William K Gray1, Stella-Maria Paddick2, Aloyce Kisoli3, Catherine L Dotchin4, Anna R Longdon5, Paul Chaote6, Maria Samuel4, Ahmed M Jusabani7, Richard W Walker8. 1. Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom wagray70@gmail.com. 2. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom. 3. Hai District Medical Centre, Boman'gombe, Hai, Tanzania. 4. Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom. 5. South Devon Healthcare NHS Foundation Trust, Torquay, United Kingdom. 6. District Medical Office, Hai District Hospital, Boman'gombe, Hai, Tanzania. 7. Department of Radiology, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro Region, Tanzania. 8. Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
Abstract
AIM: The aim of this project was to develop a dementia screening instrument for use in the hospital or community in populations with low levels of formal education. METHODS: A screening instrument was developed from retrospective data collected in a rural area of Tanzania in 2010. The community screening instrument for dementia was administered to over 95% of the population aged 70 years and older of 6 villages (n = 1198) in Hai district, Tanzania. Factor analysis, regression modeling, and Mokken scale analysis (MSA) were used to develop screening instruments from these data, which were then tested and refined during prospective fieldwork. RESULTS: A 5-item screening instrument with an area under the receiver-operating characteristic (AUROC) curve of 0.871, sensitivity of 91.7%, and specificity of 61.7% was developed using a combination of factor analysis and logistic regression modeling and had a higher AUROC (0.786) than a 7-item screening instrument developed using MSA. During prospective testing and refinement (n = 60), the 5-item instrument performed well (AUROC 0.867) and took an average of less than 10 minutes to administer. Its performance was improved by including a matchstick design item added to measure praxis, AUROC 0.888. CONCLUSIONS: The 6-item brief dementia screening instrument has acceptable properties and will be further tested and validated during future fieldwork. Although developed for use in sub-Saharan Africa, it may be of use in other world regions where the use of other cognitive screening instruments may result in bias due to low levels of formal education.
AIM: The aim of this project was to develop a dementia screening instrument for use in the hospital or community in populations with low levels of formal education. METHODS: A screening instrument was developed from retrospective data collected in a rural area of Tanzania in 2010. The community screening instrument for dementia was administered to over 95% of the population aged 70 years and older of 6 villages (n = 1198) in Hai district, Tanzania. Factor analysis, regression modeling, and Mokken scale analysis (MSA) were used to develop screening instruments from these data, which were then tested and refined during prospective fieldwork. RESULTS: A 5-item screening instrument with an area under the receiver-operating characteristic (AUROC) curve of 0.871, sensitivity of 91.7%, and specificity of 61.7% was developed using a combination of factor analysis and logistic regression modeling and had a higher AUROC (0.786) than a 7-item screening instrument developed using MSA. During prospective testing and refinement (n = 60), the 5-item instrument performed well (AUROC 0.867) and took an average of less than 10 minutes to administer. Its performance was improved by including a matchstick design item added to measure praxis, AUROC 0.888. CONCLUSIONS: The 6-item brief dementia screening instrument has acceptable properties and will be further tested and validated during future fieldwork. Although developed for use in sub-Saharan Africa, it may be of use in other world regions where the use of other cognitive screening instruments may result in bias due to low levels of formal education.
Authors: Clare Bristow; Grace George; Grace Hillsmith; Emma Rainey; Sarah Urasa; Sengua Koipapi; Aloyce Kisoli; Japhet Boni; Grace Anderson Saria; Sherika Ranasinghe; Marcella Joseph; William K Gray; Marieke Dekker; Richard W Walker; Catherine L Dotchin; Elizabeta Mukaetova-Ladinska; William Howlett; Philip Makupa; Stella-Maria Paddick Journal: J Neurovirol Date: 2021-01-11 Impact factor: 2.643
Authors: Farrah J Mateen; Emmanuel Massawe; Notburga A Mworia; Seif Ismail; Dylan R Rice; Andre C Vogel; Boniface Kapina; Novath Mukyanuzi; Deus C Buma; Jef Gluckstein; Michael Wasserman; Susan E Fasoli; Faraja Chiwanga; Kigocha Okeng'o Journal: Am J Trop Med Hyg Date: 2021-12-06 Impact factor: 3.707
Authors: Cecilia Collingwood; Stella-Maria Paddick; Aloyce Kisoli; Catherine L Dotchin; William K Gray; Godfrey Mbowe; Sarah Mkenda; Sarah Urasa; Declare Mushi; Paul Chaote; Richard W Walker Journal: Glob Health Action Date: 2014-12-22 Impact factor: 2.640
Authors: Emma Grace Lewis; William K Gray; Richard Walker; Sarah Urasa; Miles Witham; Catherine Dotchin Journal: BMC Public Health Date: 2022-10-14 Impact factor: 4.135
Authors: Johanna Kellett-Wright; Aidan Flatt; Patrick Eaton; Sarah Urasa; William Howlett; Marieke Dekker; Aloyce Kisoli; Ashanti Duijinmaijer; Jessica Thornton; Judith McCartney; Vanessa Yarwood; Charley Irwin; Elizabeta Mukaetova-Ladinska; Rufus Akinyemi; Bingileki Lwezuala; William K Gray; Richard W Walker; Catherine L Dotchin; Philip Makupa; Stella-Maria Paddick Journal: AIDS Behav Date: 2021-02