title: Linguistic adaptation of the clinical dementia rating scale for a Spanish-speaking population: a focus group approach.
abstract: BACKGROUND
  Alzheimer's disease (AD) is the most common form of dementia worldwide. In Hispanic populations there are few validated tests for the accurate identification and diagnosis of AD. The Clinical Dementia Rating (CDR) scale is an internationally recognized questionnaire used to stage dementia. This study's objective was to develop a linguistic adaptation of the CDR for the Puerto Rican population.
  
  
  METHODS
  The linguistic adaptation consisted of the evaluation of each CDR question (item) and the questionnaire's instructions, for similarities in meaning (semantic equivalence), relevance of content (content equivalence), and appropriateness of the questionnaire's format and measuring technique (technical equivalence). A focus group methodology was used to assess cultural relevance, clarity, and suitability of the measuring technique in the Argentinean version of the CDR for use in a Puerto Rican population.
  
  
  RESULTS
  A total of 27 semantic equivalence changes were recommended in four categories: higher than 6th grade level of reading, meaning, common use, and word preference. Four content equivalence changes were identified, all focused on improving the applicability of the test questions to the general population's concept of street addresses and common dietary choices. There were no recommendations for changes in the assessment of technical equivalence.
  
  
  CONCLUSIONS
  We developed a linguistically adapted CDR instrument for the Puerto Rican population, preserving the semantic, content, and technical equivalences of the original version. Further studies are needed to validate the usefulness of the adapted CDR instrument with the staging of Alzheimer's disease in the Puerto Rican population.
authors.affiliation: School of Pharmacy, Medical Sciences Campus, University of Puerto Rico, San Juan. ilia.oquendo@upr.edu
authors.forename: Ilia
authors.initials: I
authors.lastname: Oquendo-Jiménez
authors.forename: Rafaela
authors.initials: R
authors.lastname: Mena
authors.forename: Mikhail D
authors.initials: MD
authors.lastname: Antoun
authors.forename: Valerie
authors.initials: V
authors.lastname: Wojna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D011647:Puerto Rico; D011795:Surveys and Questionnaires