Presenter:

Patrick Kibuuka, African Research Center 4 Ageing & Dementia, Uganda

Co-authors:

Samuel Joloba, Community Health Access Foundation Uganda, Uganda
Daniel Ssentamu, Kalungi District Local Government, Uganda
Isaac Ddumba, African Research Center 4 Ageing & Dementia, Uganda

Abstract

Background
Although the risk of developing dementia increases in later years, identification and assessment of older persons with dementia in developing countries is still low.  Access to easy and use- friendly cognitive screening tools by the health care professional in developing countries is difficult.  The study aimed to develop, validate and field test a cognitive screening tool for use in outpatient departments within health facilities in Uganda.

Methods
In the rural eastern region of Uganda, twenty-three (23) purposively selected health facilities administered a scientifically derived cognitive screening tools to all eligible older persons.  We conducted an inter-rater reliability in all the health facilities using three raters.  Diagnosis of dementia (DSM-IV) was classified as a major cognitive impairment and was quality checked by physiatrists who were blinded to results of the screening assessment.  

Results
The area under the receiver operating characterizes (AUROC) curve in health facilities was 0.912.  The inter-rater reliability was good (Intra-class correlation coefficient of 0.692 to 0.734).  The predictive accuracy of the tool to discriminate between dementia and other cognitive impairment was 0.892.  In the regression modal, the cognitive screening tool, did not appear to be biased by age.

Conclusion
The cognitive screening tool if performed well among older persons, can be proved useful for screening dementia in other developing countries.