scholarly journals Developing guidelines for the translation and cultural adaptation of the Montreal Cognitive Assessment: scoping review and qualitative synthesis

BJPsych Open ◽  
2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Ghazn Khan ◽  
Nadine Mirza ◽  
Waquas Waheed
Keyword(s):  
Scoping Review ◽  
Cultural Adaptation ◽  
Cognitive Assessment ◽  
Cultural Context ◽  
Montreal Cognitive Assessment ◽  
Cognitive Tests ◽  
Qualitative Synthesis ◽  
Increased Risk ◽  
The Uk ◽  
Translation And Cultural Adaptation

Background Ethnic minorities in countries such as the UK are at increased risk of dementia or minor cognitive impairment. Despite this, cognitive tests used to provide a timely diagnosis for these conditions demonstrate performance bias in these groups, because of cultural context. They require adaptation that accounts for language and culture beyond translation. The Montreal Cognitive Assessment (MoCA) is one such test that has been adapted for multiple cultures. Aims We followed previously used methodology for culturally adapting cognitive tests to develop guidelines for translating and culturally adapting the MoCA. Method We conducted a scoping review of publications on different versions of the MoCA. We extracted their translation and cultural adaptation procedures. We also distributed questionnaires to adaptors of the MoCA for data on the procedures they undertook to culturally adapt their respective versions. Results Our scoping review found 52 publications and highlighted seven steps for translating the MoCA. We received 17 responses from adaptors on their cultural adaptation procedures, with rationale justifying them. We combined data from the scoping review and the adaptors’ feedback to form the guidelines that state how each question of the MoCA has been previously adapted for different cultural contexts and the reasoning behind it. Conclusions This paper details our development of cultural adaptation guidelines for the MoCA that future adaptors can use to adapt the MoCA for their own languages or cultures. It also replicates methods previously used and demonstrates how these methods can be used for the cultural adaptation of other cognitive tests.

scholarly journals Protocol for the development of versions of the Montreal Cognitive Assessment (MoCA) for people with hearing or vision impairment

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026246 ◽  
Author(s):  
Piers Dawes ◽  
Annie Pye ◽  
David Reeves ◽  
Wai Kent Yeung ◽  
Saima Sheikh ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Clinical Care ◽  
Vision Impairment ◽  
Assessment Tools ◽  
Montreal Cognitive Assessment ◽  
Link Type ◽  
Conference Presentations ◽  
Ethical Approval ◽  
Twitter Account ◽  
The Uk

IntroductionHearing and vision impairments are highly prevalent among older adults and impact commonly used cognitive assessment tools for the identification of dementia. Adaptations of such tests for people with hearing or vision impairment have not been adequately validated among populations with such sensory impairment.Methods and analysisWe will develop two versions of the Montreal Cognitive Assessment (MoCA) for people with acquired hearing impairment (MoCA-H) or vision impairment (MoCA-V). The MoCA-H and MoCA-V will exclude the existing MoCA items that are presented in spoken or visual format, respectively, and include new suitably adapted items. Participants (n=792) with combinations of hearing, vision and cognitive impairment will complete standard or adapted versions of the MoCA across three language sites (English, French and Greek). Development of the MoCA-H and the MoCA-V will be based on analysis of adapted and standard MoCA items following model-based development to select the combination of items for the MoCA-H and MoCA-V that provide optimal sensitivity and specificity for detection of dementia.Ethics and disseminationThe study has received ethical approval from respective centres in the UK, France, Greece and Cyprus. The results of the study will be disseminated through peer-reviewed publication, conference presentations, the study website (https://www.sense-cog.eu/), the SENSE-Cog Twitter account (@sense_cog) and the MoCA test website (https://www.mocatest.org/). The main outputs of the study will be versions of the MoCA that are appropriate for use with adults with acquired hearing or vision impairment and will contribute significantly to the clinical care of older people.

scholarly journals What Are the Structural Barriers to Planning for Later Life? A Scoping Review of the Literature

2019 ◽  
Vol 7 (3) ◽  
pp. 17-26
Author(s):  
Claire Preston ◽  
Nick Drydakis ◽  
Suzanna Forwood ◽  
Suzanne Hughes ◽  
Catherine Meads
Keyword(s):  
Goal Orientation ◽  
Scoping Review ◽  
Later Life ◽  
Structural Factors ◽  
Structural Barriers ◽  
Qualitative Synthesis ◽  
Related Factors ◽  
Key Barrier ◽  
The Individual ◽  
The Uk

