Development of an activities of daily living scale to screen for dementia in an illiterate rural older population in India

You should critically comment on the strengths and limitations reported by the authors on the assessment measure evaluated; consider any cultural sensitivity issues; and suggest possible uses of this tool in evaluation work.
To address the overall assignment, frame your analysis to consider the following questions:
1. Have the authors chosen the right conceptual focus, with their concern to develop indicators capturing activities of daily living, particularly focusing on cognitive function?
a. Is measuring activities of daily living (ADL) appropriate to screen for dementia?
b. How appropriate are the items chosen for inclusion in EASI as indicators of ADL?
c. Could there be better indicators?
d. Are there other appropriate aspects of function that might be measured?
2. Have the authors chosen the right methodological focus, with their concern for the reliability and validity of informant/proxy reporting of functioning?
a. Is proxy report the most appropriate method to assess activities of daily living?
b. Whose perspective counts most in this respect?
c. Is it appropriate only to have two options for scoring: can and cannot complete task? d. Does the measure capture the social factors impinging on a person�s functioning?
3. Is the measure suitable for the population being screened (older people living in a rural area of India with poor literacy skills) to provide culturally appropriate assessment?
????a. b. c. d.
Who was involved in the development and administration of the measure?
Was the process of selecting culturally appropriate indicators suitable?
How practical was the assessment process in the context of this particular culture? Are relevant demographic variables considered e.g. gender, socio-economic status?
4. What
a. Is it appropriate to model the measure on Western screening methods?
b. What is the likely impact of using this measure with the population under study?
c. How potentially generalizable is the measure for different settings or populations?
d. How might this measure be used or developed in the future?
These questions indicate general points that should be considered, not the order in which they should be presented. And, of course, the list is not exhaustive � this is a framework of key points for analysis to help you start unpicking the strengths and limitations discussed within the paper.
Draw on literature from the reading lists to examine:
? general principles about validity and reliability in the design of validation studies, the general context of cultural relevance in the evaluation of outcome measures, in addition to specific issues in the field of dementia studies such as the involvement of people with dementia
? the validation of culturally-appropriate screening tools for dementia – look at other studies that have attempted to develop new culturally-appropriate measures or adapt existing validated measures with a different population/language/culture to compare approaches

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