International Psychogeriatrics

Kimberley Indigenous Cognitive Assessment tool (KICA): development of a cognitive assessment tool for older indigenous Australians

D. LoGiudice a1a3c1, K. Smith a2a3, J. Thomas a3, N. T. Lautenschlager a4, O. P. Almeida a4, D. Atkinson a5 and L. Flicker a3
a1 National Ageing Research Institute, Parkville, Victoria, Australia
a2 Kimberley Aged and Community Services, Derby, WA, Australia
a3 School of Medicine and Pharmacology, University of Western Australia, Australia
a4 School of Psychiatry and Clinical Neurosciences, University of Western Australia, Australia
a5 Kimberley Aboriginal Medical Services Council, Western Australia and Rural Clinical School, University of Western Australia, Australia

Article author query
logiudice d   [PubMed][Google Scholar] 
smith k   [PubMed][Google Scholar] 
thomas j   [PubMed][Google Scholar] 
lautenschlager nt   [PubMed][Google Scholar] 
almeida op   [PubMed][Google Scholar] 
atkinson d   [PubMed][Google Scholar] 
flicker l   [PubMed][Google Scholar] 


Background: Indigenous Australians have a unique cultural heritage dating back many thousands of years. Unfortunately, there is no validated tool to assess cognition in older indigenous Australians. This study was designed to address this deficiency. The Kimberley Indigenous Cognitive Assessment (KICA) was developed with Indigenous health and aged care organizations, and comprises cognitive, informant and functional sections. The psychometric properties of the cognitive assessment section (KICA-Cog) are described in this paper.

Methods: The KICA-Cog was tested in 70 indigenous subjects, of varying cognitive abilities and diagnoses, over 45 years of age. Subjects were interviewed using the KICA-Cog and then independently assessed by expert clinical raters using DSM-IV and ICD-10 criteria. Interrater and internal reliability were determined.

Results: The KICA-Cog score showed no systematic interrater difference; the mean was −0.07 (SD = 1.83). Interrater reliability for 16 individual questions from the cognitive section revealed a κ-value [greater-than-or-equal] 0.6 and intraclass correlations for 12 questions. Internal consistency, as assessed by Cronbach's α, was 0.88. Three items on the cognitive score (pension week, recall and free recall) effectively discriminated 85–7% of dementia cases. Sensitivity and specificity were 90.6% and 92.6%, respectively, using a cut-off score of 31/32.

Conclusions: The KICA-Cog appears to be a reliable assessment tool for cognitive impairment in an Australian older traditionally living indigenous population.

(Received April 5 2005)
(returned for revision May 26 2005)
(revised version received June 29 2005)
(Accepted June 30 2005)
(Published Online January 11 2006)

Key Words: dementia; cross-cultural; cognitive assessment; Aboriginal.

c1 Correspondence should be addressed to: Dina LoGiudice, National Ageing Research Institute, POB 31 Parkville, 3052 Victoria, Australia. Phone: +61 3 8387 2000; Fax: +61 3 9387 3040. Email: