Abstract：
BACKGROUND: Literacy is an important factor that predicts cognitive performance. Existing cognitive screening tools are validated only in educated populations and are not appropriate for older adults with little or no education leading to poor performance on these tests and eventually leading to misdiagnosis. This challenge for clinicians necessitates a screening tool suitable for illiterate or low-literate older individuals.
OBJECTIVE: The objective was to adapt and validate Addenbrooke\'s Cognitive Examination-III (ACE-III) for screening general cognitive functions in illiterate and low-literate older populations in the Indian context in three languages.
METHODS: The Indian illiterate ACE-III was systematically adapted by modifying the original items of the Indian literate ACE-III to assess the cognitive functions of illiterates and low-literates with the consensus of an expert panel of professionals working in the area of dementia and related disorders. A total of 180 illiterate or low-literate participants (84 healthy-controls, 50 with dementia, and 46 with mild cognitive impairment [MCI]) were recruited from three different centers speaking Bengali, Hindi, and Kannada to validate the adapted version.
RESULTS: The optimal cut-off score for illiterate ACE-III to distinguish controls from dementia in all 3 languages was 75. The optimal cut-off scores in distinguishing between controls and MCI ranged from 79 to 82, with a sensitivity ranging from 93% to 99% and a specificity ranging from 72% to 99%.
CONCLUSIONS: The test is found to have good psychometric properties and is a reliable cognitive screening tool for identifying dementia and MCI in older adults with low educational backgrounds in the Indian context.
OBJECTIVE: The objective was to adapt and validate Addenbrooke\'s Cognitive Examination-III (ACE-III) for screening general cognitive functions in illiterate and low-literate older populations in the Indian context in three languages.
METHODS: The Indian illiterate ACE-III was systematically adapted by modifying the original items of the Indian literate ACE-III to assess the cognitive functions of illiterates and low-literates with the consensus of an expert panel of professionals working in the area of dementia and related disorders. A total of 180 illiterate or low-literate participants (84 healthy-controls, 50 with dementia, and 46 with mild cognitive impairment [MCI]) were recruited from three different centers speaking Bengali, Hindi, and Kannada to validate the adapted version.
RESULTS: The optimal cut-off score for illiterate ACE-III to distinguish controls from dementia in all 3 languages was 75. The optimal cut-off scores in distinguishing between controls and MCI ranged from 79 to 82, with a sensitivity ranging from 93% to 99% and a specificity ranging from 72% to 99%.
CONCLUSIONS: The test is found to have good psychometric properties and is a reliable cognitive screening tool for identifying dementia and MCI in older adults with low educational backgrounds in the Indian context.
摘要：
背景：识字是预测认知表现的重要因素。现有的认知筛查工具仅在受过教育的人群中得到验证，不适用于受过很少或没有受过教育的老年人，导致这些测试表现不佳，最终导致误诊。临床医生面临的这一挑战需要一种适用于文盲或低文化程度老年人的筛查工具。
目的：目的是适应和验证Addenbrooke的认知检查-III（ACE-III），以筛查印度文盲和低识字老年人群的一般认知功能。三种语言。
方法：通过修改印度文学ACE-III的原始项目来系统地调整印度文盲ACE-III，以评估文盲和低文化人的认知功能，并与在痴呆症和相关疾病领域工作的专家小组达成共识。共有180名文盲或低文化程度的参与者(84名健康对照，50患有痴呆症，和46名轻度认知障碍[MCI]）从三个讲孟加拉语的不同中心招募，印地语,和卡纳达语来验证改编版本。
结果：在所有3种语言中，文盲ACE-III区分对照和痴呆的最佳截止分数为75。区分对照和MCI的最佳截止分数为79至82，灵敏度为93％至99％，特异性为72％至99％。
结论：该测试被发现具有良好的心理测量特性，并且是在印度背景下识别低教育背景老年人的痴呆和MCI的可靠认知筛查工具。
目的：目的是适应和验证Addenbrooke的认知检查-III（ACE-III），以筛查印度文盲和低识字老年人群的一般认知功能。三种语言。
方法：通过修改印度文学ACE-III的原始项目来系统地调整印度文盲ACE-III，以评估文盲和低文化人的认知功能，并与在痴呆症和相关疾病领域工作的专家小组达成共识。共有180名文盲或低文化程度的参与者(84名健康对照，50患有痴呆症，和46名轻度认知障碍[MCI]）从三个讲孟加拉语的不同中心招募，印地语,和卡纳达语来验证改编版本。
结果：在所有3种语言中，文盲ACE-III区分对照和痴呆的最佳截止分数为75。区分对照和MCI的最佳截止分数为79至82，灵敏度为93％至99％，特异性为72％至99％。
结论：该测试被发现具有良好的心理测量特性，并且是在印度背景下识别低教育背景老年人的痴呆和MCI的可靠认知筛查工具。
