Published: 23 January 2023| Version 1 | DOI: 10.17632/ymsd5x9cpx.1
sameeksha shetty


Cognitive examination assessment is an important part of managing people with brain damage. Several tools are currently available for clinical use. However, the accurate interpretation of the test results relays heavily on certain extraneous variables such as literacy or educational levels among other variables like age, occupation, and gender differences. We investigated the impact of literacy on ACE performance in three groups of normal participants based on their educational (literacy) levels. Results showed significant difference among the three groups, necessitating the need to establish literacy-based normative data on this test to facilitate accurate interpretation of the test results in the clinical population. As a result, aphasia may be mislabeled as "anomic." In order to minimize false positive diagnoses of aphasia, this research strongly suggests collecting information on the client's reading level before administering the K-ACE and interpreting the performance in light of the client's literacy level.


Steps to reproduce

it is apparent that literacy influences the performance of individuals on linguistic tests. In this situation, it is very important that normative data based on literacy be set up for these tests or assessment tools. Further, the literacy-based norms may reduce the potential ‘false positives’ among non-aphasic illiterate people with brain damage. This investigation was a cross-sectional observational study. We collected data from 100 participants grouped into three groups: viz. 35 illiterates (0-3 years of schooling), 31 semi-literates (4-7 years of schooling) and 34 literates (≥ 8 years of schooling). All were neurologically healthy participants above 45 years of age. None had any significant sensory, cognitive or speech impairments. Participants lived in a community center for older people. We administered the Kannada version Addenbrooke’s Cognitive Examination (K-ACE) on each participant individually in his/her residential premises as per the guidelines of the test. Responses were recorded online using a paper and pencil. The audio responses were recorded through a portable recorder for later (offline) analysis. The accuracy of the responses were recorded and later these data were entered into an excel worksheet.


Manipal Academy of Higher Education


Education, Traumatic Brain Injury, Cognition, Memory, Stroke, Neurorehabilitation, Language in Communication Disorder, Aphasia, Literacy