ArticleJournal of geriatric psychiatry and neurology2021
Effectiveness of App-Based Cognitive Screening for Dementia by Lay Health Workers in Low Resource Settings. A Validation and Feasibility Study in Rural Tanzania.
Article in Journal of geriatric psychiatry and neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Diagnosis accuracy of touchscreen-based testings for major neurocognitive disorders: a systematic review and meta-analysis.Age and ageing · 2025Pooled it
- An update on mobile applications collecting data among subjects with or at risk of Alzheimer's disease.Frontiers in aging neuroscience · 2023Pooled it
- Epidemiology of neurodegenerative diseases in the East African region: A meta-analysis.Frontiers in neurology · 2022Pooled it
- Dementia care gaps in Sub-Saharan Africa: A scoping review of technology, environmental, community perspectives, and financial constraints.PLOS global public health · 2026Article
- Use of digital health in task-sharing for prevention and management of non-communicable diseases in Africa: A scoping review.PLOS global public health · 2026Article
- Strengthening Africa's brain health and economic resilience.Nature medicine · 2025Review
- Challenges in non-communicable disease mitigation among community health workers: A scoping review.Journal of public health in Africa · 2025Review
- Cognitive screening and education: assessing the Montreal Cognitive Assessment's validity in older Ugandan populations.Academia mental health & well-being · 2025Article
- Epidemiology of Dementia in China in 2010-2020: A Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2024Review
- Navigating the Journey of Living with Young-Onset Dementia: Experiences of Spousal Caregivers.Journal of Alzheimer's disease : JAD · 2024Article
- Standardised Practice-Based Oral Health Data Collection: A Pilot Study in Different Countries.International dental journal · 2023Article
- Development and validation of a diagnostic aid for convulsive epilepsy in sub-Saharan Africa: a retrospective case-control study.The Lancet. Digital health · 2023Article
- The current landscape and future of tablet-based cognitive assessments for children in low-resourced settings.PLOS digital health · 2023Review
- CERAD (Consortium to Establish a Registry for Alzheimer's Disease) Neuropsychology Assessment Battery: 35 Years and Counting.Journal of Alzheimer's disease : JAD · 2023Review
- Dementia in Africa: Current evidence, knowledge gaps, and future directions.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2022Review
- Review
- Remote and in-clinic digital cognitive screening tools outperform the MoCA to distinguish cerebral amyloid status among cognitively healthy older adults.Alzheimer's & dementia (Amsterdam, Netherlands)Article
- Digital phenotyping: An equal opportunity approach to reducing disparities in Alzheimer's disease and related dementia research.Alzheimer's & dementia (Amsterdam, Netherlands)Article
Corrections and comments
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Authors and funding
16 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe majority of people with dementia live in low-and middle-income countries (LMICs). In sub-Saharan Africa (SSA) human-resource shortages in mental health and geriatric medicine are well recognized. Use of technological solutions may improve access to diagnosis. We aimed to assess the diagnostic accuracy of a brief dementia screening mobile application (app) for non-specialist workers in rural Tanzania against blinded gold-standard diagnosis of DSM-5 dementia. The app includes 2 previously-validated culturally appropriate low-literacy screening tools for cognitive (IDEA cognitive screen) and functional impairment (abbreviated IDEA-IADL questionnaire).
methodsThis was a 2-stage community-based door-to-door study. In Stage1, rural primary health workers approached all individuals aged ≥60 years for app-based dementia screening in 12 villages in Hai district, Kilimanjaro Tanzania.In Stage 2, a stratified sub-sample were clinically-assessed for dementia blind to app screening score. Assessment included clinical history, neurological and bedside cognitive assessment and collateral history.
results3011 (of 3122 eligible) older people consented to screening. Of these, 610 were evaluated in Stage 2. For the IDEA cognitive screen, the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% CI 0.74-0.83) for DSM-5 dementia diagnosis (sensitivity 84.8%, specificity 58.4%). For those 358 (44%) completing the full app, AUROC was 0.78 for combined cognitive and informant-reported functional assessment.
conclusionsThe pilot dementia screening app had good sensitivity but lacked specificity for dementia when administered by non-specialist rural community workers. This technological approach may be a promising way forward in low-resource settings, specialist onward referral may be prioritized.
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