Background. There are increasing numbers of older African-Caribbeans in the United Kingdom.
Screening instruments are commonly used in the detection of cognitive impairment, but have not
been assessed within this population. This study aimed to develop culturally modified versions of
screening instruments for cognitive impairment (Mini-Mental State Examination (MMSE) and
Abbreviated Mental Test (AMT)) and to determine their sensitivity and specificity in the diagnosis
Methods. The instruments were modified using a process involving a community group of African-Caribbeans and an academic group of health professionals. They were used in a two-stage study
involving community resident African-Caribbeans aged 60 years or over in inner-city Manchester,
comparing the screening instruments against a computerized diagnostic interview.
Results. One hundred and thirty people completed the study. The results for the largest subgroup,
the Jamaicans (N = 96) were analysed. Effects of gender, age and education on the MMSE and
AMT scores were evaluated. The correlations between the screening instruments and diagnostic
interview were highly significant (P < 0·001). At appropriate cut-offs both screening instruments
demonstrated high sensitivity and acceptable specificity levels.
Conclusions. A defined process with lay input has assisted in producing culturally modified versions
of the MMSE and AMT that perform well compared with a diagnostic interview, if an appropriate
cut-off is used. They are easy to administer and acceptable to older African-Caribbean people. The
results need to be viewed within the limitations of the current study.