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Determining acceptable and reliable cognitive testing methods in an Australian Aboriginal population

Gray, Allison Olga (2015). Determining acceptable and reliable cognitive testing methods in an Australian Aboriginal population. Honours Thesis, Charles Darwin University.

Document type: Thesis
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Author Gray, Allison Olga
Title Determining acceptable and reliable cognitive testing methods in an Australian Aboriginal population
Institution Charles Darwin University
Publication Date 2015
Thesis Type Honours
Supervisor Dingwall, Kylie
1702 - Cognitive Sciences
Abstract Introduction: Cognitive tests are a measure of brain abilities including memory, judgement, evaluation, reasoning, problem solving, decision making, comprehension and language. These tests provide practitioners with information to guide treatment protocols, monitor treatment effectiveness and care planning. Cognitive tests are traditionally based on Western concepts and norms; often requiring familiarity with the English language and formal education. Current literature suggests that culturally specific and appropriate cognitive assessments for Aboriginal and Torres Strait Islander peoples is an underserved area that requires further investigation. Differences in language and culture mean that the psychometric properties of tests should be assessed prior to use in other populations, including Aboriginal Australians. The aim of this study was to examine the acceptability and reliability of four cognitive tests for future use in a randomised controlled trial investigating the optimum thiamine dose for treating and preventing Wernicke-Korsakoff Syndrome (WKS).

Methods: Medical staff at Alice Springs Hospital referred Aboriginal patients meeting the study’s inclusion and exclusion criteria. The cognitive tests included: Rowland Universal Dementia Assessment Screen (RUDAS) (n=19), PEBL Corsi Blocks (CORSI) (n=19), Story Memory Recall Test (SMRT) (n=17) and CogState Brief Battery (n=18). Each test was chosen as they measured specific cognitive domains, are supported for use in culturally and linguistically diverse populations and prior use at Alice Springs Hospital. Participants performed one to three tests with repeated assessment to determine test-retest reliability. Qualitative interviews and theme discussions were conducted to explore perceived acceptability of the tests.

Results: Test-retest reliabilities ranged from 0.61 (CogState one back accuracy) to 0.86 (RUDAS). Inter-rater reliability for the SMRT displayed high results (0.98-0.99). Several themes emerged across the four cognitive tests relating to general impressions, impacts on understanding and performance, appropriateness and assisting in understanding the task.

Discussion and Conclusion: All four tests demonstrated acceptable test-retest reliability. RUDAS, Story Recall and the CogState choice reaction time task showed the highest reliability. Overall the tests were viewed as a positive challenge, an opportunity to learn about the brain and reflect on the past. Certain caveats about test acceptability included the use of interpreters, impacts of convalescence and cultural relevance. Reliability and acceptability may be improved by providing instructions in Aboriginal language for those whose first language is not English.
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