Culturally appropriate cognitive screening tools

Early dementia can be difficult to diagnose in CALD older people. The Folstein Mini-Mental State Examination (MMSE), the General Practitioner Assessment of Cognition (GPCOG) and the Rowland Universal Dementia Assessment Scale (RUDAS) were compared in 151 older, community-dwelling persons (Basic et al., 2009). All three instruments were equally accurate in predicting dementia. All three instruments were influenced by concomitant depression. Whereas the MMSE was influenced by CALD status, the RUDAS and GPCOG were not. While the GPCOG combines participant and informant data, the RUDAS is a stand-alone measure specifically designed for, and validated in, multicultural populations (Basic et al., 2009).

The Folstein Mini-Mental State Examination (MMSE)

The Mini Mental State Examination (MMSE) is the most commonly used test for complaints of memory problems. It can be used by clinicians to help diagnose dementia and to help assess its progression and severity. The MMSE has been translated into many languages but there is criticism about its psychometric properties in CALD people, people with low education and people with very mild cognitive difficulties.

Rowland Universal Dementia Assessment Scale

The Rowland Universal Dementia Assessment Scale (RUDAS) is the preferred tool. It is a short cognitive screening instrument designed to minimise the effects of cultural learning and language diversity on the assessment of baseline cognitive performance. All resources associated with this assessment tool are available via the Rowland Universal Dementia Assessment Scale (RUDAS) information page. The RUDAS can easily be administered with an interpreter and has good psychometric properties.

Montreal Cognitive Assessment (MoCA)

The Montreal Cognitive Assessment (MOCA) is available in 36 languages and dialects. The MOCA is used for the detection of cognitive impairment in multiple conditions including Mild Cognitive Impairment (MCI), Alzheimer's disease, Vascular Dementia, Parkinson’s disease Dementia and Fronto-temporal dementia. The tool has been validated in 21 languages/dialects. It is also available in parallel versions in English. See their website for more information.

Additionally, the Alzheimer's Australia website offers a range of dementia assessment scales and tools which are appropriate for CALD older people (Basic et al., 2009).

Addenbrooke’s Cognitive Examination – Version III (ACE-III)

The ACE-III is a brief cognitive screening that assesses five cognitive domains, namely attention/ orientation, memory, verbal fluency, language and visuospatial abilities. Translated versions of ACE-III are available for download from their website.