Neuroscience Research Australia, Sydney, New South Wales, Australia.
Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.
Australas J Ageing. 2023 Jun;42(2):311-316. doi: 10.1111/ajag.13147. Epub 2022 Nov 4.
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).
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.
There was moderate correlation and reasonable agreement between MMSE versions (r = 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 (r = 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).
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.
远程医疗中的认知筛查应用日益广泛，尤其是在 COVID-19 大流行期间。现有的认知筛查测试的电话改编版必须在不同人群中得到验证。本研究旨在评估现有的 26 分电话版简易精神状态检查（tMMSE）在老年澳大利亚原住民样本中的应用。此外，我们还旨在评估城市版金伯利原住民认知评估简式（tKICA 筛查）的电话改编版。
在 Koori Growing Old Well 研究中，作为过去 6 个月内完成面对面认知评估（MMSE 和 KICA 筛查）的参与者的子样本（年龄 55-69 岁；11 名女性），不使用助手，完成了电话认知测试。
尽管一致性的界限不可接受地宽（相差-4.1 至 4.8 分），但 MMSE 版本之间存在中度相关性和合理的一致性（r=0.33；p=0.2）。在季节（p=0.02）和短语（p=0.02）项目上，tMMSE 的表现较差，而在三个词回忆（p=0.03）项目上表现较好。KICA 屏幕版本相关性较差（r=0.20；p=0.4），电话评分平均比面对面评分低 2.17 分，在性能较低的一端观察到更大的偏差，并且季节（p=0.02）和回忆（p=0.001）项目的得分较差。年龄和教育程度与电话筛查表现无关。听力障碍与 tKICA 屏幕的表现较差有关（p=0.04），但与 tMMSE 无关（p=0.6）。
结果表明，电话版 MMSE 和/或 KICA 筛查对于老年原住民来说，与面对面测试并不等效，需要进一步修订和评估。
