The feasibility and factor structure of a multi-domain cognitive test battery in older Kenyan adults

This study evaluated the feasibility and internal factor structure of an adapted multi-domain and multi-modal (paper/digital) cognitive test battery for cognitively unimpaired multilingual Kenyan adults. The battery was translated into Swahili, back-translated, culturally adapted with community input, and refined through expert review. It was administered to 148 adults (37.26% male; mean age 57.68 years, range 45-79) using paper-based measures of learning, memory, attention, fluency, and visuoconstruction, along with tablet-based tasks assessing attention, set-shifting, symbol-matching, visuoperception, and visual associative learning. Participants found the tests relevant and acceptable, recommending language simplification, short breaks, and flexibility in language use. High completion rates and positive engagement supported feasibility. Exploratory factor analyses identified a four-factor structure explaining 61.4% of variance, reflecting executive control, rote memory, contextual memory, and visuospatial functioning with preliminary evidence for acceptable model fit, pending cross-validation. Findings indicate feasibility and provide initial evidence for construct validity based on the internal structure of the test battery. These results advance multidimensional cognitive phenotyping for brain health assessment in Sub-Saharan Africa.