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Validation of the Literacy Independent Cognitive Assessment

Published online by Cambridge University Press:  15 September 2010

Seong Hye Choi
Affiliation:
Department of Neurology, Inha Univeristy School of Medicine, Incheon, Republic of Korea
Yong S. Shim
Affiliation:
Department of Neurology, Bucheon St. Mary's Hospital, The Catholic University of Korea School of Medicine, Bucheon, Republic of Korea
Seung-Ho Ryu
Affiliation:
Department of Psychiatry, Konkuk University School of Medicine, Seoul, Republic of Korea
Hui Jin Ryu
Affiliation:
Department of Neurology, Konkuk University Hospital, Seoul, Republic of Korea
Dong Woo Lee
Affiliation:
Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
Jun-Young Lee
Affiliation:
Department of Psychiatry, Seoul National University Boramae Hospital, Seoul, Republic of Korea
Jee H. Jeong
Affiliation:
Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
Seol-Heui Han*
Affiliation:
Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea
*
Correspondence should be addressed to: Seol-Heui Han, MD, PhD, Department of Neurology, Konkuk University Hospital, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Republic of Korea. Phone: +82 2 2030 7561; Fax: +82 2 2030 5169. Email: alzdoc@kuh.ac.kr.

Abstract

Background: Low education and illiteracy are associated with an increased risk of dementia. This study aimed to develop a neuropsychological test battery applicable to both illiterate and literate elderly and to assess its reliability and validity for a diagnosis of dementia.

Methods: We developed the Literacy Independent Cognitive Assessment (LICA), which consists of 13 subtests assessing memory, language, visuoconstruction, executive function, attention and calculation. We investigated its reliability and validity on 152 patients with dementia, 66 with mild cognitive impairment and 639 normal controls.

Results: The subtests were found to be applicable to most of the illiterate normal controls (97.3%) and were found to have high inter-rater reliabilities (r = 0.85–1.00, p < 0.001) and moderate to high test-retest reliabilities (r = 0.50–0.86, p < 0.001). The LICA performed well in discriminating participants across Clinical Dementia Rating stages and showed excellent internal consistency and good concurrent validity with the Korean Mini-mental State Examination in both literate and illiterate participants. The area under the curve of the receiver operating characteristic was 0.985 in each of the two literacy groups. Sensitivity and specificity of the LICA to make a diagnosis of dementia was 91.9% and 91.8% at the cutoff point of 186.0 in the literate subjects and 96.2% and 91.1% at the cutoff point of 154.5 in the illiterate subjects. The battery was factored into two separate factors consisting of verbal memory tests and tests for other cognitive domains.

Conclusion: The LICA is a valid and reliable instrument for a diagnosis of dementia in both illiterate and literate elderly.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2010

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