The Importance of Culturally Appropriate Measures for Dementia Diagnosis in SSA

Introduction:

The diagnosis of dementia can be challenging in low- and middle-income country (LMIC) settings, particularly in sub-Saharan Africa (SSA), where educational and cultural differences impact the performance on cognitive screening measures worldwide. The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) are widely used elsewhere but appear educationally biased and over-report dementia in low-literacy settings in SSA.

Existing Challenges:

Most existing SSA epidemiological studies utilize forms of the Community Screening Interview for Dementia (CSI-D), a lengthy instrument designed to incorporate cognitive assessment and informant interviews. However, these tools have well-recognized limitations when used in SSA, leading to high false-positive rates. The lack of validated and locally normed culturally appropriate measures further complicates the diagnosis of dementia.

The Need for Culturally Appropriate Measures:

As the demographic transition continues, the absolute numbers of people living with dementia in SSA are projected to increase substantially. Therefore, it is essential to develop and validate culturally appropriate measures that can accurately diagnose dementia in LMIC settings. This requires a multidisciplinary approach involving experts from various fields, including psychology, neurology, epidemiology, and sociology.

The diagnosis of dementia in SSA is a complex task that requires the development and validation of culturally appropriate measures. By addressing these challenges, we can improve the accuracy of dementia diagnosis and provide better care for individuals living with this condition in LMIC settings.

References:

Acknowledgments:

The authors would like to acknowledge the contributions of all authors listed in the authorship section, who were involved in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation, review, or approval of the manuscript; and decision to submit for publication.

Moca test english 7 1.pdf