Translation, Cultural Adaptation, and Validity of Barnes Language Assessment in Persian Ageing Population: A Preliminary Study
,
Abstract
Background: As the global population ages, the need for sensitive language assessments for dementia increases. While the Barnes Language Assessment (BLA) is a valuable tool in English, it has not been translated and validated in Persian-speaking populations.
Methods: This cross-sectional study aimed to translate and culturally adapt the BLA into Persian (BLA-Per) and evaluate its psychometric properties. The translation process followed the International Quality of Life Assessment (IQOLA) protocol. The BLA-Per was administered to 30 healthy older adults and 30 individuals with Alzheimer's disease (AD). Test-retest reliability was assessed in the AD group. Statistical data analysis was performed using SPSS software (version 24) at a significance level of 0.05.
Results: Due to significant differences between the patients and cognitively healthy groups regarding age and education years, we used ANCOVA to control for these variables' effects on between-group comparisons. Significant differences in BLA-Per scores were observed between healthy controls and AD patients in 8 out of 14 test components, demonstrating good discriminative validity. Intra-class correlation coefficients for test-retest reliability were above 0.75 for most subtests.
Conclusion: The BLA-Per demonstrated good validity and reliability in assessing language impairments in Persian-speaking individuals with AD. Future research should investigate the BLA-Per in larger samples across different age groups and stages of AD.
1. López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013;153(6):1194-217.
2. Zihl J, Reppermund S. The aging mind: A complex challenge for research and practice. Aging Brain. 2023;3:100060.
3. Emad S, Sediqe S, Hamide G, Simin A, Ruhollah T, Davood S-R. A Comparison of Language Features Between Patients With Alzheimer Disease and Their Healthy Counterparts. Journal of Modern Rehabilitation. 2020;14(1).
4. Rayathala J, Kumar K, Venkatesh P. Review on Alzheimer’s disease: Past, present and future. Journal of Innovations in Applied Pharmaceutical Science (JIAPS). 2022:28-31.
5. Zvěřová M. Clinical aspects of Alzheimer's disease. Clinical Biochemistry. 2019;72:3-6.
6. Maldonado J, Sher Y. Neurocognitive Disorders. In: Tasman A, Riba MB, Alarcón RD, Alfonso CA, Kanba S, Ndetei DM, et al., editors. Tasman’s Psychiatry. Cham: Springer International Publishing; 2020. p. 1-60.
7. Lamprini K. Emotional and Behavioral Symptoms in Neurodegenerative Diseases. In: Vlamos P, Kotsireas IS, Tarnanas I, editors. Handbook of Computational Neurodegeneration. Cham: Springer International Publishing; 2023. p. 347-66.
8. Krein L, Jeon YH, Miller Amberber A. Development of a new tool for the early identification of communication‐support needs in people living with dementia: An Australian face‐validation study. Health & Social Care in the Community. 2020;28(2):544-54.
9. Smirnova D, Smirnova T, Cumming P. Language Impairments in Dementia: From Word-Finding Difficulties to Everyday Conversation in a Dementia-Friendly Community. Dementia Care: Issues, Responses and International Perspectives. 2021:85-108.
10. Abrams L, Farrell MT. Language processing in normal aging. The handbook of psycholinguistic and cognitive processes: Psychology Press; 2011. p. 49-73.
11. Bates E, Harris C, Marchman V, Wulfeck B, Kritchevsky M. Production of complex syntax in normal ageing and alzheimer's disease. Language and Cognitive Processes. 1995;10(5):487-539.
12. Bryan K, Binder J, Funnell E, Ramsey V, Stevens S, Dann C. A screening instrument for language in older people (Barnes Language Assessment). Int J Lang Commun Disord. 2001;36 Suppl:188-93.
13. Ammar RB, Ayed YB. Language-related features for early detection of Alzheimer Disease. Procedia Computer Science. 2020;176:763-70.
14. Caramelli P, Mansur LL, Nitrini R. Chapter 32 - Language and Communication Disorders in Dementia of the Alzheimer Type. In: Stemmer B, Whitaker HA, editors. Handbook of Neurolinguistics. San Diego: Academic Press; 1998. p. 463-73.
15. Verma M, Howard RJ. Semantic memory and language dysfunction in early Alzheimer's disease: a review. International journal of geriatric psychiatry. 2012;27(12):1209-17.
16. Chapin K, Clarke N, Garrard P, Hinzen W. A finer-grained linguistic profile of Alzheimer's disease and Mild Cognitive Impairment. Journal of Neurolinguistics. 2022;63:101069.
