LoGiudice D, Smith K, Thomas J, Lautenschlager N T, Almeida O P, Atkinson D, Flicker L
National Ageing Research Institute, Parkville, Victoria, Australia.
Int Psychogeriatr. 2006 Jun;18(2):269-80. doi: 10.1017/S1041610205002681. Epub 2006 Jan 11.
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.
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.
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 kappa-value > or = 0.6 and intraclass correlations for 12 questions. Internal consistency, as assessed by Cronbach's alpha, 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.
The KICA-Cog appears to be a reliable assessment tool for cognitive impairment in an Australian older traditionally living indigenous population.
澳大利亚原住民拥有可追溯至数千年前的独特文化遗产。不幸的是，目前尚无经过验证的工具可用于评估老年澳大利亚原住民的认知能力。本研究旨在弥补这一不足。金伯利原住民认知评估（KICA）是与原住民健康和老年护理组织共同开发的，包括认知、 informant 和功能部分。本文描述了认知评估部分（KICA-Cog）的心理测量特性。
对70名年龄超过45岁、认知能力和诊断各异的原住民受试者进行了KICA-Cog测试。使用KICA-Cog对受试者进行访谈，然后由专家临床评估者根据DSM-IV和ICD-10标准进行独立评估。确定了评估者间信度和内部信度。
KICA-Cog评分未显示出评估者间的系统性差异；平均值为-0.07（标准差=1.83）。认知部分16个单独问题的评估者间信度显示kappa值>或=0.6，12个问题的组内相关性良好。通过Cronbach's alpha评估的内部一致性为0.88。认知评分中的三个项目（养老金周、回忆和自由回忆）有效区分了85-7%的痴呆病例。使用31/32的临界值时，敏感性和特异性分别为90.6%和92.6%。
KICA-Cog似乎是一种可靠的评估工具，可用于评估澳大利亚传统生活的老年原住民人群中的认知障碍。
