A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care

doi:10.1002/gps.70126

. 2025 Jul;40(7):e70126.

doi: 10.1002/gps.70126.

A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care

Huong X T Nguyen¹, Zoë Hyde^{1

2

3}, Kate Smith³, Roslyn Malay³, Leon Flicker², Rosie Watson¹, Kylie Radford^{4

5

6}, Sarah Russell^{7

8}, Rachel Quigley^{7

8}, Betty Sagigi^{7

9}, Edward Strivens^{7

8}, Adrienne Withall^{5

6}, Alison Timbery⁴, Terrence Donovan⁴, Brian Draper¹⁰, Kim Delbaere^{11

12}, Louise Lavrencic^{4

5

6}, Robert Cumming¹³, Jo-Anne Hughson¹, Bridgette J McNamara^{14

15}, Dina LoGiudice¹

Affiliations

¹ Department of Medicine - Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia.
² Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia.
³ Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australia, Perth, Australia.
⁴ Neuroscience Research Australia, Sydney, Australia.
⁵ School of Psychology, University of New South Wales, Sydney, Australia.
⁶ Ageing Futures Institute, University of New South Wales, Sydney, Australia.
⁷ College of Medicine and Dentistry, James Cook University, Cairns, Australia.
⁸ Cairns and Hinterland Hospital and Health Service, Cairns, Australia.
⁹ Torres and Cape Hospital and Health Service, Thursday Island, Australia.
¹⁰ Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
¹¹ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia.
¹² School of Health Sciences, University of New South Wales, Sydney, Australia.
¹³ School of Public Health, University of Sydney, Sydney, Australia.
¹⁴ Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia.
¹⁵ Barwon South-West Public Health Unit, Barwon Health, Geelong, Australia.

PMID: 40660785
PMCID: PMC12260483
DOI: 10.1002/gps.70126

A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care

Huong X T Nguyen et al. Int J Geriatr Psychiatry. 2025 Jul.

. 2025 Jul;40(7):e70126.

doi: 10.1002/gps.70126.

Authors

Affiliations

¹ Department of Medicine - Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia.
² Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia.
³ Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australia, Perth, Australia.
⁴ Neuroscience Research Australia, Sydney, Australia.
⁵ School of Psychology, University of New South Wales, Sydney, Australia.
⁶ Ageing Futures Institute, University of New South Wales, Sydney, Australia.
⁷ College of Medicine and Dentistry, James Cook University, Cairns, Australia.
⁸ Cairns and Hinterland Hospital and Health Service, Cairns, Australia.
⁹ Torres and Cape Hospital and Health Service, Thursday Island, Australia.
¹⁰ Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
¹¹ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia.
¹² School of Health Sciences, University of New South Wales, Sydney, Australia.
¹³ School of Public Health, University of Sydney, Sydney, Australia.
¹⁴ Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia.
¹⁵ Barwon South-West Public Health Unit, Barwon Health, Geelong, Australia.

PMID: 40660785
PMCID: PMC12260483
DOI: 10.1002/gps.70126

Abstract

Introduction: Dementia is prevalent within Aboriginal and Torres Strait Islander communities but clients attending primary care often remain undiagnosed. This project aimed to develop a rapid dementia screen for primary care.

Methods: Logistic regression was used to identify candidate items from the Kimberley Indigenous Cognitive Assessment (KICA-Cog). The psychometric properties of different scales were assessed using receiver operating characteristic curve analysis and validated in a separate cohort.

Results: Four items in the KICA-Cog demonstrated high sensitivity (82.6%), specificity (83.2%) and area under the curve (AUC = 0.90; 95% CI: 0.87-0.94) for dementia at a cut-off point of 7/8 out of 10. This scale has favourable psychometrics (sensitivity 87.5%, specificity 80.9%, AUC = 0.92; 95% CI: 0.85-0.98) when validated in separate cohort.

Discussion: The proposed prototype tool, ready for community piloting and validation, may be useful in primary care to enable rapid cognitive screening as part of routine health care.

Keywords: aboriginal and torres strait islander peoples; case detection; cognitive assessment; dementia; screening.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**FIGURE 1**
Comparison of prototype short scales. KICA items 10 (recall of three hidden objects) and 13 (free recall of five previously viewed pictures) both assess memory recall. KICA items 1,3,9,13 (green) exhibited higher AUC than the four‐item scale with item 10 (red), and comparable to the 5‐item scale (blue).

