Systematic review and meta-
analysis of reliability of assessment
instruments for Frontotemporal
Dementia
Revisión sistemática y metaanálisis de abilidad
de los instrumentos de evaluación para la Demencia
Frontotemporal
Andrés Ramírez 1*, Pedro Muñoz 2, Vanessa Quito-Calle 3, Sofía Vintimilla 4, Esteban Cañizares 5
1 Salesian Polytechnic University; aramirezc1@ups.edu.ec. Cuenca, Ecuador.
2 Salesian Polytechnic University; pmunoza@ups.edu.ec. Cuenca, Ecuador.
3 Salesian Polytechnic University; jquito@ups.edu.ec. Cuenca, Ecuador.
4 University of El Salvador; sovintimillag@gmail.com. Buenos Aires, Argentina.
5 Salesian Polytechnic University; lcanizaresa@ups.edu.ec. Cuenca, Ecuador.
How to cite:
Ramírez Coronel, A. A., Muñoz Arteaga, P. A., Quito Calle, J. V., & Vintimilla Guillén, S. C. (2025). Systematic
review and meta-analysis of the reliability of assessment instruments for frontotemporal dementia. Revista
MultidisciplinariaInvestigación Contemporánea, 3(2), 176–208. https://doi.org/10.58995/redlic.rmic.v3.n2.
a114
Article Information
Received: 24-01-2025
Accepted: 19-03-2025
Published: 01-07-2025
Editor’s Note
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claims in published messages and institutional
afliations.
Editorial
Latin American Editorial Network for
Contemporary Research (REDLIC)
www.editorialredlic.com
Funding Sources
The research was conducted using the authors’
own resources.
Conicts of Interest
No conicts of interest are declared.
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Revista multidisciplinaria
Investigación Contemporánea 07 - 2025 Vol. 3 - No. 2 ISSN-e: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Leucemia de células dendríticas plasmocitoides
- estudio y diagnóstico de un caso 49 -49
Copyright (c) 2025 Faicán Rocano Pedro Fernando, Dután Pérez Ibelice Salomé,
González González Camila Raquel, Matute Aguiar Joselyn Nayeli, Rodríguez Ver-
dugo Alejandra Valentina.
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Resumen de licencia - Texto completo de la licencia
Review article. Revista MultidisciplinariaInvestigación Contemporánea.
Vol. 3 - No. 2, pp. 176 - 208. July-December, 2025. e-ISSN: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a114
Revista multidisciplinaria
Investigación Contemporánea 07 - 2025 Vol. 3 - No. 2 ISSN-e: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Leucemia de células dendríticas plasmocitoides
- estudio y diagnóstico de un caso 32 -49
Artículo Caso clínico. Revista multidisciplinaria investigación Contemporánea.
Vol. 3 - No. 2, pp. 32 - 49. julio-diciembre, 2025. e-ISSN: 2960-8015
Leucemia de células dendríticas
plasmocitoides - estudio y diagnóstico
de un caso
Leucemia de células dendríticas plasmocitoides - estudio y
diagnóstico de un caso
Información del artículo:
Recibido: 05-12-2024
Aceptado: 21-02-2025
Publicado: 01-07-2025
Nota del editor:
REDLIC se mantiene neutral con respecto a
reclamos jurisdiccionales en mensajes publi-
cados y aliaciones institucionales.
Editorial:
Red Editorial Latinoamericana de Investigación
Contemporánea (REDLIC) www.editorialredlic.com
Fuentes de nanciamiento:
La investigación fue realizada con recursos propios.
Conictos de interés:
No presentan conicto de intereses.
Este texto está protegido por una licencia Creative Commons 4.0.
Usted es libre para Compartir —copiar y redistribuir el material en cual-
quier medio o formato— y Adaptar el documento —remezclar, transformar
y crear a partir del material— para cualquier propósito, incluso para nes
comerciales, siempre que cumpla la condición de:
Atribución: Usted debe dar crédito a la obra original de manera adecuada,
proporcionar un enlace a la licencia, e indicar si se han realizado cambios.
Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugie-
ra que tiene el apoyo del licenciante o lo recibe por el uso que hace de la obra
1 Docente Investigador; pedro.faican@ucacue.edu.ec. Azogues, Ecuador.
2 Estudiante; ibelice.dutan.44@est.ucacue.edu.ec. Azogues, Ecuador.
3 Estudiante; camila.gonzalez.66@est.ucacue.edu.ec. Azogues, Ecuador.
4 Estudiante; joselyn.matute.44@est.ucacue.edu.ec. Azogues, Ecuador.
5 Estudiante; alejandra.rodriguez.60@est.ucacue.edu.ec. Azogues, Ecuador.
Faicán Rocano Pedro Fernando 1, Dután Pérez Ibelice Salomé 2, González González Camila
Raquel 3, Matute Aguiar Joselyn Nayeli 4, Rodríguez Verdugo Alejandra Valentina 5
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Cómo citar:
Faican Rocano, P. . F., Dután Pérez, I. S. ., González González, C. R. ., Rodríguez Verdugo, A. V. ., & Matute Aguiar, J.
N. . (2025). Leucemia de células dendríticas plasmocitoides - estudio y diagnóstico de un caso.
Revista Multidisci-
plinaria Investigación Contemporánea
, 3(2), 32-49. https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Revista multidisciplinaria
Investigación Contemporánea 07 - 2025 Vol. 3 - No. 2 ISSN-e: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a114
Revisión sistemática y metaanálisis de abilidad de los instrumentos
de evaluación para la Demencia Frontotemporal 176 - 208
Artículo de revisión. Revista multidisciplinaria investigación Contemporánea.
