02/17/2024
09:00 am - 10:30 am
Room: West Side Ballroom - Salon 1
Symposia 14
Advances in cognitive screening and neuropsychological assessment of cognitive decline and dementia in individuals with low education/low literacy levels
Chair:
Unai Diaz-Orueta
Maynooth University, Maynooth, County Kildare, Ireland
Appropriate diagnosis of MCI and dementia is important in order to assess for reversible causes of cognitive impairment, help patients and families understand the cause of their cognitive concerns, and discuss prognostic possibilities (Petersen et al., 2018). Diagnosis is especially difficult for individuals raised in environments where low education and literacy are more prevalent, for two reasons: (1) difficulties for accessing healthcare resources, (2) an unacceptably high rate of false positive diagnoses, derived from cognitive tests with high verbal and educational demands that lack adequate sensitivity (Klekociuk et al., 2014). This workshop will aim to approach the problem of the assessment of populations with low education and low literacy levels from an international, multidimensional perspective. First, Ms. Dawn Higgins will present her findings with clinicians and the Travelling Community in Ireland on (1) problems and barriers to access a relevant diagnosis for marginalized communities, and (2) the need for more comprehensive assessments at a screening stage that rely on functions not usually measured (e.g. visual memory) and with tasks that go beyond the usual “exam-like” verbal component. Second, Dr. Unai Diaz-Orueta will present his research in older adults in southern Spain (matched for education, age and gender) to whom a selection of two sets of cognitive tasks (educationally biased tasks versus matching educationally unbiased tasks) were administered, in order to identify the most accurate cognitive screening tasks for early detection of MCI in individuals with low literacy levels. After, Mr. Jiaqing Zhang will present the advantages technology offers to mitigate the bias against unproper classification of individuals with fewer education years and how to build trustworthy machine learning approaches utilizing the open-source toolbox like AI-Fairness 360 (AIF360) to distinguish individuals with low and high literacy levels more precisely when conducting cognitive assessments like the widely-used Clock Drawing Test (CDT). Finally, Dr. T. Rune Nielsen will present recent attempts to develop more suitable neuropsychological tests for individuals who are illiterate and without formal education, including various types of object memory tests and tests from the European Cross-Cultural Neuropsychological Test Battery, and will introduce ecological relevance in the context of illiteracy as key to identifying and circumventing educational test bias