17. Williams E, McAuliffe M, Theys C. Language changes in Alzheimer’s disease: a systematic review of verb processing. Brain and Language. 2021;223:105041.
18. Fraser KC, Meltzer JA, Rudzicz F. Linguistic Features Identify Alzheimer’s Disease in Narrative Speech. Journal of Alzheimer's Disease. 2016;49:407-22.
19. Eyigoz E, Mathur S, Santamaria M, Cecchi G, Naylor M. Linguistic markers predict onset of Alzheimer's disease. eClinicalMedicine. 2020;28.
20. Banovic S, Zunic LJ, Sinanovic O. Communication Difficulties as a Result of Dementia. Mater Sociomed. 2018;30(3):221-4.
21. Kempler D, Goral M. Language and Dementia: Neuropsychological Aspects. Annu Rev Appl Linguist. 2008;28:73-90.
22. Klimova B, Kuca K. Speech and language impairments in dementia. Journal of Applied Biomedicine. 2016;14(2):97-103.
23. Szatloczki G, Hoffmann I, Vincze V, Kalman J, Pakaski M. Speaking in Alzheimer’s disease, is that an early sign? Importance of changes in language abilities in Alzheimer’s disease. Frontiers in aging neuroscience. 2015;7:195.
24. Dooley S, Walshe M. Assessing cognitive communication skills in dementia: a scoping review. Int J Lang Commun Disord. 2019;54(5):729-41.
25. Panisset M, Roudier M, Saxton J, Boiler F. Severe impairment battery: a neuropsychological test for severely demented patients. Archives of neurology. 1994;51(1):41-5.
26. Armstrong L, Borthwick SE, Bayles KA, Tomoeda CK. Use of the Arizona Battery for Communication Disorders of Dementia in the UK. International Journal of Language & Communication Disorders. 1996;31(2):171-80.
27. Kim ES, Bayles KA. Communication in Late-Stage Alzheimer's Disease: Relation to Functional Markers of Disease Severity. Alzheimer's Care Today. 2007;8(1):43-52.
28. Helm-Estabrooks N. Cognitive Linguistic Quick Test. San Antonio, Texas: Psychological Corporation; 2001.
29. Macoir J, Fossard M, Lefebvre L, Monetta L, Renard A, Tran TM, et al. Detection Test for Language Impairments in Adults and the Aged-A New Screening Test for Language Impairment Associated With Neurodegenerative Diseases: Validation and Normative Data. Am J Alzheimers Dis Other Demen. 2017;32(7):382-92.
30. Aaronson N, Acquadro C, Alonso J, Apolone G, Bucquet D, Bullinger M, et al. International quality of life assessment (IQOLA) project. Quality of life research. 1992;1:349-51.
31. Bijankhan M, Sheykhzadegan J, Bahrani M, Ghayoomi M. Lessons from building a Persian written corpus: Peykare. Language Resources and Evaluation. 2011;45(2):143-64.
32. Miller C, Aghajanian-Stewart K. A Frequency Dictionary of Persian: Core vocabulary for learners: Routledge; 2017.
33. Foroughan M, Jafari Z, Shirin Bayan P, Ghaem Magham Farahani Z, Rahgozar M. Validation of Mini- Mental State Examination (MMSE) in The Elderly Population of Tehran. Advances in Cognitive Sciences. 2008;10(2):29-37.
34. Hertzog MA. Considerations in determining sample size for pilot studies. Research in nursing & health. 2008;31(2):180-91.
35. Guinn CI, Habash A, editors. Language analysis of speakers with dementia of the Alzheimer’s type. 2012 AAAI fall symposium series; 2012.
36. Assal F, Ghika J. Language capacities in dementia. Swiss Arch Neurol Psychiatry. 2013;164:280-5.
37. Mueller KD, Hermann B, Mecollari J, Turkstra LS. Connected speech and language in mild cognitive impairment and Alzheimer’s disease: A review of picture description tasks. Journal of clinical and experimental neuropsychology. 2018;40(9):917-39.
38. Marra C, Piccininni C, Masone Iacobucci G, Caprara A, Gainotti G, Costantini EM, et al. Semantic memory as an early cognitive marker of Alzheimer’s disease: Role of category and phonological verbal fluency tasks. Journal of Alzheimer's Disease. 2021;81(2):619-27.
39. Masumi J, Gharamaleki FF, Gilani N, Noroozian M, Khatoonabadi AR. Exploring language performance in people with mild cognitive impairment and Alzheimer's disease: a prospective longitudinal study. International Journal of Therapy And Rehabilitation. 2023;30(12):1-13.