Vol. 3 - No. 2, pp. 176 - 208. julio-diciembre, 2025. e-ISSN: 2960-8015
Revisión sistemática y metaanálisis
de abilidad de los instrumentos
de evaluación para la Demencia
Frontotemporal
Systematic review and meta-analysis of reliability of
assessment instruments for frontotemporal dementia
Información del artículo:
Recibido: 24-01-2025
Aceptado: 19-03-2025
Publicado: 01-07-2025
Nota del editor:
REDLIC se mantiene neutral con respecto a
reclamos jurisdiccionales en mensajes publi-
cados y aliaciones institucionales.
Editorial:
Red Editorial Latinoamericana de Investigación
Contemporánea (REDLIC) www.editorialredlic.com
Fuentes de nanciamiento:
La investigación fue realizada con recursos propios.
Conictos de interés:
No presentan conicto de intereses.
Este texto está protegido por una licencia Creative Commons 4.0.
Usted es libre para Compartir —copiar y redistribuir el material en cual-
quier medio o formato— y Adaptar el documento —remezclar, transformar
y crear a partir del material— para cualquier propósito, incluso para nes
comerciales, siempre que cumpla la condición de:
Atribución: Usted debe dar crédito a la obra original de manera adecuada,
proporcionar un enlace a la licencia, e indicar si se han realizado cambios.
Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugie-
ra que tiene el apoyo del licenciante o lo recibe por el uso que hace de la obra
1 Universidad Politécnica Salesiana; aramirezc1@ups.edu.ec. Cuenca, Ecuador.
2 Universidad Politécnica Salesiana; pmunoza@ups.edu.ec. Cuenca, Ecuador.
3 Universidad Politécnica Salesiana; jquito@ups.edu.ec. Cuenca, Ecuador.
4 Universidad del Salvador; sovintimillag@gmail.com. Buenos Aires, Argentina.
5 Universidad Politécnica Salesiana; lcanizaresa@ups.edu.ec. Cuenca, Ecuador.
Andrés Ramírez 1*, Pedro Muñoz 2, Vanessa Quito-Calle 3, Sofía Vintimilla 4,
Esteban Cañizares 5
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a114
Cómo citar:
Ramírez Coronel, A. A., Muñoz Arteaga, P. A. ., Quito Calle , J. V. ., & Vintimilla Guillén, S. C. . (2025). Revisión
sistemática y meta-análisis de abilidad de los instrumentos de evaluación para la Demencia Frontotemporal
Revista Multidisciplinaria Investigación Contemporánea, 3(2) 176-208. https://doi.org/10.58995/redlic.rmic.v3.n2.
a114
Revista multidisciplinaria
investigación Contemporánea ISSN-e: 2960-8015Vol. 3 -No. 207 - 2025
Systematic review and meta-analysis of reliability of assessment
instruments for Frontotemporal Dementia
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a114
177-208
Summary
Introduction: Frontotemporal dementia (FTD) is a progressive form of dementia
that affects behavior and cognitive function. Assessing knowledge about this disease is
crucial for proper diagnosis and treatment. Several assessment instruments have been
adapted and validated in different cultural contexts, but their reliability varies. Objective:
To analyze the scientic literature on assessment instruments used to measure knowledge
and progression of FTD, in order to perform a meta-analysis of reliability, focusing on
Cronbach’s alpha in different cultural adaptations and contexts. Methodology: Four
scientic databases (Web of Science , Scopus , PsycINFO , and PubMed) on the reliability
(Cronbach’s alpha) of FTD assessment instruments in various populations. Information
was collected on the population, validation method, cultural context, and internal
consistency (Cronbach’s alpha) of each instrument. Results: Results showed that the
internal consistency of the instruments varies according to context. For example, the
FTDKS obtained an alpha of .846 in the United States, .740 in Spanish-speaking countries,
and .800 in Poland. The FTD-FRS showed an exceptional alpha of .975 in Brazil. The meta-
analytic model ( nStudies = 3) demonstrated an overall reliability of .85 (CI α = .80 - .90).
Conclusion: FTD assessment instruments vary in their reliability depending on the cultural
context. Appropriate adaptations are essential to improve its effectiveness in assessing
disease knowledge, thus facilitating better diagnosis and patient care.
Keywords: Meta-analysis, reliability, Psychometrics, Frontotemporal Dementia.
Resumen
Introducción: La demencia frontotemporal (DFT) es una forma progresiva de
demencia que afecta el comportamiento y la función cognitiva. Evaluar el conocimiento
sobre esta enfermedad es crucial para un diagnóstico y tratamiento adecuados. Varios
instrumentos de evaluación se han adaptado y validado en diferentes contextos culturales,
pero su conabilidad varía. Objetivo: Analizar la literatura cientíca sobre herramientas
de evaluación utilizadas para medir el conocimiento y la progresión de la DFT, con el
objetivo de realizar un metaanálisis de conabilidad, centrándose en el alfa de Cronbach en
diferentes adaptaciones culturales y contextos. Metodología: Se revisaron cuatro bases de
datos cientícas (Web of Science, Scopus, PsycINFO y PubMed) para recopilar información
sobre la conabilidad (alfa de Cronbach) de las herramientas de evaluación de la DFT en
diversas poblaciones. Se recopilaron datos sobre la población, el método de validación,
el contexto cultural y la consistencia interna (alfa de Cronbach) de cada instrumento.
