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Full list of author information is available at the end of the articleBackground The prevalence of dementia, alongside other non-communicable diseases (NCDs), is increasing rapidly as populations age globally, with 135.5 million people expected to have dementia by 2050 [1]. The greatest increases are predicted in low- and middle-income countries (LMICs) with 71 % of the global total of people with dementia residing in LMICs by 2050 [1]. In sub-Saharan Africa (SSA) the number of cases of de-mentia is expected to increase from 1.31 million in 2013 to 5.05 million by 2050 [1]. Identification of dementia and other major cognitive impairments in LMICs can be problematic, due to the lack of culturally appropriate validated screening tools. The vast major-ity of cognitive screening tools in common use world-wide have been developed and validated in high income countries (HIC) and usefulness in LMIC settings is greatly limited by cultural and educational differences. Illiteracy is highly prevalent in older adults in many LMICs, particularly in rural areas. Minimising educational bias in cognitive screening tools would im-prove their clinical utility. In SSA, perhaps more than * Correspondence