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Kimberley Indigenous Cognitive Assessment tool (KICA): development of a cognitive assessment tool for older indigenous Australians

Published online by Cambridge University Press:  11 January 2006

D. LoGiudice ,
K. Smith ,
J. Thomas ,
N. T. Lautenschlager ,
O. P. Almeida ,
D. Atkinson  and
L. Flicker
D. LoGiudice
Affiliation:
National Ageing Research Institute, Parkville, Victoria, Australia School of Medicine and Pharmacology, University of Western Australia, Australia
K. Smith
Affiliation:
Kimberley Aged and Community Services, Derby, WA, Australia School of Medicine and Pharmacology, University of Western Australia, Australia
J. Thomas
Affiliation:
School of Medicine and Pharmacology, University of Western Australia, Australia
N. T. Lautenschlager
Affiliation:
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Australia
O. P. Almeida
Affiliation:
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Australia
D. Atkinson
Affiliation:
Kimberley Aboriginal Medical Services Council, Western Australia and Rural Clinical School, University of Western Australia, Australia
L. Flicker
Affiliation:
School of Medicine and Pharmacology, University of Western Australia, Australia
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Abstract

Background: Indigenous Australians have a unique cultural heritage dating back many thousands of years. Unfortunately, there is no validated tool to assess cognition in older indigenous Australians. This study was designed to address this deficiency. The Kimberley Indigenous Cognitive Assessment (KICA) was developed with Indigenous health and aged care organizations, and comprises cognitive, informant and functional sections. The psychometric properties of the cognitive assessment section (KICA-Cog) are described in this paper.

Methods: The KICA-Cog was tested in 70 indigenous subjects, of varying cognitive abilities and diagnoses, over 45 years of age. Subjects were interviewed using the KICA-Cog and then independently assessed by expert clinical raters using DSM-IV and ICD-10 criteria. Interrater and internal reliability were determined.

Results: The KICA-Cog score showed no systematic interrater difference; the mean was −0.07 (SD = 1.83). Interrater reliability for 16 individual questions from the cognitive section revealed a κ-value ≥ 0.6 and intraclass correlations for 12 questions. Internal consistency, as assessed by Cronbach's α, was 0.88. Three items on the cognitive score (pension week, recall and free recall) effectively discriminated 85–7% of dementia cases. Sensitivity and specificity were 90.6% and 92.6%, respectively, using a cut-off score of 31/32.

Conclusions: The KICA-Cog appears to be a reliable assessment tool for cognitive impairment in an Australian older traditionally living indigenous population.

Keywords

dementiacross-culturalcognitive assessmentAboriginal
Type
Research Article
Information
International Psychogeriatrics , Volume 18 , Issue 2 , June 2006 , pp. 269 - 280
Copyright
International Psychogeriatric Association 2006

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