Cultural adaptation of Lithuanian version of Addenbrooke’s Cognitive Examination (ACE-III): language subdomain

Introduction. Alzheimer disease and other dementias caused three times more deaths in 2021 than in 2000. Increasing rates of dementing disorders create new challenges for society and the health care system, including the need for instruments that can help timely recognize changes in cognitive functioning. Addenbrooke’s Cognitive Examination (ACE-III) is a short neuropsychological battery which was created to detect cognitive decline. However, adapting ACE-III in different countries requires thorough process of translation and cultural adaptation, with special focus to the items that are language dependent. The main objective was to analyze Lithuanian version of ACE-III Language subdomain task performance in normative population. Methods. Protocols from the normative Lithuanian ACE-III sample were analyzed in this study (169 female, 118 male; age mean 67.08, SD 12.57; education years mean 15.21, SD 3.36). Features of performance on each Language subdomain task (Instruction comprehension, Sentence writing, Word repetition, Sentence repetition, Picture naming, Picture comprehension, Word reading) were investigated at item level. Results. Highest possible score in Language subdomain was achieved by 43.6% of normative population. Low to moderate significant correlations were identified among Language subscale tasks (Spearman rho from 0.117, p = 0.038 to 0.551 p < 0.001). Correlations between domain tasks and total ACE-III score were identified. McDonald’s ωt = 0.80 showed good inner consistency of the subdomain. Item Response Theory (IRT) model analysis showed, that majority Language subdomain items have good differentiation and difficulty. Exemptions are Sentence writing task, second proverb in Sentence repetition task and rhinoceros’ picture in Picture naming task. Conclusion. Lithuanian ACE-III Language subscale demonstrated appropriate cultural adaptation and inner consistency. However, the research revealed a few items that may require further revision to enhance the precision of language ability assessment.