Cultural Adaptation And Validation Of Low-cost

Neuropsychological Battery For Early Alzheimer’s

Detection In Nigeria

Sulton Oluwatosin Abdullahi, Bolajoko Ibiyemi MALOMO, Ositelu Comfort Oluwayomi, Usman Emmanuelle,

Adu Emmanuel Gilbert.

Nigeria’s first validated neuropsychological tool detects MCI with 92% sensitivity; cultural items improved accuracy by 15–

20%, enabling low-cost, scalable screening.

INTRODUCTION

Alzheimer's disease

disproportionately burdens

low- and middle-income

countries (LMICs), yet

culturally sensitive screening

tools are scarce in sub-Saharan

Africa. Nigeria's aging, multi-

ethnic population (e.g., Yoruba,

Igbo, Hausa) experiences

diagnostic delays from

Western-centric assessments

ignoring linguistic and cultural

factors. This study adapts a brief

neuropsychological battery for

early detection in resource-

limited settings.

 

METHODS

We adapted the Montreal

Cognitive Assessment (MoCA)

and Addenbrooke's Cognitive

Examination (ACE-III) into a

Yoruba/Igbo/Hausa multilingual

battery, integrating local idioms

(e.g., proverb recall for executive

function) and low-tech visuals. In a

prospective cohort of 250

community-dwelling adults aged

≥60 years in Lagos (n=150) and

rural Bayelsa (n=100), we

evaluated reliability (Cronbach's a

>0.85), validity (correlation with

neuroimaging, r>0.75), and

sensitivity/specificity (AUC=0.89

for MCI) against gold-standard

clinical diagnosis. Cutoffs were

calibrated for low-literacy groups.

 

RESULTS

The battery detected mild

cognitive impairment (MCI)

with 92% sensitivity and 85%

specificity, outperforming

standard MoCA (78%

sensitivity) in low-education

subgroups. Cultural items (e.g.,

market bargaining tasks)

improved executive function

scores by 15-20%. Preliminary

data revealed 28% MCI

prevalence, higher in rural

areas, linked to environmental

risks like pesticide exposure.

 

CONCLUSIONS

This validated, open-source

tool fills a key gap in global

dementia research, enabling

scalable LMIC screening. It

advocates integrating African

perspectives into international

trials for equitable prevention.

 

REFERENCES

1.WHO.Dementia fact sheet (2023).

who.int/news-room/fact-sheets/detail/dementia

2. Gureje O, et al. Neuropsychology in Africa (Lancet

Neurol, 2021). doi:10.1016/S1474-4422(21)00123-4

3. Nasreddine ZS. MoCA guidelines (moca.org).

4. Akinyemi R, et al. Vascular risk in Nigerian elderly

(J Alzheimers Dis, 2022). doi:10.3233/JAD-215472

Next steps: digital app for tele-

neuropsychology.

CONTACT

SULTON OLUWATOSIN ABDULLAHI

PSYCHOLOGIST AT FEDERAL MEDICAL

CENTER, MENTAL HEALTH

DEPARTMENT,YENAGOA, BAYELSA STATE,

NIGERIA

PSYCHOLOGIST / RESEARCH ASSISTANT AT

NEUROCEPT SPECIALTY HOSPITAL, RIVERS

STATE, NIGERIA

PSYCHOTHERAPIST AT RIPUS HOSPITAL,

YENAGOA, BAYELSA STATE, NIGERIA.

PSYCHOLOGIST AT MINDLABCLINIC, LAGOS

STATE, NIGERIA.

Sultonbigcity3@gmail.com

mindlabclinic1@gmail.com