Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-25T19:16:59.241Z Has data issue: false hasContentIssue false
  • English
  • Français

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: stella-maria.paddick@ncl.ac.uk
Get access Rights & Permissions [Opens in a new window]

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
Check for updates
Copyright
© Scandinavian College of Neuropsychopharmacology 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. George-Carey, R, Adeloye, D, Chan, KY et al. An estimate of the prevalence of dementia in Africa: a systematic analysis. J Glob Health 2012;2:020401.CrossRefGoogle ScholarPubMed
2. Olayinka, OO, Mbuyi, NN. Epidemiology of Dementia among the Elderly in Sub-Saharan Africa. International Journal of Alzheimer’s Disease 2014, 15pp, http://dx.doi.org/10.1155/2014/195750.Google Scholar
3. Paddick, SM, Longdon, A, Gray, WK et al. The association between educational level and dementia in rural Tanzania. Dement Neuropsychol 2014;8:117–125.CrossRefGoogle ScholarPubMed
4. Gray, WK, Paddick, SM, Kisoli, A et al. Development and validation of the identification and intervention for dementia in elderly Africans (IDEA) study dementia screening instrument. J Geriatr Psychiatry Neurol 2014;27:110–118.CrossRefGoogle ScholarPubMed
5. Toure, K, Coume, M, Ndiaye, NND, Thiam, MH et al. The test of Senegal: a valid and reliable screening tool to assess for dementia in a Senegalese elderly population. Afr J Neurol Sci 2008;27.Google Scholar
6. Ritchie, CW, Ames, D, Clayton, T, Lai, R. Metaanalysis of randomized trials of the efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer disease. Am J Geriatr Psychiatry 2004;12:358–369.Google Scholar
7. Rosen, W, Mohs, R., Davis, K. Alzheimer’s Disease Assessment Scale – cognitive and non-cognitive sections (ADAS-Cog, ADAS Non-Cog). J Psychiatry 1984;141:1356–1364.Google Scholar
8. Hannesdóttir, K, Snaedal, J. A study of the Alzheimer’s Disease Assessment Scale-cognitive (ADAS-Cog) in an Icelandic elderly population. Nord J Psychiatry 2002;56:201–206.CrossRefGoogle Scholar
9. Mavioglu, H, Gedizlioglu, M, Akyel, S, Aslaner, T, Eser, E. The validity and reliability of the Turkish version of Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in patients with mild and moderate Alzheimer’s disease and normal subjects. Int J Geriatr Psychiatry 2006;21:259–265.CrossRefGoogle ScholarPubMed
10. Kolibas, E, Korinkova, V, Novotny, V, Vajdickova, K, Hunakova, D. ADAS-Cog (Alzheimer’s Disease Assessment Scale-Cognitive Subscale) – validation of the Slovak version. Bratisl Lek Listy 2000;101:598–602.Google ScholarPubMed
11. Tsolaki, M, Fountoulakis, K, Nakopoulou, E, Kazis, A, Mohs, RC. Alzheimer’s Disease Assessment Scale: the validation of the scale in Greece in elderly demented patients and normal subjects. Dement Geriatr Cogn Disord 1997;8:273–280.CrossRefGoogle ScholarPubMed
12. Schultz, RR, Siviero, MO, Bertolucci, PHF. The cognitive subscale of the’ Alzheimer’s Disease Assessment Scale’ in a Brazilian sample. Braz J Med Biol Res 2001;34:1295–1302.Google Scholar
13. Pena-Casanova, J, Aguilar, M, Santacruz, P et al. [Adaptation and normalization of the Alzheimer’s Disease Assessment Scale for Spain (NORMACODEM) (II)]. Neurologia 1997;12:69–77.Google Scholar
14. Youn, JC, Lee, DY, Kim, KW et al. Development of the Korean version of Alzheimer’s Disease Assessment Scale (ADAS‐K). Int J Geriatr Psychiatry 2002;17:797–803.Google Scholar