See this image and copyright information in PMC

References

1. Prince M., Guerchet M., Prina M.. “The Global Impact of Dementia: 2013‐2050,” (2013).
1. Smith K., Flicker L., Lautenschlager N. T., et al., “High Prevalence of Dementia and Cognitive Impairment in Indigenous Australians,” Neurology 71, no. 19 (2008): 1470–1473, 10.1212/01.wnl.0000320508.11013.4f. - DOI - PubMed
1. Radford K., Mack H. A., Draper B., et al., “Prevalence of Dementia in Urban and Regional Aboriginal Australians,” Alzheimer's and Dementia 11, no. 3 (2015): 271–279, 10.1016/j.jalz.2014.03.007. - DOI - PubMed
1. Russell S. G., Quigley R., Thompson F., et al., “Prevalence of Dementia in the Torres Strait,” Australasian Journal on Ageing 40, no. 2 (2021): e125–e132, 10.1111/ajag.12878. - DOI - PubMed
1. Temple J., Wilson T., Radford K., et al., “Demographic Drivers of the Growth of the Number of Aboriginal and Torres Strait Islander People Living With Dementia, 2016–2051,” Australasian Journal on Ageing 41, no. 4 (2022): e320–e327, 10.1111/ajag.13116. - DOI - PMC - PubMed

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[1] Prince M., Guerchet M., Prina M.. “The Global Impact of Dementia: 2013‐2050,” (2013).

[2] Prince M., Guerchet M., Prina M.. “The Global Impact of Dementia: 2013‐2050,” (2013).

[3] Smith K., Flicker L., Lautenschlager N. T., et al., “High Prevalence of Dementia and Cognitive Impairment in Indigenous Australians,” Neurology 71, no. 19 (2008): 1470–1473, 10.1212/01.wnl.0000320508.11013.4f. - DOI - PubMed

[4] Smith K., Flicker L., Lautenschlager N. T., et al., “High Prevalence of Dementia and Cognitive Impairment in Indigenous Australians,” Neurology 71, no. 19 (2008): 1470–1473, 10.1212/01.wnl.0000320508.11013.4f. - DOI - PubMed

[5] Radford K., Mack H. A., Draper B., et al., “Prevalence of Dementia in Urban and Regional Aboriginal Australians,” Alzheimer's and Dementia 11, no. 3 (2015): 271–279, 10.1016/j.jalz.2014.03.007. - DOI - PubMed

[6] Radford K., Mack H. A., Draper B., et al., “Prevalence of Dementia in Urban and Regional Aboriginal Australians,” Alzheimer's and Dementia 11, no. 3 (2015): 271–279, 10.1016/j.jalz.2014.03.007. - DOI - PubMed

[7] Russell S. G., Quigley R., Thompson F., et al., “Prevalence of Dementia in the Torres Strait,” Australasian Journal on Ageing 40, no. 2 (2021): e125–e132, 10.1111/ajag.12878. - DOI - PubMed

[8] Russell S. G., Quigley R., Thompson F., et al., “Prevalence of Dementia in the Torres Strait,” Australasian Journal on Ageing 40, no. 2 (2021): e125–e132, 10.1111/ajag.12878. - DOI - PubMed

[9] Temple J., Wilson T., Radford K., et al., “Demographic Drivers of the Growth of the Number of Aboriginal and Torres Strait Islander People Living With Dementia, 2016–2051,” Australasian Journal on Ageing 41, no. 4 (2022): e320–e327, 10.1111/ajag.13116. - DOI - PMC - PubMed

[10] Temple J., Wilson T., Radford K., et al., “Demographic Drivers of the Growth of the Number of Aboriginal and Torres Strait Islander People Living With Dementia, 2016–2051,” Australasian Journal on Ageing 41, no. 4 (2022): e320–e327, 10.1111/ajag.13116. - DOI - PMC - PubMed

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A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care

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A Prototype Rapid Tool to Enhance Detection of Dementia for Aboriginal and Torres Strait Islander Peoples in Primary Care

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