Resultados: Los hallazgos mostraron que la consistencia interna de los instrumentos varía
según el contexto. Por ejemplo, la FTDKS obtuvo un alfa de Cronbach de 0,846 en Estados
Unidos, 0,740 en países 2. hispanohablantes y 0,800 en Polonia. La FTD-FRS mostró un alfa
excepcional de 0,975 en Brasil. El modelo de metaanálisis (nEstudios = 3) demostró una
abilidad general de 0,85 (CIα = 0,80-0,90). Conclusión: Las herramientas de evaluación de
la DFT presentan variaciones en su abilidad según el contexto cultural. Es fundamental
realizar adaptaciones adecuadas para mejorar su ecacia en la evaluación del conocimiento
sobre la enfermedad, facilitando así un mejor diagnóstico y atención al paciente.
Palabras clave: Metaanálisis, abilidad, psicometría, demencia frontotemporal
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Introduction
Frontotemporal dementia (FTD) is an umbrella term for a variety
of neurodegenerative disorders characterized by predominant atrophy
of the frontal and temporal lobes of the brain, manifesting primarily
through changes in behavior, personality, and language (1). Unlike other
forms of dementia such as Alzheimer’s, FTD occurs in younger individuals,
usually between 40 and 65 years of age, with symptoms primarily affecting
executive function, social behavior, and in some cases, language and
communication skills (2, 3). Clinical variants of FTD include the behavioral
variant ( bvFTD ), characterized by disinhibition, apathy, impulsivity, and
loss of empathy, and language variants, such as progressive non-uent
aphasia (PNFA) and semantic dementia (SD), which affect language
production and comprehension, respectively (4). In neuropathological
terms, FTD is associated with the abnormal accumulation of proteins such
as tau and TDP-43, which contribute to progressive neurodegeneration.
Clinical evaluations for FTD are complex due to the overlap of its
symptoms with other psychiatric disorders (5, 6). Therefore, it is crucial to
develop and validate accurate diagnostic tools to improve the diagnostic
accuracy and clinical management of this disease (7, 8). Characterization
and follow-up of patients with FTD have demonstrated variable disease
progression, underscoring the need for longitudinal studies and detailed
clinical reviews (9, 10).
Public awareness of FTD and other forms of dementia remains
limited, affecting perception and management of these conditions (11–13).
Evidence-based interventions, such as recommendations to distinguish
between FTD and psychiatric disorders, are critical for improving
diagnoses and providing support to caregivers (14–17).
The development and validation of knowledge scales and assessment
tools, such as the FTD Knowledge Scale, are essential to address these
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needs and improve understanding and management of the disease (16,
18).
The overall objective was to analyze the scientic literature on
assessment instruments used to measure knowledge and progression of
Frontotemporal Dementia, with the aim of conducting a meta-analysis of
reliability, specically Cronbach’s alpha, in various cultural adaptations
and contexts.
Methodology
Study design
The study followed the preferred reporting items for systematic
reviews (19,20) and reliability meta-analyses (21).
Inclusion and exclusion criteria
For the systematic review and meta-analysis of the reliability
of assessment instruments for Frontotemporal Dementia, prevalence
studies, as well as longitudinal and cross-sectional studies, were included.
Participants had to be adults with a conrmed or suspected diagnosis of
Frontotemporal Dementia. It was essential that the assessed studies used
instruments specically validated for this condition. Only studies that
reported instrument reliability using Cronbach’s alpha and McDonald ‘s
omega, a key indicator of internal consistency, were considered.
Studies published in English or Spanish that had been peer-reviewed
in academic journals were included. Studies that focused on other forms
of dementia or neurocognitive disorders unrelated to Frontotemporal
Dementia were excluded. Studies that did not provide data on the
reliability of the instruments used or that used tools not psychometrically
validated were also excluded. Studies that were not peer-reviewed, such
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Revisión sistemática y metaanálisis de abilidad de los instrumentos
de evaluación para la Demencia Frontotemporal 180 - 208
aquellos estudios que no proporcionaron datos sobre la abilidad de los
instrumentos utilizados o que emplearon herramientas no validadas en tér-
minos psicométricos. Los estudios que no fueron revisados por pares, como
tesis, disertaciones, informes técnicos o documentos no publicados, también
fueron excluidos del análisis.
Fuentes de información
Como fuentes de información se utilizaron cuatro bases de datos cientícas:
Web of Science, Scopus, PsycINFO y PubMed, con acceso a la biblioteca de la Uni-
versidad de Oviedo (España) y de la Universidad Politécnica Salesiana (Ecua-
dor). Se seleccionaron cuatro bases de datos por su relevancia cientíca in-
ternacional y su cobertura de alta calidad de estudios en ciencias sociales y
de la salud. Se revisaron las bibliografías de los artículos incluidos en la revi-
sión para reducir el sesgo de exclusión debido a la cobertura.
Estrategia de búsqueda
Las búsquedas para la revisión sistemática y metaanálisis de la abilidad de
los instrumentos de evaluación para la Demencia Frontotemporal se realiza-
ron el 02 de octubre de 2024, siguiendo las directrices descritas en la decla-
ración PRISMA (19). En la fase inicial, se identicaron registros duplicados,
tanto de manera algorítmica como mediante una vericación manual, con
un solapamiento de contenido superior al 90%. A continuación, se excluye-
ron aquellos registros que no se centraban en la evaluación de la Demencia
Frontotemporal. No se consideraron aptos los estudios teóricos, revisiones
sistemáticas o narrativas no sistemáticas. Dos investigadores independientes
revisaron los textos completos de los registros restantes, comparando su con-
tenido con los criterios de inclusión previamente establecidos. Los desacuer-
dos en las decisiones de codicación fueron resueltos mediante deliberación
hasta alcanzar consenso, clasicando los estudios como incluidos, excluidos
o aquellos que requerían más discusión.
as theses, dissertations, technical reports, or unpublished papers, were
also excluded from the analysis.
