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Validation of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen in Nigeria and Tanzania

Lookup NU author(s): Dr Stella Paddick, Dr Catherine DotchinORCiD, Professor Richard Walker



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: We have previously described the development of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen for use in populations with low levels of formal education. The IDEA cognitive screen was developed and field-tested in an elderly, community-based population in rural Tanzania with a relatively high prevalence of cognitive impairment. The aim of this study was to validate the IDEA cognitive screen as an assessment of major cognitive impairment in hospital settings in Nigeria and Tanzania.Methods: In Nigeria, 121 consecutive elderly medical clinic outpatients reviewed at the University College Hospital, Ibadan were screened using the IDEA cognitive screen. In Tanzania, 97 consecutive inpatients admitted to Mawenzi Regional Hospital (MRH), Moshi, and 108 consecutive medical clinic outpatients attending the geriatric medicine clinic at MRH were screened. Inter-rater reliability was assessed in Tanzanian outpatients attending St Joseph's Hospital in Moshi using three raters. A diagnosis of dementia or delirium (DSM-IV criteria) was classified as major cognitive impairment and was provided independently by a physician blinded to the results of the screening assessment.Results: The area under the receiver operating characteristic (AUROC) curve in Nigerian outpatients, Tanzanian outpatients and Tanzanian inpatients was 0.990, 0.919 and 0.917 respectively. Inter-rater reliability was good (intra-class correlation coefficient 0.742 to 0.791). In regression models, the cognitive screen did not appear to be educationally biased.Conclusions: The IDEA cognitive screen performed well in these populations and should prove useful in screening for dementia and delirium in other areas of sub-Saharan Africa.

Publication metadata

Author(s): Paddick SM, Gray WK, Ogunjimi L, Iwezuala B, Olakehinde O, Kisoli A, Kissima J, Mbowe G, Mkenda S, Dotchin CL, Walker RW, Mushi D, Collingwood C, Ogunniyi A

Publication type: Article

Publication status: Published

Journal: BMC Geriatrics

Year: 2015

Volume: 15

Online publication date: 25/04/2015

Acceptance date: 25/03/2015

Date deposited: 05/04/2016

ISSN (electronic): 1471-2318

Publisher: BioMed Central Ltd


DOI: 10.1186/s12877-015-0040-1


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Funder referenceFunder name
0086-04Grand Challenges Canada