Traducción y adaptación de la escala Disability Assessment for Dementia en población española / Translation and adaptation of the Disability Assessment for Dementia scale in the Spanish population

Antecedentes y objetivo La evaluación funcional es relevante en pacientes con deterioro cognitivo (DC). La escala Disability Assessment for Dementia (DAD) mide la capacidad funcional y su uso está cada vez más extendido. El objetivo es realizar una traducción y adaptación cultural de la escala DAD para generar una versión española: DAD-E. Pacientes y método: Se ha desarrollado un proceso de doble traducción y traducción inversa, un estudio piloto con 14 cuidadores de pacientes con deterioro cognitivo y 3 reuniones de consenso. Resultados: El DAD-E mantiene los 40 ítems originales. Se han añadido a la codificación de respuestas y puntuaciones originales 4 opciones de respuesta y 8 puntuaciones con el objetivo de detectar la discapacidad funcional exclusivamente causada por DC. Se han modificado y ampliado las instrucciones de administración para mejorar la fiabilidad del contenido. Conclusiones: La versión DAD-E supone una adaptación lingüística y cultural equivalente de la escala original, lo que permite su uso en nuestro contexto español. Puede ser un instrumento de gran utilidad clínica, ya que proporciona una evaluación más precisa de la discapacidad funcional causada por DC (AU)

Background and objective: Functional assessment is especially relevant in patients with cognitive impairment (CI). The Disability Assessment for Dementia (DAD) scale assesses functional ability and its use is becoming increasingly popular. This study aims to perform the translation and cultural adaptation of the DAD scale in order to create a Spanish version: DAD-E. Patients and method: A double translation/back-translation process was developed, as well as a pilot study with 14 caregivers of patients with CI, and 3 review meetings to achieve general agreement. Results: The DAD-E includes the 40 original items. Four response options and 8 scores were added in order to detect functional disability induced by CI independently of other possible causes. More detailed instructions for administration and scoring of the scale have been provided in order to improve the reliability of the content. Conclusions: The DAD-E was shown to be a cultural and linguistic adaptation equivalent of the original scale, which allows it to be applied to the Spanish population. It may be a useful instrument in clinical practice since it provides a more accurate assessment of functional disability due to cognitive impairment (AU)

Translation and adaptation of the Disability Assessment for Dementia scale in the Spanish population. / Traducción y adaptación de la escala Disability Assessment for Dementia en población española.

BACKGROUND AND OBJECTIVE: Functional assessment is especially relevant in patients with cognitive impairment (CI). The Disability Assessment for Dementia (DAD) scale assesses functional ability and its use is becoming increasingly popular. This study aims to perform the translation and cultural adaptation of the DAD scale in order to create a Spanish version: DAD-E. PATIENTS AND METHOD: A double translation/back-translation process was developed, as well as a pilot study with 14 caregivers of patients with CI, and 3 review meetings to achieve general agreement. RESULTS: The DAD-E includes the 40 original items. Four response options and 8 scores were added in order to detect functional disability induced by CI independently of other possible causes. More detailed instructions for administration and scoring of the scale have been provided in order to improve the reliability of the content. CONCLUSIONS: The DAD-E was shown to be a cultural and linguistic adaptation equivalent of the original scale, which allows it to be applied to the Spanish population. It may be a useful instrument in clinical practice since it provides a more accurate assessment of functional disability due to cognitive impairment.

Estrategia de tratamiento de la enfermedad de Fabry tras un ictus. Réplica / Treatment strategy for Fabry's disease following a stroke. Reply

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Enfermedad de Fabry desde la perspectiva del neurólogo: ¿una causa infrecuente de ictus? / Fabry disease from the neurologist’s point of view: is it a rare cause of strokes?

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[Biomarkers in the cerebrospinal fluid of patients with mild cognitive impairment: a meta-analysis of their predictive capacity for the diagnosis of Alzheimer's disease]. / Biomarcadores en el liquido cefalorraquideo de pacientes con deterioro cognitivo leve: metaanalisis de su capacidad predictiva para el diagnostico de la enfermedad de Alzheimer.

INTRODUCTION: Several studies have reported alterations in the cerebrospinal fluid biomarkers (Abeta-42, T-tau and P-tau proteins), both in Alzheimer's disease (AD) and in mild cognitive impairment (MCI). AIM: To perform a meta-analysis of the diagnostic yield of this technique for the prediction of patients with MCI who are going to progress to AD. MATERIALS AND METHODS: A search was conducted in PubMed and Embase of papers published between 1999 and September 2008, and as a result only prospective studies were included for the systematic review. The sensitivity and specificity for each biomarker were studied separately and also jointly. RESULTS: Of the 12 studies that were included, 6 quantified the Abeta-42 protein, 11 the T-tau protein and seven the P-tau protein. In three of the studies data was obtained from the three biomarkers in combination. The sensitivity of the quantification of the T-tau and P-tau proteins is 82%, with a diagnostic odds ratio of 12.09 (confidence interval 95%, CI 95% = 7.71-18.99; p = 0.1) and 16.29 (CI 95% = 9.69-27.4; p = 0.9), respectively. Alteration of any of the three biomarkers has a specificity of 87%, with a diagnostic odds ratio of 35.97 (CI 95% = 7.8-164.6; p = 0.04). CONCLUSIONS: The isolated alteration of T-tau or P-tau levels in cerebrospinal fluid is very sensitive for differentiating between patients with MCI who are going to develop AD and those who are going to remain stable. Normality of the three biomarkers is a very reliable way of ruling out the progression of AD in patients with MCI.