Feasibility of a culturally adapted picture description task as a measure of cognition within the older adult population of Hai

Introduction

Dementia is an increasing global health problem. Picture description tasks are a useful tool to assess semantic-based language deficits, which can occur during later stages of dementia. There is a paucity of research regarding culturally appropriate picture description tasks within sub-Saharan Africa.

Aim

Develop a culturally adapted picture description task and scoring method and evaluate its feasibility as a cognitive measure in two rural communities in the Hai district of Kilimanjaro, Tanzania.

Methods

An adaptation of a widely used picture description task was developed using community feedback. Five scoring methods were adapted from existing literature. One hundred and twenty-two participants aged ≥60 were sampled for assessment. Audio-recordings and handwritten records of participant responses were transcribed and translated for scoring and analysis.

Results

Eighty-five participants were excluded due to difficulties with task administration. Translated language samples from the remaining 37 participants were analysed. All scoring methods showed no statistically significant association with the IDEA (Identification and Intervention for Dementia in Elderly Africans) cognitive screen when controlling for age, sex and years of education. Education was significantly associated with four out of five scoring methods.

Conclusion

This is an informative first exploration of the cultural adaptation and co-production of a picture description task in sub-Saharan Africa. Most participants attempted the task, with initial analysis suggesting the task correlates with educational attainment more than cognition. Overall, the Banana Theft task shows potential, however, there are caveats to its use in a rural East African setting without additional training and support due to issues highlighted during this pilot study.