Sources of information
Four scientic databases were used as sources of information: Web
of Science , Scopus , PsycINFO , and PubMed , with access to the library of
the University of Oviedo (Spain) and the Salesian Polytechnic University
(Ecuador). Four databases were selected for their international scientic
relevance and high-quality coverage of studies in the social and health
sciences. The bibliographies of the articles included in the review were
reviewed to reduce exclusion bias due to coverage.
Search strategy
The searches for the systematic review and meta-analysis of the
reliability of assessment instruments for Frontotemporal Dementia were
conducted on October 2, 2024, following the guidelines outlined in the
PRISMA statement (19). In the initial phase, duplicate records with a
content overlap greater than 90 % were identied, both algorithmically
and by manual verication. Records that did not focus on the assessment
of Frontotemporal Dementia were then excluded. Theoretical studies,
systematic reviews, or non-systematic narratives were not considered
eligible. Two independent researchers reviewed the full texts of the
remaining records, comparing their content with previously established
inclusion criteria. Disagreements in coding decisions were resolved
through deliberation until consensus was reached, classifying studies as
included, excluded, or those requiring further discussion.
Coding in this phase was performed using the Rayyan web
application (22) and records were categorized into duplicates, deleted,
included, excluded, and possible. The reasons for each decision were
recorded in detail in the system. Finally, blinding was unblinded to allow
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the investigators to cross-check the results and continue with the study
analysis (Figure 1).
Data collection process
A thorough systematic extraction of essential bibliographic data was
conducted for the systematic review and meta-analysis of the reliability of
assessment instruments for Frontotemporal Dementia. The data collected
included author names, publication titles, source journals, and abstracts,
providing a comprehensive view of each record. A researcher downloaded
these data in RIS format, a standard for bibliographic data exchange,
managing each record individually according to the database used.
RIS les were then veried and uploaded to Rayyan (22), a specialized
tool for managing and reviewing scientic literature. To ensure accuracy
and reduce bias, an independent researcher was recruited as a blind
coding partner, allowing for a dual screening process. This meticulous
extraction and processing protocol was followed sequentially across the
selected databases, ensuring consistency and rigor in data management.
Data extraction process
For data extraction in the systematic review and meta-analysis of the
reliability of assessment instruments for Frontotemporal Dementia, two
main categories were dened: 1) the methodological characteristics of the
included studies and 2) the psychometric properties of the instruments
evaluated. The primary reviewer identied the information based on the
predened variables in a working matrix and compared the ndings with
the external reviewer. Inconsistencies were resolved by joint verication
of the data until an agreement was reached.
Regarding the methodological variables, the following data of
interest were collected: 1) author and year of publication; 2) title of the
study in the original language of publication; 3) journal and quartile; 4)
psychometric instrument used and the number of items in its structure;
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5) country, sample size and average age of participants; and 6) reliability
measures and, where applicable, the t indices of the instruments
evaluated for Frontotemporal Dementia. The psychometric data of
interest were: 1) the reliability of the instrument measured by Cronbach’s
alpha and McDonald ‘s omega .
Assessment of the risk of bias of the study
The lead reviewer (AR) and the second reviewer (VQ) analyzed the
methodological quality of the included studies, assessing their reliability
or internal consistency using Cronbach’s alpha for the psychometric
instruments used to assess frontotemporal dementia. A Cronbach’s
alpha value of 0.70 was considered acceptable, in line with established
methodological standards. The representativeness of the sample was also
assessed in relation to the number of instrument items reported in each
study.
The reviewers agreed in 97 % of cases, and discrepancies were
resolved through discussion and consensus with a third reviewer (SV).
Of the ve studies that reported relevant statistical data, the researchers
(VQ and AR) decided to document the samples separately, reviewing the
full text and comparing the data until reaching a consensus through joint
discussion.
Figure 1 illustrates the ow diagram of the systematic review,
beginning with the identication of 3456 records through databases, from
which 564 duplicate records were removed prior to screening. A total of
2888 records were reviewed, of which 1989 were excluded for not meeting
the inclusion criteria. A total of 899 reports were requested for retrieval,
but 627 of these could not be retrieved. A total of 272 full reports were
assessed for eligibility, resulting in the exclusion of 267 reports. Finally, ve
studies that reported the reliability ( Cronbach’s alpha and McDonald’s
omega) of instruments for assessing frontotemporal dementia and met
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Revisión sistemática y metaanálisis de abilidad de los instrumentos
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627 de ellos no pudieron ser recuperados. Se evaluaron 272 informes com-
pletos para determinar su admisibilidad, resultando en la exclusión de 267
informes. Finalmente, se incluyeron 5 estudios que reportaron la abilidad
(Alfa de Cronbach y omega de McDonald) de los instrumentos para evaluar la
demencia Frontotemporal que cumplían con los criterios necesarios para la
revisión sistemática, reejando un proceso riguroso y metódico de selección.
Figura 1. Diagrama de ujo de la revisión sistemática.
Identicación
ChequeoInclusión
the criteria for the systematic review were included, reecting a rigorous
and methodical selection process.
Figure 1. Flowchart of the systematic review.
Identication of studies through data bases and registers
Identication- identied
registers of data bases Register
eliminated before screening:
Duplicated register eliminated
(n=564)
Identication of studies through
data bases and registers (n=3456)
Registers revised (n=2888)
Studies included in the revision
(n=5)
Reports excluded (n=267)
Reports evaluated to determine
their admissibility (n=272)
Checking inclusion
Reports required to their
recovery reports no recovery
(n=899)
Report not recovered (n=627)
Registers excluded** (n=1989)
Identication
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Statistical analysis
This study employed reliability generalizability and meta-analysis
approaches to measure internal consistency and model t indicators of
Frontotemporal Dementia assessment instruments in published studies.
