Translation and cultural adaptation of Rowland universal dementia assessment scale (RUDAS) and European cross-cultural neuropsychological test battery (CNTB) into Italian.

BACKGROUND

An increasing number of Culturally and Linguistically Diverse (CALD) patients have sought cognitive assessment in Italian Centers for Cognitive Disorders and Dementia (CCDDs) in recent years; however, validated cross-cultural cognitive tools in Italian remain limited. The Rowland Universal Dementia Assessment Scale (RUDAS) and the European Cross-Cultural Neuropsychological Test Battery (CNTB) were developed to minimize linguistic and cultural bias.

OBJECTIVE

To translate and culturally adapt the RUDAS and CNTB into Italian for use in Italian CCDDs, both with native Italian speakers and with CALD patients assessed via trained cultural mediators.

METHODS

A step-by-step methodology was applied: forward translation, synthesis I, blind backward translation, synthesis II, and cognitive debriefing. Two bilingual and bicultural translator pairs completed the translations. Pre-final versions were tested in 40 monolingual Italian participants (8 mild cognitive impairment, 8 dementia, 24 healthy controls; mean age 71.4 ± 10.1 years; mean education 9.9 ± 3.8 years). The purpose of this phase was exclusively to evaluate comprehensibility, conceptual clarity, and cultural appropriateness; no psychometric or normative analyses were performed. Two subtests of CNTB could not be translated due to copyright restrictions.

RESULTS

Only minor adaptations were necessary. In the RUDAS memory item, "tea" was replaced with "coffee" and "cooking oil" with "olive oil," reflecting Italian cultural familiarity. Within the CNTB, only the Enhanced Cued Recall Task and Serial Threes required clarification.

CONCLUSION

The Italian versions of the RUDAS and CNTB required minimal adaptation. Future studies should assess psychometric properties, diagnostic accuracy, and normative performance in both native Italian and CALD populations.