Cognitive assessment tools in Asia: a systematic review

Abstract

Few cognitive assessment tools have been validated in Asia, with no published validation studies for many Asian nations and languages. In addition, many available tools display educational bias. Future research should include concerted efforts to develop culturally appropriate tools with minimal educational bias.

Rural–urban differences in the prevalence of cognitive impairment in independent community-dwelling elderly residents of Ojiya city, Niigata Prefecture, Japan

“…The HDS-R is frequently used in East Asian populations [13,14], and is similar to the MMSE in its diagnostic accuracy for dementia [20]. One advantage of using the HDS-R over the MMSE is its diagnostic accuracy regardless of education level [20].…”

“…The HDS-R was originally used to screen for dementia, with a sensitivity of 0.90 and a specificity of 0.82 using a cutoff point of 20/21, and also correlates well with the mini mental state examination (MMSE) [12]. Like the MMSE, the HDS-R has been used in population-based epidemiologic studies, especially in Asia [13,14]. Information on frequency and average daily consumption of alcohol was obtained.…”

Current approaches to dementia screening and case finding in low‐ and middle‐income countries: Research update and recommendations

“…Adapting cognitive assessment instruments from HICs to LMIC settings has been criticized as this typically introduces cultural, educational, and literacy biases increasing the risk of misclassification and an overestimation of dementia prevalence . It is further noted that some widely adapted measures lack rigorous psychometric validation across different LMIC settings …”

A novel language-neutral Visual Cognitive Assessment Test (VCAT): validation in four Southeast Asian countries

“…There is evidence to demonstrate that when using cognitive screening tools that have been modified or translated to meet local demands, these tests often result in overdiagnosis of cognitive impairment in non-English speakers [19]. Furthermore, the lack of standardized cognitive screening tools across Asian countries [20] will prevent meaningful crosscultural comparisons and poses major challenges when conducting international clinical trials with cognition as outcome measures [21].…”