Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening Tools
The rising prevalence of dementia, particularly in low-income and developing countries, highlights the urgent need for effective cognitive screening tools. However, the existing tools often fail to address the unique needs of low-educated and illiterate populations, leading to diagnostic disparities...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-02-01
|
| Series: | Behavioral Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-328X/15/2/207 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850081077423505408 |
|---|---|
| author | Jonathan Adrián Zegarra-Valdivia Brenda Chino Kuripacha Tituana Lina Zapata-Restrepo María Martha Unaucho Milton Lopez-Norori Carmen Paredes-Manrique Nilton Custodio |
| author_facet | Jonathan Adrián Zegarra-Valdivia Brenda Chino Kuripacha Tituana Lina Zapata-Restrepo María Martha Unaucho Milton Lopez-Norori Carmen Paredes-Manrique Nilton Custodio |
| author_sort | Jonathan Adrián Zegarra-Valdivia |
| collection | DOAJ |
| description | The rising prevalence of dementia, particularly in low-income and developing countries, highlights the urgent need for effective cognitive screening tools. However, the existing tools often fail to address the unique needs of low-educated and illiterate populations, leading to diagnostic disparities. This review aimed to evaluate cognitive screening tests and domains employed globally to detect mild cognitive impairment (MCI) and dementia in low-educated and illiterate older adults. Following the PRISMA guidelines, Searches were performed in Web of Science, Scopus, and PubMed, targeting studies from January 2000 to 2023 involving adults over 45 years old. Of 1611 studies identified, 27 met the inclusion criteria and underwent pair review. The results revealed that most studies preferred adapting the existing tools to local languages over developing culturally tailored instruments. Twelve cognitive tests specifically designed for low-educated populations were identified, with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) being the most utilized, despite their educational biases. Adjusting the cutoff points improved detection (e.g., MoCA: sensitivity 82.5%, specificity 82%). Notably, the Rowland Universal Dementia Assessment Scale (RUDAS) demonstrated superior performance for low-educated groups (sensitivity 89% and specificity 93%). The findings underscore the critical need for region-specific cognitive batteries that integrate functional assessments, ensuring equitable and accurate diagnosis across diverse educational backgrounds. |
| format | Article |
| id | doaj-art-ee26a882b7e34829aa2c16a19b084fe7 |
| institution | DOAJ |
| issn | 2076-328X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Behavioral Sciences |
| spelling | doaj-art-ee26a882b7e34829aa2c16a19b084fe72025-08-20T02:44:49ZengMDPI AGBehavioral Sciences2076-328X2025-02-0115220710.3390/bs15020207Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening ToolsJonathan Adrián Zegarra-Valdivia0Brenda Chino1Kuripacha Tituana2Lina Zapata-Restrepo3María Martha Unaucho4Milton Lopez-Norori5Carmen Paredes-Manrique6Nilton Custodio7Faculty of Health Sciences, Universidad Señor de Sipán, Km5 Road to Pimentel, Chiclayo 14001, PeruCenter of Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, 28040 Madrid, SpainGlobal Brain Health Institute (GBHI), University of California San Francisco, San Francisco, CA 90025, USAGlobal Brain Health Institute (GBHI), University of California San Francisco, San Francisco, CA 90025, USAGlobal Brain Health Institute (GBHI), University of California San Francisco, San Francisco, CA 90025, USAGlobal Brain Health Institute (GBHI), University of California San Francisco, San Francisco, CA 90025, USAFacultad de Psicologia, Universidad Tecnológica del Perú, Lima 15073, PeruInstituto Peruano de Neurociencias, Lima 15046, PeruThe rising prevalence of dementia, particularly in low-income and developing countries, highlights the urgent need for effective cognitive screening tools. However, the existing tools often fail to address the unique needs of low-educated and illiterate populations, leading to diagnostic disparities. This review aimed to evaluate cognitive screening tests and domains employed globally to detect mild cognitive impairment (MCI) and dementia in low-educated and illiterate older adults. Following the PRISMA guidelines, Searches were performed in Web of Science, Scopus, and PubMed, targeting studies from January 2000 to 2023 involving adults over 45 years old. Of 1611 studies identified, 27 met the inclusion criteria and underwent pair review. The results revealed that most studies preferred adapting the existing tools to local languages over developing culturally tailored instruments. Twelve cognitive tests specifically designed for low-educated populations were identified, with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) being the most utilized, despite their educational biases. Adjusting the cutoff points improved detection (e.g., MoCA: sensitivity 82.5%, specificity 82%). Notably, the Rowland Universal Dementia Assessment Scale (RUDAS) demonstrated superior performance for low-educated groups (sensitivity 89% and specificity 93%). The findings underscore the critical need for region-specific cognitive batteries that integrate functional assessments, ensuring equitable and accurate diagnosis across diverse educational backgrounds.https://www.mdpi.com/2076-328X/15/2/207cognitive screening testilliteracylow educationolder adultsdementiamiddle cognitive impairment |
| spellingShingle | Jonathan Adrián Zegarra-Valdivia Brenda Chino Kuripacha Tituana Lina Zapata-Restrepo María Martha Unaucho Milton Lopez-Norori Carmen Paredes-Manrique Nilton Custodio Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening Tools Behavioral Sciences cognitive screening test illiteracy low education older adults dementia middle cognitive impairment |
| title | Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening Tools |
| title_full | Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening Tools |
| title_fullStr | Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening Tools |
| title_full_unstemmed | Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening Tools |
| title_short | Dementia and Mild Cognitive Impairment Identification in Illiterate and Low-Educated People: Systematic Review About the Use of Brief Cognitive Screening Tools |
| title_sort | dementia and mild cognitive impairment identification in illiterate and low educated people systematic review about the use of brief cognitive screening tools |
| topic | cognitive screening test illiteracy low education older adults dementia middle cognitive impairment |
| url | https://www.mdpi.com/2076-328X/15/2/207 |
| work_keys_str_mv | AT jonathanadrianzegarravaldivia dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools AT brendachino dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools AT kuripachatituana dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools AT linazapatarestrepo dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools AT mariamarthaunaucho dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools AT miltonlopeznorori dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools AT carmenparedesmanrique dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools AT niltoncustodio dementiaandmildcognitiveimpairmentidentificationinilliterateandloweducatedpeoplesystematicreviewabouttheuseofbriefcognitivescreeningtools |