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.

中文翻译：

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阿尔茨海默病评估量表的文化适应——在印度使用的认知分量表和南印度人口泰米尔语版本的验证

摘要

客观的

目前还没有印度语言的标准化工具来评估认知变化。我们的目标是在文化上调整阿尔茨海默病评估量表 - 认知分量表 (ADAS-Cog) 以供在印度使用，并在讲泰米尔语的城市老年人群中验证泰米尔语版本。

方法

两个关键利益相关者小组和一系列定性访谈为 ADAS-Cog-Tamil 的文化和语言适应提供了信息。在改编过程中考虑了与识字水平有关的问题。ADAS-Cog-Tamil 的验证在 107 名参与者中完成 - 54 名确诊为轻度中度痴呆的病例，以及 53 名年龄、性别和教育匹配的对照组。使用泰米尔语的 Vellore 痴呆筛查工具 (VSID) 检查了同时有效性。使用 Cronbach's alpha 的内部一致性，使用接收器操作特征 (AUROC) 曲线值下的面积计算灵敏度和特异性数据。在子样本中建立了评估者间信度。

结果

ADAS-Cog-Tamil 显示出良好的内部一致性 ( α  = 0.91)、评估者间信度和同时效度（VSID-Patient 版本：r = –0.84 和 VSID-Caregiver 版本：r = –0.79）。分界值为 13，诊断痴呆的特异性为 89%，敏感性为 90%。

结论

ADAS-Cog-Tamil 源自一个涉及服务用户和专家的严格、可复制的语言和文化适应过程，尽管研究存在局限性，但仍显示出良好的心理测量特性。它显示了在城市泰米尔语人群的临床环境中使用的潜力。该工具的英文版源自文化适应过程，可用于整个南亚的进一步语言适应。