Psychometric Evaluation of Self-assessment Persian Version of the Alzheimer Questionnaire (AQ).

Introduction: Mild cognitive impairment (MCI) is a primary disorder intensified by aging. Rapid diagnosis of MCI can prevent its progression towards the development of dementia. Thus, the present study was conducted to evaluate the psychometric features of the self-assessment Persian version of the Alzheimer questionnaire (AQ) in the elderly to detect MCI.

Methods: First, the AQ was translated into the Persian language; then, its content validity was evaluated by the content validity index (CVI) and content validity ratio (CVR) method, and face validity was determined by two checklists for expert panel and the elderly. The convergent validity of the self-assessment AQ with the Montreal cognitive assessment (MoCA) was assessed using the Pearson correlation. The test-retest and internal consistency reliability were evaluated using intra-class correlation (ICC) and Kuder-Richardson coefficients, respectively. Moreover, the receiver operating characteristic curve was used to determine the optimal cut-off point of self-assessment AQ. Among 148 older people who took part in this study, 93 met our inclusion criteria (aged 60 years old or older, had reading and writing skills, and were able to speak and communicate).

Results: A translated version of the questionnaire was named "M-check." The developed test showed good content and face validity. Statistically significant correlations were found between M-check and MoCA (r=-0.83, P<0.05). The Kuder-Richardson and ICC coefficients were obtained as 0.84 and 0.92, respectively. Area under the curve presented satisfactory values (Area under curve [AUC]=0.852, sensitivity=0.62, specificity=0.94).

Conclusion: The M-check can be used as a valid and reliable instrument for assessing cognitive state and screening MCI in older adults.

Highlights: All questions achieved desired face validity.The convergent validity of Alzheimer Questioner (AQ) was confirmed with high correlation.The AQ is statistically significant with Montreal Cognitive Assessment (MoCA).The AQ had acceptable stability, repeatability, and reliability.All findings demonstrated that the M-Check had high values in predicting MCI in the early stages.

Plain language summary: Mild cognitive impairment (MCI) is a subset of mental disorders that is an early condition that may lead to dementia. People with MCI are usually prone to forgetfulness in a short time. If MCI is not detected in the early stages, it can progress to dementia or Alzheimer's to higher degrees. On the other hand, cognitive decline and MCI can cause major problems for patients and their families. So it is essential to act out as soon as possible. It is considered that a tool for the early identification of MCI that is self-assessed by individuals, without the presence of an expert and trained person to interpret the results, was not observed in Iran. Thus, the present study was conducted to evaluate the psychometric features of the self-assessment Persian version of the Alzheimer questionnaire (AQ) in the elderly. The results showed that the AQ is a simple one that can be quickly completed by any person at home or by family members of the elderly so that people can refer to the relevant specialist more soon if needed.