Pooled reliability was estimated using Cronbach ‘s alpha and McDonald ‘s
omega (23), transformed using the Hakstian – Whalen method to facilitate
random effects modeling (24). Heterogeneity was assessed using Cochran’s
Q, I², H² , and τ² (25) .
To ensure the reliability of the results, studies with Cronbach’s
alpha values less than 0.70 or inadequate case-to-item ratios (less than
10:1) were removed using trimming techniques before calculating pooled
estimates. Potential publication bias was assessed by visual inspection of
funnel plot asymmetry and Egger ‘s regression test (25). By meta-analyzing
reliability and validity indicators across diverse applications, this study
facilitates generalizations about the effectiveness of existing tools in
consistently measuring FTD across diverse samples. All analyses were
performed using Jamovi and R .
Results
Table 2 presents the descriptives of the selected studies on
assessment instruments for frontotemporal dementia, with a total of ve
studies analyzed.
Regarding the year of publication, the studies are evenly distributed
between 2017, 2018, 2020, 2021, and 2022, with one study (20 % ) published
in each of these years. This suggests that studies on the reliability of
instruments for frontotemporal dementia have been relatively consistent
over recent years.
Regarding the scientic journals in which these studies were
published, the largest proportion (40%) comes from the journal
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Alzheimer’s Disease and Associated Disorders , while the other three
publications are distributed between Archivos de Neuro- Psiquiatria (20
% ), Dementia and Geriatric Cognitive Disorders (20 % ) and Neurologia
(Barcelona, Spain ) (20 % ).
Table 1. Articles selected on the reliability of fontotemporal dementia
instruments .
No.Authors Year Magazine Quartile SJR
2023 H-INDEX Country Continent Sample n items Cronbach’s
alpha
1
Wynn and
Carpenter
(26)
2020
Alzheimer
disease and
associated
disorders
Q2 0.61 109 United
States America 174 4 .846
2
Magrath-
Guimet et al.
(27)
2022
Neuro-
psychiatry
archives
Q3 0.34 58 Germany Europe 134 18 .74
3
Turró-
Garriga et al.
(28)
2017
Neurology
(Barcelona,
Spain )
Q4 0.52 50 Spain Europe 60 30 .897
4
Karasiewicz
and Leszko
(29)
2021
Dementia
and
geriatric
cognitive
disorders
Q2 0.81 123 Switzerland Europe 869 4 .80
5Lima-Silva et
al. (30) 2018
Alzheimer
disease and
associated
disorders
Q2 0.61 109 United
States America 97 8 .975
Regarding the journal quartile, three of the studies (60%) were
published in journals classied in the second quartile (Q2 50% ),
indicating a medium-high impact level. One study (20 % ) was published
in a third quartile journal (Q3 75% ) and another in a fourth quartile
journal (Q4 100% ), indicating lower relevance within the eld. Regarding
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pa, mientras que los otros dos estudios (40%) se realizaron en América. Esto
sugiere un interés relevante en la investigación de la demencia frontotempo-
ral en ambos continentes.
Tabla 2. Descriptivos de los estudios seleccionados sobre los instrumentos de
evaluación para la Demencia Frontotemporal (n = 5).
n (%)
Año
2017 1 (20%)
2018 1 (20%)
2020 1 (20%)
2021 1 (20%)
2022 1 (20%)
Revista
Alzheimer disease and associated disor-
ders
2 (40%)
Arquivos de neuro-psiquiatria 1 (20%)
Dementia and geriatric cognitive disor-
ders
1 (20%)
Neurologia (Barcelona, Spain) 1 (20%)
Cuartil
Q2 3 (60%)
Q3 1 (20%)
Q4 1 (20%)
País
Germany 1 (20%)
Spain 1 (20%)
Switzerland 1 (20%)
United States 2 (40%)
Continente
América 2 (40%)
Europa 3 (60%)
geographic distribution, the selected studies come from diverse countries.
Two studies (40 % ) were conducted in the United States, while Germany,
Spain, and Switzerland each contributed one study (20 % ). Finally,
regarding continental distribution, three studies (60%) were conducted
in Europe, while the other two studies (40 % ) were conducted in America.
This suggests a relevant interest in frontotemporal dementia research on
both continents.
Table 2. Descriptives of the selected studies on assessment instruments
for Frontotemporal Dementia (n = 5).
Year n (%)
2017 1 (20%)
2018 1 (20%)
2020 1 (20%)
2021 1 (20%)
2022 1 (20%)
Magazine
Alzheimer disease and associated
disorders
2 (40%)
Neuro- psychiatry archives 1 (20%)
Dementia and geriatric cognitive
disorders
1 (20%)
Neurology (Barcelona, Spain ) 1 (20%)
Quartile
Q2 3 (60%)
Q3 1 (20%)
Q4 1 (20%)
Country
Germany 1 (20%)
Spain 1 (20%)
Switzerland 1 (20%)
United States 2 (40%)
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Continent
America 2 (40%)
Europe 3 (60%)
Table 3 shows the descriptives of the selected publications,
analyzing several factors such as the impact of the journals, the sample
size, the number of items and the reliability measures of the assessment
instruments used for frontotemporal dementia.
Regarding journal impact, all studies report both the SJR and the
H-INDEX . The average SJR is 0.578, indicating that the journals in which
the studies were published have a moderate to high impact in their
eld. The average H-INDEX is 89.8, reecting a high level of scholarly
recognition of these journals, with a range from 50 to 123. This suggests
that the studies come from relevant and well-established sources in the
scientic eld.
