Neuropsychiatric Symptoms Assessment: Cross-cultural Adaptation and Validation of the Portuguese Abe’s BPSD Score (ABS)

ABSTRACT

Objectives

This study aims to report on the development and psychometric properties of the Portuguese-language Abe’s BPSD score (ABS) to screen for neuropsychiatric symptoms (NPS).

Methods

ISPOR and COSMIN recommendations were followed to translate and culturally adapt the ABS. A validation study was conducted to assess the psychometric properties of the newly-translated instrument. Outpatients attending a psychogeriatric consultation were included by consecutive referrals and were assessed with the ABS, the Neuropsychiatric Inventory (NPI) and NPI Caregiver Distress scale (NPI-D), and the Mini-Mental State Examination (MMSE). The ABS reliability (internal consistency, item-total correlations, inter-rater and test-retest reliability), validity (concurrent and convergent), feasibility and diagnostic accuracy were examined.

Results

Overall, 107 participants were included. The ABS Cronbach alpha was 0.672, and item-total correlations ranged from −0.056 to 0.546. Strong inter-rater (ICC 0.997; 95%CI: 0.995–0.999) and test-retest reliability (ICC 0.976; 95%CI: 0.958–0.986) were found. Concurrent validity with NPI was high (r_s = 0.847, p < .001), and correlations with MMSE and NPI-D were also significant. An exploratory threshold score ≥2 is proposed to identify clinically relevant NPS.

Conclusions

Data provide satisfactory proof of ABS psychometric characteristics. Nevertheless, some items exhibited less optimal properties.

Clinical Implications

The newly-translated instrument proved to be relevant, valid and easy to use in a real geriatric clinical setting.

KEYWORDS:

• Neuropsychiatric symptoms
• dementia
• measurement
• cross-cultural adaptation
• validation study

Acknowledgments

The authors would like to express their gratitude to the mental health professionals who took part in the different steps of the ABS translation and adaptation.

Disclosure statement

No authors reported any financial or other conflicts of interest in relation to this work.

Clinical implications

• The ABS proved to be relevant, valid and easy to use in a real geriatric clinical setting.

• The ABS completion time suggests that this instrument could become a suitable tool to be used as part of dementia evaluation to routinely assess neuropsychiatric symptoms.

• This study contributes with a valid tool to further investigate the neuropsychiatric features of dementia across cultures.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, ARF. The data are not publicly available due to ethical and privacy issues.

Additional information

Funding

This work was supported by the Fundação para a Ciência e a Tecnologia [PD/BD/114555/2016], ERDF through operation POCI-01-0145-FEDER-007746 funded by Programa Operacional Competitividade Internacionalização-COMPETE2020, and by National Funds through Fundação para a Ciência e a Tecnologia (FCT) within CINTESIS, R&D Unit (ref. UID/IC/4255/2013 and UIDB/4255/2020).