title: The Stick Design Test on the assessment of older adults with low formal education: evidences of construct, criterion-related and ecological validity.
abstract: BACKGROUND
  The assessment of visuospatial abilities is usually performed by drawing tasks. In patients with very low formal education, the use of these tasks might be biased by their cultural background. The Stick Design Test was developed for the assessment of this population. We aim to expand the test psychometric properties by assessing its construct, criterion-related and ecological validity in older adults with low formal education.
  
  
  METHODS
  Healthy older adults (n = 63) and Alzheimer's disease patients (n = 92) performed the Stick Design Test, Mini-Mental State Examination, Digit Span Forward and the Clock Drawing Test. Their caregivers answered Personal Care and Instrumental Activities of Daily Living). Construct validity was assessed by factor analysis, convergent correlations (with the Clock Drawing Test), and divergent correlations (with Digit Span Forward); criterion-related validity by receiver operating characteristic curve analysis and binary logistic regression; and Ecological validity by correlations with ADL.
  
  
  RESULTS
  The test factor structure was composed by one component (R 2 = 64%). Significant correlations with the Clock Drawing Test and Digit Span Forward were found, and the relationship was stronger with the first measure. The test was less associated with formal education than the Clock Drawing Test. It classified about 76% of the participants correctly and had and additive effect with the Mini-Mental State Examination (84% of correct classification). The test also correlated significantly with measures of ADL, suggesting ecological validity.
  
  
  CONCLUSIONS
  The Stick Design Test shows evidence of construct, criterion-related and ecological validity. It is an interesting alternative to drawing tasks for the assessment of visuospatial abilities.
authors.affiliation: Laboratory of Neuropsychological Investigations (LIN), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Jonas Jardim
authors.initials: JJ
authors.lastname: de Paula
authors.forename: Mônica Vieira
authors.initials: MV
authors.lastname: Costa
authors.forename: Matheus Bortolosso
authors.initials: MB
authors.lastname: Bocardi
authors.forename: Mariana
authors.initials: M
authors.lastname: Cortezzi
authors.forename: Edgar Nunes
authors.initials: EN
authors.lastname: De Moraes
authors.forename: Leandro Fernandes
authors.initials: LF
authors.lastname: Malloy-Diniz
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D016022:Case-Control Studies; D004522:Educational Status; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D015203:Reproducibility of Results