40. Kim SN, Shin S. Storytelling Ability of Patients With Dementia of the Alzheimer’s Type as a Function of Auditory Cues. Journal of Speech. 2024;33(4):011-20.
41. Clouston SAP, Smith DM, Mukherjee S, Zhang Y, Hou W, Link BG, et al. Education and Cognitive Decline: An Integrative Analysis of Global Longitudinal Studies of Cognitive Aging. The Journals of Gerontology: Series B. 2020;75(7):e151-e60.
42. Hersi M, Irvine B, Gupta P, Gomes J, Birkett N, Krewski D. Risk factors associated with the onset and progression of Alzheimer’s disease: A systematic review of the evidence. NeuroToxicology. 2017;61:143-87.
43. Wilson RS, Wang T, Yu L, Grodstein F, Bennett DA, Boyle PA. Cognitive Activity and Onset Age of Incident Alzheimer Disease Dementia. Neurology. 2021;97(9):e922-e9.
44. Farfel JM, Nitrini R, Suemoto CK, Grinberg LT, Ferretti REL, Leite REP, et al. Very low levels of education and cognitive reserve: a clinicopathologic study. Neurology. 2013;81(7):650-7.
45. Woods DL, Wyma JM, Herron TJ, Yund EW. The effects of aging, malingering, and traumatic brain injury on computerized trail-making test performance. PloS one. 2015;10(6):e0124345.
46. Ruffolo LF, Guilmette TJ, Willis GW. FORUM Comparison of Time and Error Rates on the Trail Making Test Among Patients with Head Injuries, Experimental Malingerers, Patients with Suspect Effort on Testing, and Normal Controls. The Clinical Neuropsychologist. 2000;14(2):223-30.
47. Nathan J, Wilkinson D, Stammers S, Low JL. The role of tests of frontal executive function in the detection of mild dementia. International Journal of Geriatric Psychiatry. 2001;16(1):18-26.
48. Hoffman P, Morcom AM. Age-related changes in the neural networks supporting semantic cognition: A meta-analysis of 47 functional neuroimaging studies. Neuroscience & Biobehavioral Reviews. 2018;84:134-50.
49. Caputi N, Di Giacomo D, Aloisio F, Passafiume D. Deterioration of semantic associative relationships in mild cognitive impairment and Alzheimer Disease. Applied Neuropsychology: Adult. 2016;23(3):186-95.
50. Krein L, Jeon Y-H, Amberber AM, Fethney J. The assessment of language and communication in dementia: A synthesis of evidence. The American Journal of Geriatric Psychiatry. 2019;27(4):363-77.
2. Zihl J, Reppermund S. The aging mind: A complex challenge for research and practice. Aging Brain. 2023;3:100060.
3. Emad S, Sediqe S, Hamide G, Simin A, Ruhollah T, Davood S-R. A Comparison of Language Features Between Patients With Alzheimer Disease and Their Healthy Counterparts. Journal of Modern Rehabilitation. 2020;14(1).
4. Rayathala J, Kumar K, Venkatesh P. Review on Alzheimer’s disease: Past, present and future. Journal of Innovations in Applied Pharmaceutical Science (JIAPS). 2022:28-31.
5. Zvěřová M. Clinical aspects of Alzheimer's disease. Clinical Biochemistry. 2019;72:3-6.
6. Maldonado J, Sher Y. Neurocognitive Disorders. In: Tasman A, Riba MB, Alarcón RD, Alfonso CA, Kanba S, Ndetei DM, et al., editors. Tasman’s Psychiatry. Cham: Springer International Publishing; 2020. p. 1-60.
7. Lamprini K. Emotional and Behavioral Symptoms in Neurodegenerative Diseases. In: Vlamos P, Kotsireas IS, Tarnanas I, editors. Handbook of Computational Neurodegeneration. Cham: Springer International Publishing; 2023. p. 347-66.
8. Krein L, Jeon YH, Miller Amberber A. Development of a new tool for the early identification of communication‐support needs in people living with dementia: An Australian face‐validation study. Health & Social Care in the Community. 2020;28(2):544-54.
9. Smirnova D, Smirnova T, Cumming P. Language Impairments in Dementia: From Word-Finding Difficulties to Everyday Conversation in a Dementia-Friendly Community. Dementia Care: Issues, Responses and International Perspectives. 2021:85-108.