15. Liu, HC, Teng, EL, Chuang, YY, Lin, KN, Fuh, JL, Wang, PN. The Alzheimer’s Disease Assessment Scale: findings from a low-education population. Dement Geriatr Cogn Disord 2002;13:21–26.CrossRefGoogle ScholarPubMed
16. Paddick, S-M, Longdon, AR, Kisoli, A et al. Dementia prevalence estimates in sub-Saharan Africa: comparison of two diagnostic criteria. Glob Health Action 2013;6.Google Scholar
17. Hall, KS, Ogunniyi, AO, Hendrie, HC, Osuntokun, BO. Indianapolis, USA, and Ibadan, Nigeria. Int J Methods Psychiatr Res 1996;6:129–142.Google Scholar
18. Longdon, AR, Paddick, SM, Kisoli, A et al. The prevalence of dementia in rural Tanzania: a cross-sectional community-based study. Int J Geriatr Psychiatry 2013;28:728–737.Google Scholar
19. Collingwood, C, Paddick, SM, Kisoli, A et al. Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL) questionnaire. Glob Health Action 2014;7:25988.Google Scholar
20. American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-IV-TR fourth edition (text revision), 2000. Arlington, VA, USA.Google Scholar
21. Nitrini, R, Caramelli, P, Herrera, E et al. Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. J Int Neuropsychol Soc 2004;10:634–638.CrossRefGoogle ScholarPubMed
22. Verghese, J, Noone, ML, Johnson, B et al. Picture‐based memory impairment screen for dementia. J Am Geriatr Soc 2012;60:2116–2120.Google Scholar
23. Rosselli, M, Ardila, A, Rosas, P. Neuropsychological assessment in illiterates. II. Language and praxic abilities. Brain Cogn 1990;12:281–296.Google Scholar
24. Ostrosky-Solis, F, Ardila, A, Rosselli, M, Lopez-Arango, G, Uriel-Mendoza, V. Neuropsychological test performance in illiterate subjects. Arch Clin Neuropsychol 1998;13:645–660.CrossRefGoogle ScholarPubMed
25. Baiyewu, O, Unverzagt, FW, Lane, KA et al. The stick design test: a new measure of visuoconstructional ability. J Int Neuropsychol Soc 2005;11:598–605.Google Scholar
26. de Paula, JJ, Costa, MV, Bocardi, MB, Cortezzi, M, De Moraes, EN, Malloy-Diniz, LF. The stick design test on the assessment of older adults with low formal education: evidences of construct, criterion-related and ecological validity. Int Psychogeriatr 2013;25:2057–2065.CrossRefGoogle ScholarPubMed
27. Sosa, AL, Albanese, E, Prince, M et al. Population normative data for the 10/66 dementia research group cognitive test battery from Latin America, India and China: a cross-sectional survey. BMC Neurol 2009;9:1.Google Scholar
28. Gureje, G, Ogunniyi, A, Kola, L. The profile and impact of probable dementia in a sub-Saharan African community: results from the Ibadan Study of Aging. J Psychosom Res 2006;61:327–333.Google Scholar
29. Paddick, SM, Dotchin, C, Gray, WK et al. Utility of the mini-mental state examination (MMSE) for identification of dementia in a low-literacy setting in rural Tanzania. Age and Ageing 2015;44:ii25–ii25.Google Scholar
30. Graham, DPCJ, Snow, AL, Massman, P, Doody, R. The Alzheimer’s Disease Assessment Scale-Cognitive subscale: normative data for older adult controls. Alzheimer Dis Assoc Disord 2004;18:236–240.Google Scholar
31. Paddick, S-M, Longdon, A, Kisoli, A et al. The prevalence of dementia subtypes in rural Tanzania. Am J Geriatr Psychiatry 2014;22:1613–1622.Google Scholar
32. Brucki, SMD. Illiteracy and dementia. Dement Neuropsychol 2010;4:153–157.Google Scholar
33. Ardila, A, Bertolucci, PH, Braga, LW et al. Illiteracy: the neuropsychology of cognition without reading. Arch Clin Neuropsychol 2010;25:689–712.Google Scholar
Supplementary material: File

Paddick supplementary material

Paddick supplementary material 1

Download Paddick supplementary material(File)
File 53.3 KB