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Comparison of Computerised and Pencil-and-Paper Neuropsychological Assessments in Older Culturally and Linguistically Diverse Australians

Published online by Cambridge University Press:  10 December 2021

Zara A. Page Open the ORCID record for Zara A. Page [Opens in a new window] ,
Karen Croot ,
Perminder S. Sachdev ,
John D. Crawford ,
Ben C.P. Lam ,
Henry Brodaty ,
Amanda Miller Amberber ,
Katya Numbers  and
Nicole A. Kochan
Zara A. Page
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
Karen Croot
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
Perminder S. Sachdev
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Sydney Australia Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia
John D. Crawford
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
Ben C.P. Lam
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
Henry Brodaty
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia
Amanda Miller Amberber
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
Katya Numbers
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
Nicole A. Kochan*
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
*
*Correspondence and reprint requests to: Nicole A Kochan, Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Syndey, NSW, 2056, Australia. E-mail: n.kochan@unsw.edu.au
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Abstract

Objectives:

Computerised neuropsychological assessments (CNAs) are proposed as an alternative method of assessing cognition to traditional pencil-and-paper assessment (PnPA), which are considered the “gold standard” for diagnosing dementia. However, limited research has been conducted with culturally and linguistically diverse (CALD) individuals. This study investigated the suitability of PnPAs and CNAs for measuring cognitive performance in a heterogenous sample of older, Australian CALD English-speakers compared to a native English-speaking background (ESB) sample.

Methods:

Participants were 1037 community-dwelling individuals aged 70–90 years without a dementia diagnosis from the Sydney Memory and Ageing Study (873 ESB, 164 CALD). Differences in the level and pattern of cognitive performance in the CALD group were compared to the ESB group on a newly developed CNA and a comprehensive PnPA in English, controlling for covariates. Multiple hierarchical regression was used to identify the extent to which linguistic and acculturation variables explained performance variance.

Results:

CALD participants’ performance was consistently poorer than ESB participants on both PnPA and CNA, and more so on PnPA than CNA, controlling for socio-demographic and health factors. Linguistic and acculturation variables together explained approximately 20% and 25% of CALD performance on PnPA and CNA respectively, above demographics and self-reported computer use.

Conclusions:

Performances of CALD and ESB groups differed more on PnPAs than CNAs, but caution is needed in concluding that CNAs are more culturally-appropriate for assessing cognitive decline in older CALD individuals. Our findings extend current literature by confirming the influence of linguistic and acculturation variables on cognitive assessment outcomes for older CALD Australians.

Keywords

Acculturationagedcognitioncomputercross-cultural comparisondementiaethnic groupslinguistics

Information

Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 10 , November 2022 , pp. 1050 - 1063
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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