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Title: Adaptation of the ACE for a Malayalam speaking population in southern India
Authors: Mathuranath, PS
Hodges, JR
Mathew, R
Cherian, PJ
George, A
Bak, TH
Keywords: Neurology
Issue Date: 2004
Abstract: Objective To adapt the Addenbrooke's Cognitive Examination (ACE) as a dementia-screening tool in a community in south India. To establish that items in the adapted version are equivalent to that in the original.Methods The ACE was adapted into the local language, Malayalam (m-ACE), following cultural/linguistic modifications. To establish equivalence, qualitative comparisons were made (on the distribution of scores, percentage scoring at ceiling, and relative difficulty across items) between a UK sample receiving the ACE (n = 50; mean age = 67.9 +/- 7.4; education greater than or equal to9, mean = 10.9 +/- 2.5) and a community-based educationally-stratified Indian sample receiving the m-ACE: 'India greater than or equal to9' (n = 50; mean age = 67.8 +/- 5.2; education greater than or equal to9, mean = 13.9 +/- 2.7) and 'India less than or equal to8' (n = 50; mean age = 67.1 +/- 5.3; education less than or equal to8, mean = 3.1 +/- 2.0).Results Most ACE items were retained. The score distribution (mean +/- ISD), percentage at ceiling, and relative difficulties across items is comparable between the UK and the educationally equivalent India greater than or equal to9 groups. Language, Naming, Attention and Orientation are relatively easy (greater than or equal to80% at ceiling) and Recall and Verbal fluency are relatively difficult (less than or equal to22% at ceiling). Although the percentage at ceiling were lower for the India less than or equal to8 group, the order of relative difficulty was similar and the percentage scoring at floor was less than or equal to10% on all except visuospatial item.Conclusions The m-ACE provides a culture-fair Malayalam adaptation of the ACE with component items of equivalent difficulty. Copyright (C) 2004 John Wiley Sons, Ltd.
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