Diagnosing dementia in the Arctic:translating tools and developing and validating an algorithm for assessment of impaired cognitive function in Greenland Inuit

• Published in: International Journal of Circumpolar Health
• Main Authors: Kleist, Inaluk, Noahsen, Paneeraq, Gredal, Ole, Riis, Johannes, Andersen, Stig
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2021
• Subjects: Arctic; Greenland; Circumpolar Health; greenlandic; International Journal of Circumpolar Health; inuit
• Online Access: https://vbn.aau.dk/da/publications/95d0f3d8-ccdf-4c60-af39-f7dedf8e1674; https://doi.org/10.1080/22423982.2021.1948247; https://vbn.aau.dk/ws/files/427267409/Kleist_et_al._2021_Diagnosing_dementia_in_the_Arctic.pdf

Background: The ageing Arctic populations raise the need for work-up of cognitive function that reflects language and cultural understandings.Aim: To translate and evaluate tools for work-up of cognitive impairment in Greenland.Methods: Step A: An expert panel was established to select tools suitable for the work-up of cognitive impairment at three different settings in Greenland. Step B: Tools were translated in a multiple-step process of independent translations with back-translation and adaptations by two independent translators and two Greenlandic physicians. Step C: a testing and validation process of the tools at three locations: the national hospital in the capital city; regional hospital in a town; health care centre in a small town.Results: Tools selected were Mini-Cog and RUDAS. Participants for testing of tools were 43 of 61 invited, of which six had dementia. RUDAS and Mini-Cog scores were associated (p < 0.001). The smoothed AUC was 0.87 (95%-CI, 0.65-0.95) for Mini-Cog and 0.90 (95%-CI, 0.76-0.97) for RUDAS. The sensitivity of Mini-Cog with a cut-off at ≤3 was 83.3%, and specificity was 62.2%. For RUDAS with a cut-off at ≤23, these were 100% and 75.7%, respectively.Conclusion: Requested tools have been translated for assessing cognitive function in the native Arctic setting. Small town residents with a Mini-Cog score of 3 or lower should be referred to a regional hospital for RUDAS, and a score of 23 or less should cause referral to the national hospital for a full work-up of cognitive function.