Monisha Lakshminarayanan1, Sridhar Vaitheswaran1, Nivedhitha Srinivasan1, Gayathri Nagarajan1, Ahalya Ganesh2, Kunnukatil S Shaji3, Mina Chandra4, Murali Krishna5, Aimee Spector6. 1. Dementia Care in Schizophrenia Research Foundation (DEMCARES), Chennai, Tamil Nadu, India. 2. Master's Degree Programme in Gender Studies, Tampere University Keskustakampus, Tampere, Finland. 3. Department of Psychiatry, Jubilee Mission Medical College & Research Institute, Thrissur, Kerala, India. 4. Department of Psychiatry, Centre of Excellence in Mental Health, Postgraduate Institute of Medical Education and Research (PGIMER), and Dr Ram Manohar Lohia Hospital, New Delhi, India. 5. Department of Research, Foundation for Research and Advocacy in Mental Health (FRAMe), Mysore, India. 6. Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK.
Abstract
OBJECTIVE: Currently no standardized tools are available in the Indian languages to assess changes in cognition. Our objectives are to culturally adapt the Alzheimer's disease Assessment Scale-Cognitive Subscale (ADAS-Cog) for use in India and to validate the Tamil version in an urban Tamil-speaking older adult population. METHODS: Two panels of key stakeholders and a series of qualitative interviews informed the cultural and linguistic adaptation of the ADAS-Cog-Tamil. Issues related to levels of literacy were considered during the adaptation. Validation of the ADAS-Cog-Tamil was completed with 107 participants - 54 cases with a confirmed diagnosis of mild-moderate dementia, and 53 age, gender and education matched controls. Concurrent validity was examined with the Vellore Screening Instrument for Dementia (VSID) in Tamil. Internal consistency using Cronbach's alpha, sensitivity and specificity data using the Area under the Receiver Operating Characteristics (AUROC) curve values were computed. Inter-rater reliability was established in a subsample. RESULTS: The ADAS-Cog-Tamil shows good internal consistency (α = 0.91), inter-rater reliability and concurrent validity (with VSID-Patient version: r = -0.84 and with VSID-Caregiver version: r = -0.79). A cut-off score of 13, has a specificity of 89% and sensitivity of 90% for the diagnosis of dementia. CONCLUSION: ADAS-Cog-Tamil, derived from a rigorous, replicable linguistic and cultural adaptation process involving service users and experts, shows good psychometric properties despite the limitations of the study. It shows potential for use in clinical settings with urban Tamil speaking populations. The English version of the tool derived from the cultural adaptation process could be used for further linguistic adaptation across South Asia.
OBJECTIVE: Currently no standardized tools are available in the Indian languages to assess changes in cognition. Our objectives are to culturally adapt the Alzheimer's disease Assessment Scale-Cognitive Subscale (ADAS-Cog) for use in India and to validate the Tamil version in an urban Tamil-speaking older adult population. METHODS: Two panels of key stakeholders and a series of qualitative interviews informed the cultural and linguistic adaptation of the ADAS-Cog-Tamil. Issues related to levels of literacy were considered during the adaptation. Validation of the ADAS-Cog-Tamil was completed with 107 participants - 54 cases with a confirmed diagnosis of mild-moderate dementia, and 53 age, gender and education matched controls. Concurrent validity was examined with the Vellore Screening Instrument for Dementia (VSID) in Tamil. Internal consistency using Cronbach's alpha, sensitivity and specificity data using the Area under the Receiver Operating Characteristics (AUROC) curve values were computed. Inter-rater reliability was established in a subsample. RESULTS: The ADAS-Cog-Tamil shows good internal consistency (α = 0.91), inter-rater reliability and concurrent validity (with VSID-Patient version: r = -0.84 and with VSID-Caregiver version: r = -0.79). A cut-off score of 13, has a specificity of 89% and sensitivity of 90% for the diagnosis of dementia. CONCLUSION: ADAS-Cog-Tamil, derived from a rigorous, replicable linguistic and cultural adaptation process involving service users and experts, shows good psychometric properties despite the limitations of the study. It shows potential for use in clinical settings with urban Tamil speaking populations. The English version of the tool derived from the cultural adaptation process could be used for further linguistic adaptation across South Asia.
Entities:
Keywords:
ADAS-Cog; India; South Asia; Tamil; adaptation; cognition; dementia; validation
Authors: R G Stern; R C Mohs; M Davidson; J Schmeidler; J Silverman; E Kramer-Ginsberg; T Searcey; L Bierer; K L Davis Journal: Am J Psychiatry Date: 1994-03 Impact factor: 18.112
Authors: R F Zec; E S Landreth; S K Vicari; J Belman; E Feldman; A Andrise; R Robbs; R Becker; V Kumar Journal: Alzheimer Dis Assoc Disord Date: 1992 Impact factor: 2.703