title: Cognitive Function in Low-Income and Low-Literacy Settings: Validation of the Tablet-Based Oxford Cognitive Screen in the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI).
abstract: OBJECTIVE
  1. Assess validity of the Oxford Cognitive Screen (OCS-Plus), a domain-specific cognitive assessment designed for low-literacy settings, especially in low- and middle-income countries (LMIC); 2. Advance theoretical contributions in cognitive neuroscience in domain-specific cognitive function and cognitive reserve, especially related to dementia.
  
  
  METHODS
  In a cross-sectional study of a sample of 1,402 men and women aged 40-79 in the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we administered OCS-Plus along with health and sociodemographic assessments. HAALSI is a representative sample of older adults in Agincourt, South Africa contributing to normative understanding of cognition in LMIC. We report measure distributions, construct and external validity of the OCS-Plus.
  
  
  RESULTS
  OCS-Plus has excellent construct and external validity. Intra-class correlations between similar basic measures of orientation in OCS-Plus and in HAALSI assessments was 0.79, and groups of people performing well on the OCS-Plus verbal memory also showed superior performance on HAALSI verbal memory. The OCS-Plus scores showed consistent associations with age and education and domain-specific associations with alcohol and depression. Younger respondents and the more educated did better on all assessments.
  
  
  CONCLUSIONS
  The OCS-Plus represents a major methodological advance in dementia studies in LMICs, and enhances understanding of cognitive aging.
authors.affiliation: Department of Experimental Psychology, University of Oxford.
authors.forename: Glyn W
authors.initials: GW
authors.lastname: Humphreys
authors.affiliation: Department of Experimental Psychology, University of Oxford. mihaela.duta@psy.ox.ac.uk.
authors.forename: Mihaela D
authors.initials: MD
authors.lastname: Duta
authors.affiliation: Harvard Center for Population and Development Studies, Cambridge, Massachusetts.
authors.forename: Livia
authors.initials: L
authors.lastname: Montana
authors.affiliation: Department of Experimental Psychology, University of Oxford.
authors.forename: Nele
authors.initials: N
authors.lastname: Demeyere
authors.affiliation: TILDA, Trinity College Dublin, Dublin, Ireland.
authors.forename: Cathal
authors.initials: C
authors.lastname: McCrory
authors.affiliation: Harvard Center for Population and Development Studies, Cambridge, Massachusetts.
authors.forename: Julia
authors.initials: J
authors.lastname: Rohr
authors.affiliation: MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|INDEPTH Network, Accra, Ghana.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kahn
authors.affiliation: MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|INDEPTH Network, Accra, Ghana.
authors.forename: Stephen
authors.initials: S
authors.lastname: Tollman
authors.affiliation: Harvard Center for Population and Development Studies, Cambridge, Massachusetts.|MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Lisa
authors.initials: L
authors.lastname: Berkman
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition; D058245:Cognitive Reserve; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D000067010:Literacy; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011203:Poverty / Q000523:psychology* / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D013019:South Africa
keywords: Agincourt; Cognition; Cognitive screens in LMIC; HAALSI; INDEPTH; OCS-Plus; South Africa