10. Abrams L, Farrell MT. Language processing in normal aging. The handbook of psycholinguistic and cognitive processes: Psychology Press; 2011. p. 49-73.
11. Bates E, Harris C, Marchman V, Wulfeck B, Kritchevsky M. Production of complex syntax in normal ageing and alzheimer's disease. Language and Cognitive Processes. 1995;10(5):487-539.
12. Bryan K, Binder J, Funnell E, Ramsey V, Stevens S, Dann C. A screening instrument for language in older people (Barnes Language Assessment). Int J Lang Commun Disord. 2001;36 Suppl:188-93.
13. Ammar RB, Ayed YB. Language-related features for early detection of Alzheimer Disease. Procedia Computer Science. 2020;176:763-70.
14. Caramelli P, Mansur LL, Nitrini R. Chapter 32 - Language and Communication Disorders in Dementia of the Alzheimer Type. In: Stemmer B, Whitaker HA, editors. Handbook of Neurolinguistics. San Diego: Academic Press; 1998. p. 463-73.
15. Verma M, Howard RJ. Semantic memory and language dysfunction in early Alzheimer's disease: a review. International journal of geriatric psychiatry. 2012;27(12):1209-17.
16. Chapin K, Clarke N, Garrard P, Hinzen W. A finer-grained linguistic profile of Alzheimer's disease and Mild Cognitive Impairment. Journal of Neurolinguistics. 2022;63:101069.
17. Williams E, McAuliffe M, Theys C. Language changes in Alzheimer’s disease: a systematic review of verb processing. Brain and Language. 2021;223:105041.
18. Fraser KC, Meltzer JA, Rudzicz F. Linguistic Features Identify Alzheimer’s Disease in Narrative Speech. Journal of Alzheimer's Disease. 2016;49:407-22.
19. Eyigoz E, Mathur S, Santamaria M, Cecchi G, Naylor M. Linguistic markers predict onset of Alzheimer's disease. eClinicalMedicine. 2020;28.
20. Banovic S, Zunic LJ, Sinanovic O. Communication Difficulties as a Result of Dementia. Mater Sociomed. 2018;30(3):221-4.
21. Kempler D, Goral M. Language and Dementia: Neuropsychological Aspects. Annu Rev Appl Linguist. 2008;28:73-90.
22. Klimova B, Kuca K. Speech and language impairments in dementia. Journal of Applied Biomedicine. 2016;14(2):97-103.
23. Szatloczki G, Hoffmann I, Vincze V, Kalman J, Pakaski M. Speaking in Alzheimer’s disease, is that an early sign? Importance of changes in language abilities in Alzheimer’s disease. Frontiers in aging neuroscience. 2015;7:195.
24. Dooley S, Walshe M. Assessing cognitive communication skills in dementia: a scoping review. Int J Lang Commun Disord. 2019;54(5):729-41.
25. Panisset M, Roudier M, Saxton J, Boiler F. Severe impairment battery: a neuropsychological test for severely demented patients. Archives of neurology. 1994;51(1):41-5.
26. Armstrong L, Borthwick SE, Bayles KA, Tomoeda CK. Use of the Arizona Battery for Communication Disorders of Dementia in the UK. International Journal of Language & Communication Disorders. 1996;31(2):171-80.
27. Kim ES, Bayles KA. Communication in Late-Stage Alzheimer's Disease: Relation to Functional Markers of Disease Severity. Alzheimer's Care Today. 2007;8(1):43-52.
28. Helm-Estabrooks N. Cognitive Linguistic Quick Test. San Antonio, Texas: Psychological Corporation; 2001.
29. Macoir J, Fossard M, Lefebvre L, Monetta L, Renard A, Tran TM, et al. Detection Test for Language Impairments in Adults and the Aged-A New Screening Test for Language Impairment Associated With Neurodegenerative Diseases: Validation and Normative Data. Am J Alzheimers Dis Other Demen. 2017;32(7):382-92.
30. Aaronson N, Acquadro C, Alonso J, Apolone G, Bucquet D, Bullinger M, et al. International quality of life assessment (IQOLA) project. Quality of life research. 1992;1:349-51.
31. Bijankhan M, Sheykhzadegan J, Bahrani M, Ghayoomi M. Lessons from building a Persian written corpus: Peykare. Language Resources and Evaluation. 2011;45(2):143-64.
32. Miller C, Aghajanian-Stewart K. A Frequency Dictionary of Persian: Core vocabulary for learners: Routledge; 2017.
33. Foroughan M, Jafari Z, Shirin Bayan P, Ghaem Magham Farahani Z, Rahgozar M. Validation of Mini- Mental State Examination (MMSE) in The Elderly Population of Tehran. Advances in Cognitive Sciences. 2008;10(2):29-37.
