Spanish Translation and Validation of the Medication Management Ability Assessment
Garcia, Joshua M.
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Impairment in daily function is required for a dementia diagnosis, but no gold standard exists on how to assess this in clinical and research settings. Assessment of daily function often relies on self-report by the patient or on the report of a knowledgeable informant (e.g., spouse, caregiver). However, these subjective methods are vulnerable to unrelated factors, like insight, depression, and caregiver distress. Performance-based functional assessments (PBFAs) objectively assess an individual’s functional ability in activities of daily living and have demonstrated several advantages to subjective measures. In the context of Alzheimer’s disease and related dementias, certain communities are at increased risk but less likely to be engaging in research. One reason for this may be the lack of culturally appropriate tools. To address this limitation, we translated and validated the Medication Management Abilities Assessment (MMAA) from English to Spanish to increase the number of culturally-sensitive diagnostic tools available for use with Hispanic/Latin Americans, as well as provide a promising measure for medication adherence in this population. Face validity was demonstrated through a focus group (n=6) to revise the translation to acceptable contextual and cultural conditions, while construct validity was demonstrated with a multitrait-multimethod approach through a pilot sample (n=60) that completed psychological and cognitive assessment measures. The hypotheses for establishing convergent and discriminant validity were overall supported by the pilot sample analysis. The test-retest reliability estimate of the MMAA was medium in effect size and demonstrated a small practice effect. PBFAs and objective measures of cognition were significantly and positively associated with medium effect sizes. The self-reported measures of daily function and cognition, as well as the verbal health literacy and reading test were not significantly associated with MMAA performance. The present study provides a measure to further expand the potential clinical utility of PBFAs in culturally diverse, Spanish-speaking populations.