Document Type
Article
Department
Population Health (East Africa); Institute for Human Development
Abstract
Cross-cultural adaptation of cognitive assessments is crucial for detecting Alzheimer's disease (AD) and related dementias (ADRD) in aging populations. This study documents the adaptation of the Harmonized Cognitive Assessment Protocol (HCAP) for a pilot study on the Longitudinal Study of Health and Aging in Kenya (LOSHAK) in rural Kilifi County, Kenya, highlighting challenges and strategies for optimizing outcomes. As part of the LOSHAK feasibility phase, cognitive tests including: the Swahili Mental State Examination, 10-word recall, animal naming, story recall, clock drawing, and making change, were administered to 202 participants (≥45 years) from the Kaloleni/Rabai Health and Demographic Surveillance System (KRHDSS). Measures were adapted culturally and linguistically, and trained local enumerators conducted home-based assessments. Low literacy (60.1% had no schooling), linguistic diversity, cultural norms, and infrastructure limitations influenced assessments. Key adaptations included translation, culturally relevant modifications, flexible administration, and community engagement. Contextualized cognitive assessments improve validity in rural resource-limited settings, offering insights for future research.
Publication (Name of Journal)
Alzheimer's & dementia : the journal of the Alzheimer's Association
DOI
https://doi.org/10.1002/alz.70552
Recommended Citation
Riang’a, R.,
Muthoni, E.,
Nagarajan, N.,
Agoi, F.,
Mwangala, P.,
Gross, A.,
Ikanga, J.,
Langa, K.,
Miguel, E.,
Ngugi, A.
(2025). Contextualization of Harmonized Cognitive Assessment Protocol (HCAP) in an aging population in rural low-resource settings in Africa: Experiences and strategies adopted to optimize effective adaption of cognitive tests in Kenya. Alzheimer's & dementia : the journal of the Alzheimer's Association, 1-11.
Available at:
https://ecommons.aku.edu/eastafrica_fhs_mc_popul_health/185
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.