Abstract
Dementia has become a growing public health issue in an aging Indigenous population in Canada. The Canadian Consortium on Neurodegeneration in Aging (CCNA) includes a research team specifically addressing issues related to quality of life for Indigenous people with dementia and their caregivers. A key component of the work encompasses development of a culturally relevant and psychometrically sound cognitive assessment screening tool. Current cognitive assessments present varying degrees of cultural, educational and language bias, impairing their application in Indigenous communities. This paper reports on the piloting and evaluation of an adapted Indigenous cognitive assessment tool in First Nations communities in Canada.
Using community-based participatory methods and a “two-eyed seeing approach,” researchers worked closely with community partners to adapt the Kimberly Indigenous Cognitive Assessment (KICA) for use with Indigenous populations in Northern Ontario, Canada. The KICA was developed to address the gap of culturally appropriate assessment tools for older Indigenous people in Australia. The adaptation involved an iterative process where an advisory group, expert Anishinaabe language speakers, team members, and a key expert panel analysed each assessment domain and adjusted the questions to reflect the local cultural understandings and nuances within the Anishinaabe language. The adaptation of the KICA produced a culturally relevant cognitive assessment tool that was piloted with Indigenous participants from seven First Nations communities in Ontario, Canada. The assessment was provided in English or Anishinaabemowin. Culturally appropriate diagnosis and screening may lead to earlier, more accurate diagnosis and improved health outcomes for Indigenous people with dementia in Ontario.