Validation of the Literacy Independent Cognitive Assessment.
BACKGROUND
Low education and illiteracy are associated with an increased risk of dementia. This study aimed to develop a neuropsychological test battery applicable to both illiterate and literate elderly and to assess its reliability and validity for a diagnosis of dementia.


METHODS
We developed the Literacy Independent Cognitive Assessment (LICA), which consists of 13 subtests assessing memory, language, visuoconstruction, executive function, attention and calculation. We investigated its reliability and validity on 152 patients with dementia, 66 with mild cognitive impairment and 639 normal controls.


RESULTS
The subtests were found to be applicable to most of the illiterate normal controls (97.3%) and were found to have high inter-rater reliabilities (r = 0.85-1.00, p < 0.001) and moderate to high test-retest reliabilities (r = 0.50-0.86, p < 0.001). The LICA performed well in discriminating participants across Clinical Dementia Rating stages and showed excellent internal consistency and good concurrent validity with the Korean Mini-mental State Examination in both literate and illiterate participants. The area under the curve of the receiver operating characteristic was 0.985 in each of the two literacy groups. Sensitivity and specificity of the LICA to make a diagnosis of dementia was 91.9% and 91.8% at the cutoff point of 186.0 in the literate subjects and 96.2% and 91.1% at the cutoff point of 154.5 in the illiterate subjects. The battery was factored into two separate factors consisting of verbal memory tests and tests for other cognitive domains.


CONCLUSIONS
The LICA is a valid and reliable instrument for a diagnosis of dementia in both illiterate and literate elderly.
Choi
Seong Hye
SH
Department of Neurology, Inha Univeristy School of Medicine, Incheon, Republic of Korea.
Shim
Yong S
YS
Ryu
Seung-Ho
SH
Ryu
Hui Jin
HJ
Lee
Dong Woo
DW
Lee
Jun-Young
JY
Jeong
Jee H
JH
Han
Seol-Heui
SH
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests / Q000592:standards*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000379:methods; D015203:Reproducibility of Results