An adapted Arabic version of the Test of Nine Images for the illiterate Lebanese population: Validation and preliminary normative data. (4th March 2023)

• Record Type: Journal Article
• Authors: El-Hayeck, Rita; Baddoura, Rafic; Wehbé, Amine; Bassil, Nazem; Koussa, Salam; Abou Khaled, Karine; Richa, Sami; Khoury, Rita; Alameddine, Abbas; Sellal, François
• Is Part Of: Journal of the International Neuropsychological Society. Volume 29:Number 3(2023)
• Page Start: 316
• Page End: 323
• Publication Date: 2023-03-04
• Subjects: aged -- cognitive dysfunction -- Lebanon -- literacy -- mental status and dementia tests -- sensitivity and specificity; Neuropsychology -- Periodicals; 616.8
• DOI: 10.1017/S1355617722000236
• Languages: English
• ISSNs: 1355-6177

Abstract

Abstract: Objectives: In the absence of a simple validated instrument to screen for cognitive impairment among illiterate Lebanese older adults, the aims of this study were to validate an Arabic version of the Test of Nine Images (A-TNI93) adapted by the Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'Univesité Saint Joseph (GTD-USJ) for illiterate older Lebanese and to establish normative data. Method: A national population-based sample of 332 community-dwelling illiterate Lebanese aged 55 years and older was administered the A-TNI93 (GTD-USJ) scoring free and overall recall. The sample is part of a larger national sample (1342 participants) used to validate an Arabic version of the Mini-Mental State Examination already reported. Reproducibility, sensitivity, specificity, and area under the curve of the A-TNI93 (GTD-USJ) scoring to detect cognitive impairment according to Clinical Dementia Rating (CDR) as the gold standard were measured. Normative data were established among 188 cognitively normal participants. Results: A threshold score of six on free recall (FR) provided a sensitivity of 66.7% and a specificity of 90.5%. The area under the curve was 0.93. By taking either scores, that is, a FR ≤ 6 or a total recall ≤ 8, the A-TNI93 (GTD-USJ) slightly improved dementia case detection with a sensitivity of 70.8% and a specificity of 88%. Normative data illustrate the distribution of cognitive performance among illiterate older adults. Conclusions: Compared to the CDR requiring physician's competence, the A-TNI93 (GTD-USJ) is a valid Arabic adaptation to screen for cognitive impairment among illiterate Lebanese older adults.