Low educational attainment is risk factor for Alzheimer’s disease and other dementias. In developing countries, detecting dementia is a challenge because low cognitive test performance can be caused by dementia and/or limited education. Paper-based neuropsychological tests are most commonly used and persons with very low education or limited literacy may be unfairly disadvantaged by a paper-pencil response format. Our aim is to determine the accuracy of manual-, paper-, and tablet-based assessments for the detection of cognitive impairment, including dementia, in very low and moderate to high education Brazilians.
Manual-based tests, which typically require subjects to name and remember real objects and where they are hidden, are likely more appropriate for very low education persons, but they do not provide a comprehensive cognitive assessment because they focus on memory but not executive functions and require even more training than paper-based tests to administer reliably. With the advancement of technology, digital platform tests have been developed and may be appropriate for persons with very low education at the bedside.
Our preliminary data suggests that even persons who have very low education are comfortable with the touch-response format. These tests are easy to administer reliably even by non-specialists. All participants will be evaluated using manual-based (Fuld Object-Memory Evaluation), paper-based (Montreal Cognitive Assessment), and tablet-based (the Brazilian version of the Brain Health Assessment).
The results of this study will guide the selection of brief cognitive assessments for the detection of cognitive impairment especially among vulnerable persons with very low education, resulting in earlier identification and appropriate treatment for dementia.