Canadian indigenous cognitive assessment (Cica): Inter-rater reliability and criterion validity in anishinaabe communities on Manitoulin Island, Canada

Jennifer D. Walker, Megan E. O’connell, Karen Pitawanakwat, Melissa Blind, Wayne Warry, Andrine Lemieux, Christopher Patterson, Cheryl Allaby, Meghan Valvasori, Yantao Zhao, Kristen Jacklin

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Despite increasing dementia rates, few culturally informed cognitive assessment tools exist for Indigenous populations. The Canadian Indigenous Cognitive Assessment (CICA) was adapted with First Nations on Manitoulin Island, Canada, and provides a brief, multi-domain cognitive assessment in English and Anishinaabemowin. Methods: Using community-based participatory research (CBPR) methods, we assessed the CICA for inter-rater and test–retest reliability in 15 individuals. We subsequently evaluated validity and established meaningful CICA cut-off scores in 55 individuals assessed by a geriatrician. Results: The CICA demonstrated strong reliability (intra-class coefficient = 0.95 [0.85,0.98]). The area under the curve (AUC) was 0.98 (0.94, 1.00), and the ideal cut-point to identify likely cases of dementia was a score of less than or equal to 34 with sensitivity of 100% and specificity of 85%. Discussion: When used with older First Nations men and women living in First Nations communities, the CICA offers a culturally safe, reliable, and valid assessment to support dementia case-finding.

Original languageEnglish (US)
Article numbere12213
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume13
Issue number1
DOIs
StatePublished - 2021

Bibliographical note

Funding Information:
CIHR Operating Grant, Grant/Award Number: 150743; Canadian Consortium on Neurodegeneration in Aging, Grant/Award Number: CNA-137794 This work was supported by a grant from the Canadian Institutes of Health Research (CIHR): Validation of the Canadian Indigenous Cognitive Assessment Tool in three provinces, CIHR Operating Grant (grant number 150743, 2017 to J. Walker). The work was also supported by the Canadian Consortium on Neurodegeneration in Aging, which is supported by a grant from CIHR (grant number CNA-137794, 2014, to H. Chertkow, K. Jacklin et al.) with funding from several partners. The authors would like to acknowledge the members of the Manitoulin Community Advisory Council, who guided the methodology for the study and the interpretation of results: Bill Antoine, Bonita Bebamash, Edward Osawamick, Evelyn Roy, Jean McGregor-Andrews, Joe Peltier, Jules Osawamick, Marion McGregor, Rose Shawanda, Roseanne Debassige, Roselinda Peltier, Rosella Kinoshame, and Monica Pheasant. The Canadian Indigenous Cognitive Assessment (CICA) is based on the Kimberley Indigenous Cognitive Assessment (KICA). We acknowledge the guidance, direction, and advice of the KICA?s developers, including Dr. Kate Smith, Dr. Leon Flicker, and Dr. Dina LoGiudice. We would also like to acknowledge additional members of the project team who provided research support, including Rosanna Pietrangeli, Louise Jones, Rhonda Trudeau, and Sharlene Webkamigad.

Funding Information:
This work was supported by a grant from the Canadian Institutes of Health Research (CIHR): Validation of the Canadian Indigenous Cognitive Assessment Tool in three provinces, CIHR Operating Grant (grant number 150743, 2017 to J. Walker). The work was also supported by the Canadian Consortium on Neurodegeneration in Aging, which is supported by a grant from CIHR (grant number CNA-137794, 2014, to H. Chertkow, K. Jacklin et al.) with funding from several partners.

Publisher Copyright:
© 2021 The Authors.

Keywords

  • Aging
  • Cognitive assessment
  • Cross-cultural
  • Dementia

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