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Adaptation and validation of the Alzheimer’s Disease Assessment Scale – Cognitive (ADAS-Cog) in a low-literacy setting in sub-Saharan Africa

Published online by Cambridge University Press:  27 March 2017

Stella-Maria Paddick ,
Aloyce Kisoli ,
Sarah Mkenda ,
Godfrey Mbowe ,
William Keith Gray ,
Catherine Dotchin ,
Adesola Ogunniyi ,
John Kisima ,
Olaide Olakehinde  and
Declare Mushi
...Show all authors
Stella-Maria Paddick*
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
Aloyce Kisoli
Affiliation:
Kilimanjaro Christian Medical University College, Moshi, Tanzania
Sarah Mkenda
Affiliation:
Kilimanjaro Christian Medical University College, Moshi, Tanzania
Godfrey Mbowe
Affiliation:
Kilimanjaro Christian Medical University College, Moshi, Tanzania
William Keith Gray
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
Catherine Dotchin
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
Adesola Ogunniyi
Affiliation:
University College Hospital, University of Ibadan, Ibadan, Nigeria
John Kisima
Affiliation:
Hai District Hospital, Boman’gombe, Kilimanjaro, Tanzania
Olaide Olakehinde
Affiliation:
University College Hospital, University of Ibadan, Ibadan, Nigeria
Declare Mushi
Affiliation:
Kilimanjaro Christian Medical University College, Moshi, Tanzania
Richard William Walker
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
*
Stella-Maria Paddick, Northumbria Healthcare NHS Foundation Trust, Rake Lane, North Shields NE29 8NH, UK. Tel: +44 344 811 8111; Fax: +44 1912937495; E-mail: [email protected]
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Abstract

Objective

This study aimed to assess the feasibility of a low-literacy adaptation of the Alzheimer’s Disease Assessment Scale – Cognitive (ADAS-Cog) for use in rural sub-Saharan Africa (SSA) for interventional studies in dementia. No such adaptations currently exist.

Methods

Tanzanian and Nigerian health professionals adapted the ADAS-Cog by consensus. Validation took place in a cross-sectional sample of 34 rural-dwelling older adults with mild/moderate dementia alongside 32 non-demented controls in Tanzania. Participants were oversampled for lower educational level. Inter-rater reliability was conducted by two trained raters in 22 older adults (13 with dementia) from the same population. Assessors were blind to diagnostic group.

Results

Median ADAS-Cog scores were 28.75 (interquartile range (IQR), 22.96–35.54) in mild/moderate dementia and 12.75 (IQR 9.08–16.16) in controls. The area under the receiver operating characteristic curve (AUC) was 0.973 (95% confidence interval (CI) 0.936–1.00) for dementia. Internal consistency was high (Cronbach’s α 0.884) and inter-rater reliability was excellent (intra-class correlation coefficient 0.905, 95% CI 0.804–0.964).

Conclusion

The low-literacy adaptation of the ADAS-Cog had good psychometric properties in this setting. Further evaluation in similar settings is required.

Keywords

Alzheimer’s diseaseclinical trialscognitiondementia
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 29 , Issue 4 , August 2017 , pp. 244 - 251
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Copyright
© Scandinavian College of Neuropsychopharmacology 2017 

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