SA-MRC/Wits Agincourt Unit (Research Outputs/Publications)

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Feasibility of an online consensus approach for the diagnosis of cognitive impairment and dementia in rural South Africa
(2023-03-04) Darina T. Bassil; Meagan T. Farrell; AlbertWeerman; Muqi Guo; Ryan G.Wagner; AdamM. Brickman; M. Maria Glymour; Kenneth M. Langa; Jennifer J. Manly; Brent Tipping; India Butler; Stephen Tollman; Lisa F. Berkman
INTRODUCTION:We describe the development and feasibility of using an online consensus approach for diagnosing cognitive impairment and dementia in rural South Africa. METHODS: Cognitive assessments, clinical evaluations, and informant interviews from Cognition and Dementia in the Health and Aging in Africa Longitudinal Study (HAALSI Dementia) were reviewed by an expert panel using a web-based platform to assign a diagnosis of cognitively normal, mild cognitive impairment (MCI), or dementia. RESULTS: Six hundred thirty-five participants were assigned a final diagnostic category, with 298 requiring adjudication conference calls. Overall agreement between each rater’s independent diagnosis and final diagnosis (via the portal or consensus conference) was 78.3%. A moderate level of agreement between raters’ individual ratings and the final diagnostic outcomes was observed (average κ coefficient = 0.50).DISCUSSION: Findings show initial feasibility in using an online consensus approach for the diagnosis of cognitive impairment and dementia in remote, rural, and lowresource settings.