Cross-Cultural Adaptation and Psychometric Evaluation of the Persian Cognitive Assessment Scale for Stroke Patients: A Cross-Sectional Study.

BACKGROUND AND AIMS: This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Persian Cognitive Assessment Scale for Stroke Patients (P-CASP).

METHODS

In this cross-sectional psychometric study, 136 individuals with stroke and 60 age- and sex-matched healthy controls were enrolled. Translation and cultural adaptation followed the Beaton and Dewey protocol. Content validity was assessed using CVR and CVI based on ratings from 20 experts. Concurrent validity was assessed using Pearson's correlation with the MMSE, and known-groups validity was examined by comparing stroke and control groups. Test-retest reliability was assessed in 76 participants over 2 weeks. Internal consistency was estimated using Guttman's lambda-2 (λ2). Measurement error was assessed using MDC95, and ROC analysis evaluated discrimination between groups.

RESULTS

CVR and CVI ranged from 0.70 to 1.00 and 0.95-1.00, respectively. P-CASP scores correlated strongly with MMSE scores (r = 0.886, p < 0.001). Known-groups validity was supported by a significant between-group difference (t = 7.508, p < 0.001; Cohen's d = 1.36). Internal consistency was high (λ2 = 0.922), and test-retest reliability was excellent (ICC = 0.997, 95% CI: 0.996-0.998). MDC95 was 1.66 points. ROC analysis showed excellent discrimination (AUC = 0.980, 95% CI: 0.93-0.98); a cutoff of 31.25 yielded 100% sensitivity and 73.7% specificity.

CONCLUSION

The P-CASP demonstrated strong validity, high internal consistency, excellent test-retest reliability, and good discriminative performance. It may provide a practical cognitive assessment tool for individuals with stroke, including those with aphasia. Further factor-analytic and longitudinal studies are warranted.