Telephone cognitive screening with older Aboriginal Australians: A preliminary study

Abstract

Objectives Cognitive screening via telehealth is increasingly employed, particularly during the COVID‐19 pandemic. Telephone adaptations of existing cognitive screening tests must be validated across diverse populations. The present study sought to evaluate an existing 26‐point telephone adaptation of the Mini‐Mental State Examination (tMMSE) in a sample of older Aboriginal Australians. Additionally, we aimed to evaluate a telephone adaptation of the urban version of the Kimberley Indigenous Cognitive Assessment short‐form (tKICA screen). Methods A sub‐sample (n = 20) of participants (aged 55–69 years; 11 women) who had completed an in‐person cognitive assessment (MMSE and KICA screen) within the past 6 months as part of the Koori Growing Old Well Study completed telephone‐based cognitive testing without an assistant. Results There was moderate correlation and reasonable agreement between MMSE versions (rs = 0.33; p = 0.2), although the limits of agreement were unacceptably wide (−4.1 and 4.8 points difference). Poorer performance was seen on the tMMSE for Season (p = 0.02) and Phrase (p = 0.02) items, and better performance for three‐word Recall (p = 0.03). KICA‐screen versions were poorly correlated (rs = 0.20; p = 0.4) with telephone scoring a mean of 2.17 points below the face‐to‐face score, greater bias observed at the lower end of the performance and worse scores for Season (p = 0.02) and Recall (p = 0.001) items. Age and education were not associated with telephone screening performance. Hearing impairment was associated with poorer performance on the tKICA screen (p = 0.04) but not the tMMSE (p = 0.6). Conclusions Results indicate that telephone administration of the MMSE and/or KICA screen is not equivalent to in‐person testing for older Aboriginal people, and further revision and evaluation are required.

Promoting equity and inclusion

“…With this in mind, it is pleasing to see a collection of articles in this issue reporting research with Aboriginal people in Australia, including papers on the use of facial recognition software with Aboriginal aged care residents, 1 and telephone cognitive screening with older Aboriginal people. 2 Gilchrist et al 3 report on the psychometric properties of the Good Spirit, Good Life (GSGL) quality of life tool for older Aboriginal people, which was developed through an Indigenous research methodology and participatory action research, with the research process being guided by an Elders Governance Group. Participatory action research was also used by Mackell et al 4 in their study on how Aboriginal community-controlled art centres support Aboriginal Elders, older people and people living with dementia.…”