The Effect of Illiteracy on Performance in Screening Tools for Dementia: A Meta-Analysis

Journal of Clinical and Experimental Neuropsychology

Maher, C., & Calia, C. (2021).

Journal of Clinical and Experimental Neuropsychology, 43(10), 945-966.

This systematic review and meta-analysis investigates the validity of dementia screening tools for adults, 50 years and older, with low levels of literacy or formal education.

No funding received

1975 to June 2021

Quantitative studies

27

Findings demonstrated that adults who were literate scored significantly higher on dementia screening tools&nbsp; (g = -1.2, 95% CI= -1.47 to -0.95, p&lt; 0.001) than adults who are illiterate and/or who have a low level of formal education. <span style="color: #333333;">Tests adapted for [e.g., modified versions of the Mini-Mental State Examination (MMSE)] or designed for [e.g., Rowland Universal Dementia Assessment Scale (RUDAS), Literacy Independent Cognitive Assessment (LICA)] use with illiterate individuals showed less of a discrepancy between literate and illiterate groups in a limited number of studies investigating newer screening instruments. However, literate individuals still outperformed illiterate individuals (g = -0.81, 95% CI = -1.32, to -0.29], p = .008), especially in populations without cognitive impairment (g= -1.57, 95% CI= -2.19 to -0.95, p&lt; 0.001).&nbsp;</span><br /><span style="color: #333333;"><br />The authors conclude that most dementia screening tools are inappropriate for use with adult populations who are illiterate and/or who have low levels of formal education. </span><span style="color: #333333;">Screening tools that show promise for these populations currently lack research on their validity and applicability. Of note, 25 of the 27 studies utilizied the MMSE or a modified version of it. Additional research validating dementia screening tools for these populations is warranted.</span>