title: Cross-national comparison and validation of the Alzheimer's Disease Assessment Scale: results from the European Harmonization Project for Instruments in Dementia (EURO-HARPID).
abstract: BACKGROUND
  The Alzheimer's Disease Assessment Scale (ADAS) is often used in international multicenter trials. Use across countries presupposes correct translation and adaptation of the scale, and maintenance of its psychometric properties.
  
  
  OBJECTIVE
  To compare the various translations of the ADAS used in Western Europe, to design internationally harmonized translations and to validate these.
  
  
  METHODS
  International cooperative study in eight European countries.
  
  
  METHODS
  An inventory was made of existing versions of the ADAS-Cog used in eight European countries, and adaptations were made. The concurrent validity of the harmonized versions of the ADAS was tested in 283 patients with probable or possible Alzheimer's disease. The Nurses Observation Scale for Geriatrics (NOSGER), CAMCOG-R and MMSE was used to assess concordance between cognitive and behavioral measures.
  
  
  RESULTS
  Differences between the versions mainly involved object naming, items for verbal memory, such as the number of trials allowed, the imagery value of the words selected as targets or distractors, and the number of parallel versions. These differences were eliminated by adapting and harmonizing the various versions of the ADAS-Cog. Thereafter, only small differences between the different countries were found, and patterns of correlation between ADAS-Cog, and the NOSGER, CAMCOG-R and MMSE were consistent.
  
  
  CONCLUSIONS
  The study underlines the need to use harmonized versions of instruments for rating dementia in multinational studies. The findings indicate that the harmonization of the ADAS-Cog was successful.
authors.affiliation: Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands. f.verhey@np.unimaas.nl
authors.forename: Frans R
authors.initials: FR
authors.lastname: Verhey
authors.forename: Peter
authors.initials: P
authors.lastname: Houx
authors.forename: Natascha
authors.initials: N
authors.lastname: Van Lang
authors.forename: Felicia
authors.initials: F
authors.lastname: Huppert
authors.forename: Gabriella
authors.initials: G
authors.lastname: Stoppe
authors.forename: Jos
authors.initials: J
authors.lastname: Saerens
authors.forename: Peter
authors.initials: P
authors.lastname: Böhm
authors.forename: Luc
authors.initials: L
authors.lastname: De Vreese
authors.forename: Arto
authors.initials: A
authors.lastname: Nordlund
authors.forename: Peter P
authors.initials: PP
authors.lastname: DeDeyn
authors.forename: Mirco
authors.initials: M
authors.lastname: Neri
authors.forename: Jordi
authors.initials: J
authors.lastname: Peña-Casanova
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.forename: Eduard
authors.initials: E
authors.lastname: Bollen
authors.forename: Huub
authors.initials: H
authors.lastname: Middelkoop
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Nargeot
authors.forename: Michèle
authors.initials: M
authors.lastname: Puel
authors.forename: Ulrich M
authors.initials: UM
authors.lastname: Fleischmann
authors.forename: Jellemer
authors.initials: J
authors.lastname: Jolles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D003071:Cognition; D003431:Cross-Cultural Comparison; D005060:Europe; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D011569:Psychiatric Status Rating Scales / Q000592:standards; D011594:Psychometrics; D015203:Reproducibility of Results; D014177:Translations