Determination of Normative Criteria and Validation of the SKT for Use in Spanish-Speaking Populations

Abstract

Most of the tests, questionnaires, and neuropsychological batteries for the assessment of dementia have been translated and adapted for use in the Hispanic population without having normative data, which results in a high number of false positives when age and educational level are not considered. The Short Cognitive Performance Test (SKT) is a psychometric instrument evaluating memory and attention deficits that has been developed and standardized in Germany (Erzigkeit, 1989a, 1989b). The objective of this study was to adapt the SKT, to establish normative criteria that take into consideration age and educational level, and to establish its concurrent validity in comparison to other neuropsychological tests: Brief Neuropsychological Evaluation for Spanish-Speaking Subjects (Ostrosky-Solís et al., 1994), the Mini-Mental State Examination (Folstein et al., 1975), and the Blessed Functional Scale (Blessed et al., 1968) in 238 neurologically intact subjects and 97 subjects with mild to moderate dementia. The SKT showed adequate sensitivity (80.5%) and specificity (80.3%) in subjects with medium and high educational level; however, the sensitivity and specificity diminished (75% and 56.7%) in subjects with no education or low educational level. The adapted and validated version of the SKT in the Mexican population has been shown to be a psychometric instrument that in subjects with medium educational level can detect cognitive alterations and is able to determine the severity of deterioration; however, in subjects with low educational level and severe dementia, the SKT cannot be usefully administered.

The Short Cognitive Performance Test (SKT): a preliminary study of its psychometric properties in Brazil

“…Our results are in agreement with previous studies conducted in different countries, suggesting that the SKT carries good transcultural validity as a screening test for dementia (Ihl et al, 1992;1999;Kim et al, 1993;Lehfeld et al, 1997;Ostrosky-Solís et al, 1999). As the SKT involves no written tasks, the adaptation of the test to different cultures is limited to the translation of the test instructions, and to the substitution of any pictures that might be unfamiliar to the target population.…”

“…Accordingly, a previous study by Ostrosky-Solís et al (1999) in a Mexican Hispanic group suggested that the psychometric properties of the SKT may be different in populations with lower educational level. This issue still needs clarification in the Brazilian population, particularly because higher educational strata were intentionally over-represented in the present sample, with 54.9% of subjects with 13 years of schooling or more.…”

“…However, methodological limitations, such as the lack of a uniform protocol specifying inclusion and exclusion criteria, may jeopardize the generalization of these findings, and require further replication in more homogeneous diagnostic groups. Ostrosky-Solís et al (1999) conducted a study with 97 subjects with mild to moderate dementia and 238 controls, to validate the use of the SKT, considering age and educational level, to a Hispanic (Mexican) population. The authors also intended to establish the concurrent validity of the SKT as compared to the Brief Neuropsychological Evaluation for Spanish-speaking Subjects (OstroskySolís et al, 1999), the MMSE and the Blessed Functional Scale (Blessed et al, 1968).…”

The Newly Normed SKT Reveals Differences in Neuropsychological Profiles of Patients with MCI, Mild Dementia and Depression

“…A final remark refers to the international validity of the SKT, which up to about 1990 was mainly used in German-speaking countries. However, in the following years an increasing number of international studies were performed, e.g., in the United States, the UK, Greece, Russia, Chile, Mexico, Brazil or South Korea [44][45][46][47][48][49][50]. Some of these studies specifically aimed at validating the SKT for the respective target language or culture.…”

Teste Breve de Perfomance Cognitiva (SKT): estudo de validação e propriedades diagnósticas em uma amostra clínica brasileira

“…analfabeta ou com até cinco anos de estudo, indicou que o instrumento não sofre influência da variável escolaridade para amostra de sujeitos-controles e com demência de grau leve a grave, independentemente da etiologia. Estudo semelhante realizado na população mexicana(Ostrosky-Solís et al, 1999) com amostra similar reportou que o SKT, versão A, indica altas taxas de sensibilidade (80,5%) e especificidade (80,3%) para sujeitos com escolaridade média, considerada de cinco a nove anos de estudo, e alta, para dez ou mais anos de estudo. No entanto, em sujeitos analfabetos ou com até quatro anos de escolaridade, a acurácia do SKT diminui (75% e 56,7%).Apesar de não terem sido encontrados dados na literatura em inglês sobre avaliação da acurácia do instrumento considerando-se o grupo diagnóstico CCL, além de DA e CN, os achados apresentados nos dois estudos acima mencionados são compatíveis com os do atual estudo quando se considera a acurácia do SKT quanto aos grupos DA e CN.…”