The sample sizes used in the studies vary signicantly. The average is
267 participants, although the median is lower at 134, indicating that most
studies include moderately sized samples. However, some studies present
much larger samples, which raises the average. The number of items in the
assessment instruments varies between 4 and 30 items, with an average of
12.8, demonstrating diversity in the length of the instruments used.
All studies report Cronbach ‘s alpha as a measure of reliability, with a
mean of 0.852 and a median of 0.846, indicating high internal consistency
across the instruments evaluated. The range varies between 0.740 and
0.975, suggesting that some instruments have higher reliability than
others. However, only one study reports McDonald ‘s omega , with a value
of 0.800, also indicating good internal consistency. The lack of further
reporting on McDonald ‘s omega limits a broader comparison between
the two reliability measures. Overall, the selected studies reect a solid
methodological basis, with instruments that present acceptable reliability
and were published in well-recognized academic journals.
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Table 3. Descriptives of the selected publications based on the impact of
the journals (SJR and H-INDEX), sample, number of items and reliability
(Cronbach’s Alpha and McDonald’s Omega).
SJR 2023 H-INDEX Sample n items Cronbach’s
alpha
Omega
McDonald
Report 5 5 5 5 5 1
Does not
report
0 0 0 0 0 4
M 0.578 89.8 267 12.8 0.852 0.800
MD 0.610 109 134 8 0.846 0.800
OF 0.170 33.3 339 11.2 0.0901 ----
Min 0.340 50 60 4 0.740 0.800
Max 0.810 123 869 30 0.975 0.800
Note. M = Mean, Md = Median, SD = Standard Deviation, Min = Minimum,
and Max = Maximum.
Table 4 presents the results of the random-effects model and
heterogeneity statistics for two models examining frontotemporal
dementia assessment instruments. Model 1 includes ve studies, while
Model 2 includes three studies.
Regarding the estimates of the combined effects of the studies, Model
1 has an estimate of 0.855, while Model 2 has a slightly lower estimate of
0.846. Both models have a low standard error (se), 0.0358 for Model 1 and
0.0284 for Model 2, indicating precision in the estimates. The Z values for
both models are high (23.9 and 29.8, respectively), demonstrating a strong
association in the data. The p values are highly signicant for both models
(p < .001), indicating that the estimates are statistically signicant.
The condence intervals ( CIs ) for the estimates are also narrow,
reinforcing the reliability of the results. In Model 1, the condence interval
ranges from 0.785 to 0.925, and in Model 2, from 0.790 to 0.902, suggesting
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that the true parameter values are likely within these ranges, and both
models show high consistency.
The heterogeneity statistics show a notable difference between the
two models. In Model 1, the Tau value is 0.078, and in Model 2 it is 0.046,
indicating less heterogeneity in the second model. Tau², which measures
the variance between studies, is lower in Model 2 (0.0021) than in Model
1 (0.006), suggesting that the studies in Model 2 are more homogeneous.
The I² value is extremely high in both models, with 97.44% for
Model 1 and 88.94% for Model 2. This indicates that most of the variability
observed between studies is not due to chance, but to real differences
between studies, although Model 2 shows less heterogeneity compared to
Model 1.
The H² values, which also reect heterogeneity, are considerably
high in both models, especially in Model 1 (39,038 versus 9,043 in Model
2), again indicating greater heterogeneity in the rst model.
Q statistic , which assesses consistency across studies, is signicant
in both models ( p < .001), but the Q value is much higher in Model 1 ( Q =
301.577) than in Model 2 ( Q = 19.833), reinforcing the idea that studies in
Model 1 have more variability across them.
In summary, both models present robust and signicant estimates
for the reliability of frontotemporal dementia assessment instruments.
However, Model 2 shows less heterogeneity, indicating greater consistency
across the studies included in this model compared to Model 1.
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Table 4. Random effects model and heterogeneity statistics of model 1 (n =
5) and model 2 (n = 3) of the assessment instruments for Frontotemporal
Dementia.
Model 1 Model 2
Dear 0.855 0.846
HE 0.0358 0.0284
Z 23.9 29.8
p < .001 < .001
Lower IQ Bound 0.785 0.790
Upper IQ Bound 0.925 0.902
Tau 0.078 0.046
Tau² 0.006 ( SE= 0.004) 0.0021 ( SE= 0.0024)
I² 97.44 % 88.94 %
H² 39.038 9.043
df 4,000 2,000
Q 301,577 19,833
p < .001 < .001
Note. Tau² Estimator: Restricted Maximum-Likelihood.
Table 5 presents the results of the assessment of publication bias in
two models of assessment instruments for frontotemporal dementia.
In Model 1, the Fail-Safe N value is 70,339,000, with a p value < .001,
indicating that a large number of additional null studies would be needed
to invalidate the results of the meta-analysis . This suggests that the
model is robust and not signicantly inuenced by the lack of published
studies. Model 2 also shows a high Fail-Safe N value (9,740,000), with p <
.001, reinforcing the reliability of the results in this second model.
Kendall’s Tau test in Model 1 has a value of -0.200 and a p-value
= 0.817, indicating no signicant correlation between effect size and
variance, demonstrating no apparent publication bias. In Model 2, the
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Kendall’s Tau value is 1.000, but the p-value = 0.333 indicates no signicant
evidence of bias in that model either.
Regarding Egger ‘s regression , Model 1 presents a value of -2.418
and a p-value = 0.016, suggesting the presence of a statistically signicant
publication bias. This implies that there may be some asymmetry in
the distribution of the studies included in this model, possibly because
studies with less favorable results were not published. On the other hand,
in Model 2, the Egger ‘s Regression is 1.859 and the p-value = 0.063, which
is not statistically signicant, suggesting that Model 2 does not present
considerable publication bias.
