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Bias in discriminating very mild dementia for older adults with different levels of education in Hong Kong

Published online by Cambridge University Press:  26 February 2014

Jianfang Chang ,
Chi-Shing Tse ,
Grace Tak Yu Leung ,
Ada Wai Tung Fung ,
Kit-Tai Hau ,
Helen Fung Kum Chiu  and
Linda Chiu Wa Lam
Jianfang Chang*
Affiliation:
Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China Department of Psychology, Guangdong University of Education, Guangzhou, China
Chi-Shing Tse
Affiliation:
Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
Grace Tak Yu Leung
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
Ada Wai Tung Fung
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
Kit-Tai Hau
Affiliation:
Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
Helen Fung Kum Chiu
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
Linda Chiu Wa Lam
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
*
Correspondence should be addressed to: Jianfang Chang, PhD, Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong. Phone: +852-39438226; Fax: +852-39433700. Email: ffchangpsy@gmail.com.
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Abstract

Background:

Education has a profound effect on older adults’ cognitive performance. In Hong Kong, some dementia screening tasks were originally designed for developed population with, on average, higher education.

Methods:

We compared the screening power of these tasks for Chinese older adults with different levels of education. Community-dwelling older adults who were healthy (N = 383) and with very mild dementia (N = 405) performed the following tasks: Mini-Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive subscales, Verbal Fluency, Abstract Thinking, and Visual/Digit Span. Logistic regression was used to examine the power of these tasks to predict Clinical Dementia Rating (CDR 0.5 vs. 0).

Results:

Logistic regression analysis showed that while the screening power of the total scores in all tasks was similar for high and low education groups, there were education biases in some items of these tasks.

Conclusion:

The differential screening power in high and low education groups was not identical across items in some tasks. Thus, in cognitive assessments, we should exercise great caution when using these potentially biased items for older adults with limited education.

Keywords

Alzheimer's diseaseChineseclinical dementia ratingeducationHong Kong
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 6 , June 2014 , pp. 995 - 1010
Copyright
Copyright © International Psychogeriatric Association 2014 

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