A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Purpose: compare the Southwestern Indigenous Cognitive Assessment (SWICA), a novel tool for screening AI older adults in Arizona, with The Montreal Cognitive Assessment (MoCA), a commonly used memory screening tool, for comparison of cultural bias. Methods: Cultural bias was assessed by retrospectively comparing coded participant responses to 16 questions about their cultural context. Intrasample variation on MoCA and SWICA tests was controlled by using the participants as their own controls. Data were analyzed using a multiple regression general linear model on SPSS software. Results: Scores on the SWICA test were independently associated with English use in the home (Beta = .396, p = .026), years of education (Beta = 335, p = .027), and ease of learning (Beta = .361, p = .029), but not age (Beta = .366, p = .054). Scores on the MoCA test were independently associated with age (Beta = ‐.491, p = .001), English use in the home (Beta = ‐.320, p = .039) , and years of education (Beta = ‐.284. p = .030), but not ease of learning (Beta = ‐.267, p = .067). Conclusions: Scores were similar on both tests (t=3.934, p=.001), and were independently associated with English use in the home and years of education. SWICA was uniquely associated with ease of learning and MoCA was uniquely associated with age. This preliminary comparison demonstrates the usefulness of SWICA, and validation of this tool is recommended.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Memory screening in the community promotes early detection of memory problems, as well as Alzheimer’s disease (AD) and related illnesses, and encourages appropriate intervention. The Montreal Cognitive Assessment (MoCA) is a rapid and sensitive screening tool for cognitive impairment that can be readily employed at the clinical level, but little is known about its utility as a community screening tool. Also, little is known regarding the demographics of the population that presents for a community screen. The research aims to evaluate the demographics of the participants that attended community memory screens in the greater Phoenix metropolitan area and to evaluate the prevalence of screen positives using the MoCA. It is hypothesized that cognitive impairment will be significantly prevalent in the screened population and that age and family history of dementia will correlate with the presence of cognitive impairment. The study methods involve descriptive analysis and application of statistical tests to evaluate for significant relationships between demographic variables and MoCA scores. The population (n=346) had a mean age of 72 (SD =10.7), was primarily female (70%), primarily Caucasian (68%) and 86% had greater than a high school education. A 58% prevalence of cognitive impairment was found in the population as defined by the MoCA. Increased age, male gender, and non‐Caucasian race correlated with lower MoCA scores. Lower education correlated with lower MoCA scores despite the inherent educational correction in the MoCA. Diabetes and a family history of AD were not significant factors. Although the number of true positives following methodical diagnosis is unknown, given the validity of the MoCA in discerning cognitive impairment, the screen was likely worthwhile and supports more routine use of community memory screens. Variables identified that were associated with increased cognitive impairment better describe the population at risk and can be utilized to focus future screening efforts.