COSMIN database

Insufficient cross-cultural adaptations and psychometric properties for many translated health assessment scales: a systematic review

Uysal-Bozkir, O., Parlevliet, J. L., and de Rooij, S. E.
OBJECTIVES: If researchers want to assess reliably different aspects of general health in the migrant populations, they need translations of internationally used health assessment scales with appropriate cross-cultural adaptations and satisfactory psychometric properties. A systematic review was performed to assess the quality of the cross-cultural adaptations and the psychometric properties of health assessment scales measuring cognition, mood, activities of daily living, health-related quality of life, and loneliness. We focused on the scales that were adapted for use with Turkish, Arab, and Surinamese (Creole and Hindi) individuals aged 65 years and older.

STUDY DESIGN AND SETTING: PubMed, PsycINFO, and EMBASE databases were systematically searched, and selected articles were cross-checked for other relevant publications.

RESULTS: In total, 68 relevant studies of the Turkish, Arab, and Surinamese populations were identified. To arrive at an appropriate cross-culturally adapted scale, five steps are required. Six studies followed this complete process. Only a few studies assessed all the psychometric properties of the cross-culturally adapted scales. The studies in which these were best assessed primarily involved cognitive and functional scales.

CONCLUSION: Cross-cultural adaptations are insufficient, and psychometric properties are unknown for many translated health assessment scales.
J Clin Epidemiol
1878-5921 (Electronic)
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Physical state
Functional status:
Cognitive/mental functioning
Physical functioning
Social functioning
Overall quality of life:
Overall quality of life
Seniors (65+)
Certain infections and parasitic diseases and related symptoms
Codes for special purposes
Congenital malformations, deformations and chromosomal abnormalities and related symptoms
Diseases of and symptoms related to the blood and blood-forming organs and certain disorders involving the immune mechanism
Diseases of and symptoms related to the circulatory system
Diseases of and symptoms related to the digestive system
Diseases of and symptoms related to the ear and mastoid process
Diseases of and symptoms related to the eye and adnexa
Diseases of and symptoms related to the genitourinary system
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Diseases of and symptoms related to the nervous system
Diseases of and symptoms related to the respiratory system
Diseases of and symptoms related to the skin and subcutaneous tissue
Endocrine, nutritional and metabolic diseases and related symptoms
External causes of morbidity and mortality
Injury, poisoning and certain other consequences of external causes
Mental and behavioural disorders and related symptoms
Neoplasms and related symptoms
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
3W3S - Three Words-Three Shapes test
ADAS - Alzheimer’s Disease Assessment Scale (versions: ADAS-Noncog; VCB-ADAS)
BCST - Brookdale Cognitive Screening Test
BDI - Beck Depression Inventory (versions: mBDI)   
BI - Barthel Index   
BOMC - Blessed Orientation-Memory- Concentration Test
CDR - Clinical Dementia Rating scale
CES-D - Centre for Epidemiologic Studies-Depression Scale (versions: CES-D-R; CES-D-8; CES-D-10; CES-D-11; CES-D-15; CES-D-20; CES-D-Children; CES-D-SF; CES-D m)   
CIDI - Composite International Diagnostic Interview
COOP/WONCA charts - COOP/WONCA Functional Healh assessment charts   
CSDD - Cornell Scale for Depression in Dementia
CTT - Color Trail Test (versions: CCTT - Children's CTT)
DS test - Digit Span test (versions: Visual aural DS test; FDS - Forward DS test; BDS - Backward DS)
Enhanced cued recall
FIM - Functional Independence Measure (versions: FIMmodified; FIM observation; FIM phone)
GDS - Geriatric Depression Scale (versions: GDS-SF; GDS-5; GDS-15)   
GDS - Global Deterioration scale
GHQ - General Health Questionnaire (versions: original = GHQ-60; GHQ-12; GHQ-20; GHQ-28; GHQW-30; GHQ-36)
HADS - Hospital Anxiety and Depression Scale   
HAM-D - Hamilton Rating Scale for Depression [alias: HAMD; HDRS; HRSD]   
Hodkinson Mental Test
HRQOL - health-related quality of life
Katz ADL - Katz’ Index Of Independence In Activities Of Daily Living (versions: KATZ-1; KATZ-2; other modifications)    | 
MEAMS - Middlesex Elderly Assessment of Mental State
MMSE - Mini-Mental State Examination (versions: MMSE-illiterate; telephone MMSE; VCB-MMSE - Videoconference-based-MMSE)   
NEADL - Nottingham Extended Activities of Daily Living Scale   
Rankin scale
RMI - Rivermead Mobility Index   
SCID - Structured Clinical Interview (versions: SCID-III-R - for DSM-III-R; SCID-I - for DSM-1; SCID-5 - for DSM-5; SCID-NP - for DSMIII-R-NP Complicated Grief Module)
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
Short Orientation-Memory-Concentration test
STMS - Short Test of Mental Status
UCLA Loneliness Scale - University of California Los Angeles Loneliness Scale (versions: r-UCLA Loneliness Scale)
Visual-verbal test
WHOQOL-BREF - World Health Organization Quality of Life questionnaire–Abbreviated Questionnaire (versions: WHOQOL-HIV-BREF)