Turkish adaptation of the cognitive and leasure activity scale (CLAS) among nursing home residents

Abstract Background There is growing evidence that engaging in cognitively stimulating leisure activities may reduce the risk of dementia and cognitive decline. Encouraging lifelong participation in such activities is considered a key component of multidomain primary prevention strategies. However, there remains a lack of tools for assessing cognitive impairment risk within the Turkish context. The Cognitive and Leisure Activity Scale (CLAS), shown to perform well across different cognitive stages provides a brief yet comprehensive evaluation of the type and frequency of older adults’ activity engagement. Methods This methodological study was conducted in a nursing home. A 52-item questionnaire, including the Mini-Mental State Examination (MMSE), was administered to 288 participants through face-to-face interviews. Psycholinguistic and psychometric evaluations were conducted. The scale underwent forward and backward translation, and its final version was generated following content and face validity assessments by ten experts. For reliability, 33 participants completed the scale twice for test-retest analysis. Results Participants had a mean age of 77.4 years; 43.4% were female, and 91% had a chronic condition other than dementia. Cronbach's alpha for CLAS was 0.753. The test-retest Pearson correlation coefficient was 0.850. The correlation between CLAS and MMSE scores was 0.650. ROC analysis showed strong discriminative ability (AUC = 0.819, p < 0.001), with an optimal cut-off score of 21, yielding 72% sensitivity and 75% specificity. Conclusions CLAS demonstrated acceptable internal consistency, high test-retest reliability, and moderate concurrent validity with the MMSE. Its strong discriminative power supports its potential use in assessing cognitive impairment risk among older adults in Turkey. Key messages • Given the increasing focus on cognitive decline prevention, valid and reliable tools like CLAS may help identify at-risk individuals and support intervention efforts to reduce dementia incidence. • Individuals engaging in cognitively stimulating activities in their leisure time may be beneficial in preventing dementia.