Fail-Safe N values , indicating that they are robust to publication
bias, Model 1 shows evidence of bias according to Egger ‘s regression , while
Model 2 does not show signicant bias according to the tests applied. This
shows that Model 2 is more reliable in terms of avoiding publication bias.
Table 5. Assessment of publication bias.
Model 1 Model 2
Test Name Statistical p Statistical p
Fail-Safe N 70,339,000 < .001 9,740,000 < .001
Kendalls
Tau -0.200 0.817 1,000 0.333
Egger’s
Regression -2.418 0.016 1,859 0.063
Note. Fail-safe N Calculation Using the Rosenthal Approach
Figure 1 shows the meta-analysis of the reliability of assessment
instruments for Frontotemporal Dementia, with a sample of 5 studies
(n = 5). Each study is represented by a point indicating the reliability
coefcient, with horizontal bars representing the 95% condence intervals
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La Figura 1 muestra el metaanálisis de la abilidad de los instrumentos
de evaluación para la Demencia Frontotemporal, con una muestra de 5 estu-
dios (n = 5). Cada estudio está representado por un punto que indica el coe-
ciente de abilidad, con barras horizontales que representan los intervalos
de conanza (IC) del 95%. Los coecientes de abilidad varían entre los es-
tudios, con algunos intervalos más amplios que sugieren mayor incertidum-
bre en los resultados. El coeciente global, representado por un diamante en
la parte inferior del gráco, indica un promedio ponderado de la abilidad,
mostrando que en general los instrumentos tienen una abilidad adecuada.
Sin embargo, se observa cierta heterogeneidad entre los estudios, lo que su-
giere diferencias en las características de los instrumentos o las poblaciones
evaluadas.
Figura 2. Modelo 1 del metaanalisis de abilidad de los instrumentos de eva-
luación para la Demencia Frontotemporal (n = 5).
Se observó en la gura 2 que los estudios no están distribuidos de ma-
nera completamente simétrica alrededor de la línea central, lo que sugiere
la posible presencia de sesgo de publicación o heterogeneidad en los resul-
tados. Algunos puntos están fuera del área de conanza, indicando estudios
con efectos más extremos o menos precisos. La forma asimétrica del gráco
(CI). Reliability coefcients vary across studies, with some wider intervals
suggesting greater uncertainty in the results. The overall coefcient,
represented by a diamond at the bottom of the graph, indicates a weighted
average of the reliability, showing that the instruments generally have
adequate reliability. However, some heterogeneity is observed across
studies, suggesting differences in the characteristics of the instruments or
the populations assessed.
Figure 2. Model 1 of the meta-analysis of reliability of the assessment
instruments for Frontotemporal Dementia (n = 5).
It was noted in Figure 2 that the studies are not completely
symmetrically distributed around the center line, suggesting the possible
presence of publication bias or heterogeneity in the results. Some points are
outside the condence area, indicating studies with more extreme or less
precise effects. The asymmetric shape of the graph could reect the lack of
small studies with negative effects or studies with variability in reliability.
Although only ve studies were included, this visual representation
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podría reejar la falta de estudios pequeños con efectos negativos o estudios
con variabilidad en la abilidad. Aunque solo se incluyeron cinco estudios,
esta representación visual indica que podría ser necesario examinar más a
fondo la calidad y la homogeneidad de los estudios incluidos en el metaaná-
lisis.
Figura 3. Gráco de embudo del Modelo 1 (n = 5).
Los puntos en la Figura 3 indican las estimaciones de Tau con y sin la
exclusión del Modelo 1. En este caso, el gráco sugiere que al excluir el Mode-
lo 1, la estimación de Tau cambia, lo que indica que este estudio podría estar
inuyendo en la variabilidad total entre los estudios. Los puntos en rojo pro-
bablemente representan los valores de Tau sin y con la exclusión del Modelo
1, mostrando que la variabilidad entre estudios podría reducirse o aumentar
según se incluya o excluya este modelo en particular. Este tipo de análisis es
útil para identicar estudios que contribuyen de manera desproporcionada
a la heterogeneidad y para evaluar la robustez de los resultados globales del
metaanálisis.
indicates that further examination of the quality and homogeneity of the
studies included in the meta-analysis may be necessary.
Figure 3. Funnel plot of Model 1 (n = 5) .
The points in Figure 3 indicate the Tau estimates with and without
excluding Model 1. In this case, the graph suggests that excluding Model 1
changes the Tau estimate, indicating that this study could be inuencing
the overall variability across studies. The red points likely represent the
Tau values with and without excluding Model 1, showing that the variability
across studies could be reduced or increased depending on whether this
particular model is included or excluded. This type of analysis is useful for
identifying studies that contribute disproportionately to heterogeneity
and for assessing the robustness of the overall meta-analysis results.
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Figura 3. Estimaciones de Tau con exclusión del Modelo 1 (n = 5).
La Figura 4 mostró un modelo de metaanálisis de abilidad para ins-
trumentos de evaluación de la Demencia Frontotemporal, basado en 3 estu-
dios. En este análisis, se visualizaron las estimaciones de abilidad, probable-
mente Alfa de Cronbach, para cada instrumento o estudio individual, junto
con un resumen global. El eje x representó los coecientes de abilidad, que
probablemente oscilaron entre 0 y 1, donde 1 indicaba una abilidad perfec-
ta y 0 una ausencia de abilidad. Los tres estudios (n = 3) presentaron sus
respectivas estimaciones de abilidad, posiblemente acompañadas de inter-
valos de conanza (IC), los cuales reejaban el rango dentro del cual se espe-
raba que estuviera el verdadero valor de la abilidad con cierto margen de
error. La gura también incluyó un diagrama de puntos o barras horizontales
que mostró las estimaciones de abilidad para cada estudio. Los intervalos
de conanza más amplios indicaron mayor incertidumbre en las estimacio-
nes. Finalmente, el modelo global del metaanálisis presentó una estimación
combinada de la abilidad, que resumió las abilidades de los estudios indi-
viduales.