34. Hertzog MA. Considerations in determining sample size for pilot studies. Research in nursing & health. 2008;31(2):180-91.
35. Guinn CI, Habash A, editors. Language analysis of speakers with dementia of the Alzheimer’s type. 2012 AAAI fall symposium series; 2012.
36. Assal F, Ghika J. Language capacities in dementia. Swiss Arch Neurol Psychiatry. 2013;164:280-5.
37. Mueller KD, Hermann B, Mecollari J, Turkstra LS. Connected speech and language in mild cognitive impairment and Alzheimer’s disease: A review of picture description tasks. Journal of clinical and experimental neuropsychology. 2018;40(9):917-39.
38. Marra C, Piccininni C, Masone Iacobucci G, Caprara A, Gainotti G, Costantini EM, et al. Semantic memory as an early cognitive marker of Alzheimer’s disease: Role of category and phonological verbal fluency tasks. Journal of Alzheimer's Disease. 2021;81(2):619-27.
39. Masumi J, Gharamaleki FF, Gilani N, Noroozian M, Khatoonabadi AR. Exploring language performance in people with mild cognitive impairment and Alzheimer's disease: a prospective longitudinal study. International Journal of Therapy And Rehabilitation. 2023;30(12):1-13.
40. Kim SN, Shin S. Storytelling Ability of Patients With Dementia of the Alzheimer’s Type as a Function of Auditory Cues. Journal of Speech. 2024;33(4):011-20.
41. Clouston SAP, Smith DM, Mukherjee S, Zhang Y, Hou W, Link BG, et al. Education and Cognitive Decline: An Integrative Analysis of Global Longitudinal Studies of Cognitive Aging. The Journals of Gerontology: Series B. 2020;75(7):e151-e60.
42. Hersi M, Irvine B, Gupta P, Gomes J, Birkett N, Krewski D. Risk factors associated with the onset and progression of Alzheimer’s disease: A systematic review of the evidence. NeuroToxicology. 2017;61:143-87.
43. Wilson RS, Wang T, Yu L, Grodstein F, Bennett DA, Boyle PA. Cognitive Activity and Onset Age of Incident Alzheimer Disease Dementia. Neurology. 2021;97(9):e922-e9.
44. Farfel JM, Nitrini R, Suemoto CK, Grinberg LT, Ferretti REL, Leite REP, et al. Very low levels of education and cognitive reserve: a clinicopathologic study. Neurology. 2013;81(7):650-7.
45. Woods DL, Wyma JM, Herron TJ, Yund EW. The effects of aging, malingering, and traumatic brain injury on computerized trail-making test performance. PloS one. 2015;10(6):e0124345.
46. Ruffolo LF, Guilmette TJ, Willis GW. FORUM Comparison of Time and Error Rates on the Trail Making Test Among Patients with Head Injuries, Experimental Malingerers, Patients with Suspect Effort on Testing, and Normal Controls. The Clinical Neuropsychologist. 2000;14(2):223-30.
47. Nathan J, Wilkinson D, Stammers S, Low JL. The role of tests of frontal executive function in the detection of mild dementia. International Journal of Geriatric Psychiatry. 2001;16(1):18-26.
48. Hoffman P, Morcom AM. Age-related changes in the neural networks supporting semantic cognition: A meta-analysis of 47 functional neuroimaging studies. Neuroscience & Biobehavioral Reviews. 2018;84:134-50.
49. Caputi N, Di Giacomo D, Aloisio F, Passafiume D. Deterioration of semantic associative relationships in mild cognitive impairment and Alzheimer Disease. Applied Neuropsychology: Adult. 2016;23(3):186-95.
50. Krein L, Jeon Y-H, Amberber AM, Fethney J. The assessment of language and communication in dementia: A synthesis of evidence. The American Journal of Geriatric Psychiatry. 2019;27(4):363-77.
| Issue | Articles in Press | |
| Section | Research Article(s) | |
| Keywords | ||
| Alzheimer Disease, Aging, Language Tests, Psychometrics, Test Validity, Test Reliability | ||
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How to Cite
1.
Khatoonabadi AR, Modarres Zadeh A, Jafari S, Maroufizadeh S, Brayan K. Translation, Cultural Adaptation, and Validity of Barnes Language Assessment in Persian Ageing Population: A Preliminary Study. jmr. 2025;(-).
