Chithiramohan Tamara, Santhosh Smrithi, Threlfall Grace, Hull Louise, Mukaetova-Ladinska Elizabeta B, Subramaniam Hari, Beishon Lucy
Leicestershire Partnership NHS Trust, Leicester UK.
Salford Royal Hospital, Salford, UK.
J Alzheimers Dis Rep. 2024 Feb 16;8(1):289-306. doi: 10.3233/ADR-230194. eCollection 2024.
Cognitive screening tools are important in the detection of dementia, including Alzheimer's disease; however, they may contain cultural biases.
This review examines culture-fair cognitive screening tools and evaluates their screening accuracy, strengths, and limitations.
Medline, Embase, PsychINFO and CINAHL were searched. The protocol was registered on PROSPERO (CRD42021288776). Included studies used a culture-fair tool to assess cognition in older adults from varying ethnicities. Narrative synthesis was conducted.
28 studies were included assessing eleven different tools. The Rowland Universal Dementia Assessment Scale (RUDAS) was as accurate as the Mini-Mental State Examination (MMSE) (AUC 0.62-0.93), with a similar sensitivity (52-94%) and better specificity (70-98%), and the Multicultural Cognitive Examination (MCE) had improved screening accuracy (AUC 0.99) compared to RUDAS (AUC 0.92). The Visual Cognitive Assessment Test (VCAT) was equivalent to MMSE (AUC 0.84-0.91). The Kimberley Indigenous Cognitive Assessment tool (KICA) had AUC of 0.93-0.95; sensitivity of 90.6%, specificity 92.6%.
The RUDAS, KICA and VCAT were superior to MMSE for screening dementia in ethnic minorities. Other tools also showed good screening accuracy. Further research should be done to validate tools in different populations.
认知筛查工具在痴呆症（包括阿尔茨海默病）的检测中很重要；然而，它们可能存在文化偏见。
本综述考察文化公平的认知筛查工具，并评估其筛查准确性、优点和局限性。
检索了Medline、Embase、PsychINFO和CINAHL。该方案已在PROSPERO（CRD42021288776）上注册。纳入的研究使用文化公平工具评估不同种族老年人的认知。进行了叙述性综合分析。
纳入28项研究，评估了11种不同工具。罗兰通用痴呆评估量表（RUDAS）与简易精神状态检查表（MMSE）的准确性相当（曲线下面积0.62 - 0.93），敏感性相似（52 - 94%），特异性更好（70 - 98%），多元文化认知检查（MCE）与RUDAS相比，筛查准确性有所提高（曲线下面积0.99）（RUDAS曲线下面积0.92）。视觉认知评估测试（VCAT）与MMSE相当（曲线下面积0.84 - 0.91）。金伯利原住民认知评估工具（KICA）的曲线下面积为0.93 - 0.95；敏感性为90.6%，特异性为9 .6%。
在筛查少数族裔痴呆症方面，RUDAS、KICA和VCAT优于MMSE。其他工具也显示出良好的筛查准确性。应进一步开展研究，在不同人群中验证这些工具。
