Feasibility and Determinants of Performance for a Tablet-Based Cognitive Assessment Tool in Rural and Urban Southeast Nigeria

Article type: Research Article

Authors: Ogbuagu, Chukwuanugo^{a; b; *} | Ogbuagu, Ekenechukwu^c | Emelumadu, Obiageli^a | Okereke, Uzoma^a | Okeke, Irene^a | Chigbo, Godswill^d | Javendal, Shireen^b | Miller, Bruce^b | Valcour, Victor^b | Allen, Isabel Elaine^{b; e} | Goode, Collette^b | Possin, Katherine L.^b | Uwakwe, Richard^f

Affiliations: [a] Comprehensive Health Center, Nnamdi Azikiwe University Teaching Hospital, Neni, Nigeria | [b] Memory and Aging Center, Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA | [c] Family Medicine Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria | [d] School of Public Health, University of Port-Harcourt, Port Harcourt, Nigeria | [e] Biostatistics and Epidemiology Department, University of California San Francisco, San Francisco, CA, USA | [f] Department of Medicine, Mental Health Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Correspondence: [*] Correspondence to: Chukwuanugo Ogbuagu, MD, MSc, PhD, MWACP, Comprehensive Health Center, Nnamdi Azikiwe University Teaching Hospital Neni, Anambra State, Nigeria. Tel.: +234 803 552 1954; E-mails: [email protected]; [email protected].

Abstract: Background:Cognitive assessment is a key component of clinical evaluations for patients with dementia and Alzheimer’s disease in primary health care (PHC) settings. The need for well-validated, culturally appropriate, and easy-to-use assessments is especially urgent in low- and middle-income countries (LMICs) that are experiencing rapid growth in their older adult populations. Objective:To examine the feasibility and demographic determinants of performance for a tablet-based cognitive assessment tool (TabCAT) battery, which includes subtests for four cognitive domains, among older PHC patients in southeastNigeria. Methods:A cross-sectional mixed-method descriptive study evaluating the useability and performance of TabCAT. Results:We enrolled 207 participants (mean age of 64.7±13.5 years; 52% with only primary, 41% secondary, and 7% tertiary education). Most (91%) who initiated the assessment were able to complete it, requiring 10–15 minutes to complete. More years of education was associated with better test scores across all tests (p < 0.001). Living in a rural location was also associated with better performance (p < 0.05). Male compared to female sex did not associate with performance on any of the tests (all ps > 0.05). Conclusions:Tablet-based cognitive assessment was feasible in rural and urban settings of Nigeria. Better performance on cognitive subtests linked to more education and residing in a rural area; however, sex did not predict performance. Digital cognitive assessment tools hold potential for widespread use in healthcare and educational contexts, particularly in regions with varying levels of urbanization and educational access.

Keywords: Alzheimer’s disease, cognitive assessment, dementia, Nigeria, primary healthcare

DOI: 10.3233/JAD-240518

Journal: Journal of Alzheimer's Disease, vol. 101, no. 1, pp. 175-182, 2024