employed Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) to examine the factor structure.
  • Included subtest scores from established tests (NIH HCAP) and novel tablet-based assessments (Tablet-based Cognitive Assessment Tool [TabCAT]).

Main Results:

  • EFA revealed a three-factor structure explaining 62.6% of the variance, primarily representing episodic memory and executive function/attention.
  • Episodic memory subtests loaded strongly on two distinct factors.
  • The Tablet-based Cognitive Assessment Tool (TabCAT) measures loaded on a third factor, alongside attention and executive function, while semantic fluency showed weak loadings.

Conclusions:

  • The findings support the construct validity of the multi-domain cognitive test battery in Kenyan adults.
  • The low loading of semantic fluency suggests a need for modification to better capture the language domain in this multilingual population.
  • Further research is needed to refine cognitive assessment tools for diverse linguistic and cultural contexts.