Publication

Abstract : Title: Cross-cultural adaption of the Computerized Assessment of Information Processing battery (COGNITO) for an Indian longitudinal study on rural elderly: An elucidation of the adaptation process Authors and affiliation: Ammu Lukose1*, Rahul K V1*, Mino Susan Joseph1, Girish N Rao2, P T Sivakumar3, Karen Ritchie4, Naren P Rao3 and SANSCOG investigators1 1Center for Brain Research (CBR), Indian Institute of Sciences (IISC), Bangalore, India; 2Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; 3Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; 4 Inserm, Montpellier, France. * Both authors contributed equally to this work. Abstract: Background: Evidence shows that pathological ageing is detectable decades prior to clinically manifested dementia. Computerized cognitive batteries that precisely record accuracy and latency, and cover a wide range of cognitive functions could enable large-scale epidemiological research, aiding earlier detection of cognitive changes in the elderly, Alzheimer’s Dementia (AD), and other related disorders. However, the lack of formal education and familiarity to testing in low-middle income country is a challenge especially in a multi-cultural and multi-lingual setting. In India, there are no indigenously developed or scientifically adapted comprehensive cognitive batteries for the detection of temporal changes in cognitive functions in the public domain. Hence, for our large population based study- Srinivaspura Aging, Neuro Senescence and Cognition (SANSCOG), we sought to compile a suitable cognitive battery and perform its cross-cultural adaptation. Methods: Key domains that differentiated normal and pathological ageing were identified through an extensive review of national and international longitudinal studies. The cognitive battery apart from addressing these core domains needed to be inclusive for a heterogeneous rural elderly sample of both literates and illiterates. The COGNITO battery (Ritchie et al. 2014), developed by Inserm, France, was adapted in this study in view of these properties, developed specifically for ageing research with established psychometric properties, requisite difficulty level to address ceiling and floor effect, and its scope for cultural adaptation. We followed the guidelines detailed by the International Test Commission (ITC) and qualitative procedures for the cross-cultural adaptation of COGNITO. Judgmental methods of forward and backward translation of instructions and linguistic elements along with detailed qualitative procedures for stimulus adaptation of each test were performed. Discussion: This presentation highlights the significance and details of qualitative procedures involved in linguistic, cultural, and regional adaptation of a cognitive battery to a non-western context. This systematic manner of qualitative adaptation would ensure semantic, construct equivalence with the source tool and cultural and socio-economic suitability of the adapted tool to the target community. It provides a paradigm for cross-cultural adaptation of other non-indigenous cognitive batteries. In addition, the subsequently generated normative and longitudinal cognitive data could provide definitive evidence regarding the effect of education on cognitive degeneration and differential rates of dementia in those across various educational levels. Key words: Cognition, ageing, dementia, cross-cultural adaptation, literacy, developing country, India