The rollback of the welfare state in countries such as the UK, coupled with population ageing, have contributed to a situation in which responsibility for older people’s wellbeing is placed more heavily on the individual. This is exemplified in the notion in popular and policy circles that individuals should plan for later life, particularly financially, and a corresponding concern that they are not doing so sufficiently. This scoping review aimed to identify the structural factors which inhibit people from engaging in planning for later life. For the purposes of this review, we characterised planning as the range of activities people deliberately pursue with the aim of achieving desired outcomes in later life. This entails a future, as opposed to shorter-term, goal orientation. In study selection, we focused on planning at mid-life (aged 40 to 60). Systematic and snowball searching identified 2,317 studies, of which 36 were included in the final qualitative synthesis. The review found that limited financial resources were a key barrier to planning. Related factors included: living in rented accommodation, informal caring, and working part-time. A lack of support from employers, industry, regulators and landlords was also found to inhibit planning. The findings suggest that certain sections of society are effectively excluded from planning. This is particularly problematic if popular and policy discourse comes to blame individuals for failing to plan. The review also provides a critical perspective on planning, highlighting a tendency in the literature towards individualistic and productivist interpretations of the concept.

scholarly journals Cross-cultural adaptation of the Spence Children's Anxiety Scale in Malaysia

2015 ◽  
Vol 37 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Atefeh Ahmadi ◽  
Mohamed Sharif Mustaffa ◽  
AliAkbar Haghdoost ◽  
Aqeel Khan ◽  
Adibah Abdul Latif
Keyword(s):  
Cultural Adaptation ◽  
Cultural Context ◽  
Task Force ◽  
Cross Cultural ◽  
Anxiety Scale ◽  
Community Settings ◽  
Culturally Adapted ◽  
Children’S Anxiety ◽  
Spence Children’S Anxiety Scale ◽  
Translation And Cultural Adaptation

Introduction: Anxiety among children has increased in recent years. Culturally adapted questionnaires developed to measure the level of anxiety are the best screening instruments for the general population. This study describes the scientific translation and adaptation of the Spence Children's Anxiety Scale (SCAS) into the Malay language.Method: The process of scientific translation of this selfreport instrument followed the guidelines of the Task Force for Translation and Cultural Adaptation of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).Results: The Malay version and its adaptation for a new cultural context are described.Conclusion: The Malay version achieved the aims of the original version and its conceptual and operational equivalence. It may be used as the first Malay instrument to measure anxiety among children in research and in clinical and community settings.

scholarly journals Developing and implementing guidelines on culturally adapting the Addenbrooke’s cognitive examination version III (ACE-III): a qualitative illustration

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Waquas Waheed ◽  
Nadine Mirza ◽  
Muhammed Wali Waheed ◽  
Abid Malik ◽  
Maria Panagioti
Keyword(s):  
Systematic Review ◽  
Focus Groups ◽  
South Asian ◽  
Cultural Adaptation ◽  
Cultural Context ◽  
Asian Population ◽  
Cognitive Test ◽  
Cognitive Tests ◽  
South Asian Population ◽  
Minimum Criteria

Abstract Background Cognitive tests currently used in healthcare and research settings do not account for bias in performance that arises due to cultural context. At present there are no universally accepted steps or minimum criteria for culturally adapting cognitive tests. We propose a methodology for developing specific guidelines to culturally adapt a specific cognitive test and used this to develop guidelines for the ACE-III. We then demonstrated their implementation by using them to produce an ACE-III Urdu for a British South Asian population. Methods This was a several stage qualitative study. We combined information from our systematic review on the translation and cultural adaptation of the ACE-III with feedback from previous ACE-III adaptors. This identified steps for cultural adaptation. We formatted these into question-by-question guidelines. These guidelines, along with feedback from focus groups with potential users were used to develop ACE-III Urdu questions. Clinical experts reviewed these questions to finalise an ACE-III Urdu. Results Our systematic review found 32 adaptations and we received feedback from seven adaptors to develop the guidelines. With these guidelines and two focus groups with 12 participants a sample ACE-III Urdu was developed. A consensus meeting of two psychiatrists with a South Asian background and familiarity with cognitive tests and cultural adaptation finalised the ACE-III Urdu. Conclusions We developed a set of guidelines for culturally adapting the ACE-III that can be used by future adaptors for their own language or cultural context. We demonstrated how guidelines on cultural adaptation can be developed for any cognitive test and how they can be used to adapt it.

scholarly journals The Montreal Cognitive Assessment (MoCA) with a double threshold: improving the MoCA for triaging patients in need of a neuropsychological assessment.

