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Feasibility of an online consensus approach for the diagnosis of cognitive impairment and dementia in rural South Africa.

Bassil DT, Farrell MT, Weerman A, Guo M, Wagner RG, Brickman AM, Glymour MM, Langa KM, Manly JJ, Tipping B, Butler I, Tollman S, Berkman LF. Feasibility of an online consensus approach for the diagnosis of cognitive impairment and dementia in rural South Africa. Alzheimer's & dementia (Amsterdam, Netherlands). 2023 Apr 4; 15(2):e12420.

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Abstract:

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 ? 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 low-resource settings.




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