2021 ◽  
pp. 1-13
Author(s):  
Géraud M. F. C. Dautzenberg ◽  
Jeroen G. Lijmer ◽  
Aartjan T. F. Beekman
Keyword(s):  
Neuropsychological Assessment ◽  
Cognitive Assessment ◽  
Selection Process ◽  
High Sensitivity ◽  
Montreal Cognitive Assessment ◽  
Initial Assessment ◽  
Clinical Value ◽  
Active Monitoring ◽  
Increased Risk ◽  
Double Threshold

ABSTRACT Objectives: Diagnosis of patients suspected of mild dementia (MD) is a challenge and patient numbers continue to rise. A short test triaging patients in need of a neuropsychological assessment (NPA) is welcome. The Montreal cognitive assessment (MoCA) has high sensitivity at the original cutoff <26 for MD, but results in too many false-positive (FP) referrals in clinical practice (low specificity). A cutoff that finds all patients at high risk of MD without referring to many patients not (yet) in need of an NPA is needed. A difficulty is who is to be considered at risk, as definitions for disease (e.g. MD) do not always define health at the same time and thereby create subthreshold disorders. Design: In this study, we compared different selection strategies to efficiently identify patients in need of an NPA. Using the MoCA with a double threshold tackles the dilemma of increasing the specificity without decreasing the sensitivity and creates the opportunity to distinguish the clinical (MD) and subclinical (MCI) state and hence to get their appropriate policy. Setting/participants: Patients referred to old-age psychiatry suspected of cognitive impairment that could benefit from an NPA (n = 693). Results: The optimal strategy was a two-stage selection process using the MoCA with a double threshold as an add-on after initial assessment. By selecting who is likely to have dementia and should be assessed further (MoCA<21), who should be discharged (≥26), and who’s course should be monitored actively as they are at increased risk (21<26). Conclusion: By using two cutoffs, the clinical value of the MoCA improved for triaging. A double-threshold MoCA not only gave the best results; accuracy, PPV, NPV, and reducing FP referrals by 65%, still correctly triaging most MD patients. It also identified most MCIs whose intermediate state justifies active monitoring.

scholarly journals Developing and implementing guidelines on culturally adapting the Addenbrooke’s Cognitive Examination Version III (ACE-III): A qualitative illustration

2020 ◽  
Author(s):  
Waquas Waheed ◽  
Nadine Mirza ◽  
Muhammed Wali Waheed ◽  
Abid Malik ◽  
Maria Panagioti
Keyword(s):  
Systematic Review ◽  
Focus Groups ◽  
South Asian ◽  
Cultural Adaptation ◽  
Cultural Context ◽  
Asian Population ◽  
Cognitive Test ◽  
Cognitive Tests ◽  
South Asian Population ◽  
Minimum Criteria

Abstract Background: Cognitive tests currently used in healthcare and research settings do not account for bias in performance that arises due to cultural context. At present there are no universally accepted steps or minimum criteria for culturally adapting cognitive tests. We propose a methodology for developing specific guidelines to culturally adapt a specific cognitive test and used this to develop guidelines for the ACE-III. We then demonstrated their implementation by using them to produce an ACE-III Urdu for a British South Asian population. Methods: This was a several stage qualitative study. We combined information from our systematic review on the translation and cultural adaptation of the ACE-III with feedback from previous ACE-III adaptors. This identified steps for cultural adaptation. We formatted these into question-by-question guidelines. These guidelines, along with feedback from focus groups with potential users were used to develop ACE-III Urdu questions. Clinical experts reviewed these questions to finalise an ACE-III Urdu. Results: Our systematic review found 32 adaptations and we received feedback from seven adaptors to develop the guidelines. With these guidelines and two focus groups with 12 participants a sample ACE-III Urdu was developed. A consensus meeting of two psychiatrists with a South Asian background and familiarity with cognitive tests and cultural adaptation finalised the ACE-III Urdu. Conclusions: We developed a set of guidelines for culturally adapting the ACE-III that can be used by future adaptors for their own language or cultural context. We demonstrated how guidelines on cultural adaptation can be developed for any cognitive test and how they can be used to adapt it.

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