Figure 3. Tau estimates excluding Model 1 (n = 5).
Figure 4 showed a meta-analysis model of reliability for
Frontotemporal Dementia assessment instruments, based on three
studies. In this analysis, reliability estimates, probably Cronbach’s alpha
, were displayed for each individual instrument or study, along with an
overall summary. The x-axis represented the reliability coefcients,
which probably ranged from 0 to 1, with 1 indicating perfect reliability
and 0 indicating no reliability. The three studies (n = 3) presented their
respective reliability estimates, possibly accompanied by condence
intervals (CIs), which reected the range within which the true reliability
value was expected to lie, with some margin of error. The gure also
included a horizontal bar or dot plot showing the reliability estimates for
each study. Wider condence intervals indicated greater uncertainty in
the estimates. Finally, the overall meta-analysis model presented a pooled
reliability estimate, which summarized the reliabilities of the individual
studies.
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Figura 4. Modelo 2 del metaanalisis de abilidad de los instrumentos de eva-
luación para la Demencia Frontotemporal (n = 3).
La Figura 5 presentó un gráco de embudo correspondiente al Modelo
2, basado en 3 estudios. Este tipo de gráco se utiliza comúnmente en metaa-
nálisis para detectar posibles sesgos de publicación o para evaluar la simetría
en los datos. Un gráco de embudo simétrico indica que es poco probable
que haya sesgo de publicación, mientras que una asimetría puede sugerir
lo contrario. En este gráco, los puntos representaron los estudios incluidos
en el metaanálisis. Cada punto correspondió a un estudio, y su posición de-
pendió de la precisión de los resultados (generalmente representada en el
eje vertical) y el tamaño del efecto o coeciente de abilidad (en el eje hori-
zontal). El embudo ideal debería ser simétrico alrededor de una línea central
(la línea de efecto combinado del metaanálisis). Sin embargo, en la gura,
uno de los estudios apareció aislado a la izquierda, lo que podría indicar una
asimetría en el gráco. Esta asimetría podría ser un indicio de sesgo de publi-
cación o de heterogeneidad entre los estudios, aunque con solo tres estudios
en el análisis, las conclusiones acerca de la presencia de sesgo deben tomar-
se con precaución. Además, las áreas sombreadas del gráco representaron
los intervalos de conanza de los estudios. Los estudios que caen dentro de
las áreas sombreadas más cercanas al vértice del embudo indican una mayor
Figure 4. Model 2 of the meta-analysis of reliability of the assessment
instruments for Frontotemporal Dementia (n = 3).
Figure 5 presented a funnel plot corresponding to Model 2, based
on 3 studies. This type of plot is commonly used in meta-analyses to
detect potential publication bias or to assess symmetry in the data. A
symmetrical funnel plot indicates that publication bias is unlikely, while
asymmetry may suggest the opposite. In this plot, the points represented
the studies included in the meta-analysis . Each point corresponded to a
study, and its position depended on the precision of the results (usually
represented on the vertical axis) and the effect size or reliability coefcient
(on the horizontal axis). The ideal funnel should be symmetrical around
a center line (the pooled effect line from the meta-analysis ). However, in
the gure, one of the studies appeared isolated on the left, which could
indicate asymmetry in the plot. This asymmetry could be an indication
of publication bias or heterogeneity between the studies, although with
only three studies in the analysis, conclusions about the presence of
bias should be taken with caution. Additionally, the shaded areas of the
graph represented the condence intervals for the studies. Studies falling
within the shaded areas closest to the apex of the funnel indicated greater
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precisión, mientras que aquellos más alejados del vértice, como el estudio de
la izquierda, mostraron menor precisión en sus resultados.
Figura 5. Gráco de embudo del Modelo 2 (n = 3).
La Figura 6 mostró las estimaciones de Tau con exclusión del Modelo
2, basadas en 3 estudios. Tau es una medida utilizada en metaanálisis para
evaluar la heterogeneidad entre los estudios incluidos. Especícamente, Tau²
representa la varianza verdadera entre los estudios, es decir, la cantidad de
variabilidad en los resultados que no puede explicarse por el error aleato-
rio y que se atribuye a diferencias reales entre los estudios. En esta gura, se
visualizaron dos puntos, uno a la izquierda y otro a la derecha, los cuales re-
presentaron las estimaciones de Tau al excluir ciertos resultados del Modelo
2. El punto rojo en el centro del gráco probablemente indicó la estimación
combinada de Tau cuando se aplicó esta exclusión. El hecho de que las esti-
maciones se separaran en los extremos podría haber indicado variabilidad
signicativa entre los estudios excluidos y los incluidos, lo que podría reejar
un alto grado de heterogeneidad en los datos. Esto sugería que, al excluir el
precision, while those further from the apex, such as the study on the left,
showed lower precision in their results.
Figure 5. Funnel plot of Model 2 (n = 3).
Figure 6 showed the Tau estimates excluding Model 2, based
on three studies. Tau is a measure used in meta-analyses to assess
heterogeneity among included studies. Specically, Tau² represents the
true variance between studies—that is, the amount of variability in the
results that cannot be explained by random error and is attributable to
true differences between studies. In this gure, two points were displayed,
one on the left and one on the right, representing the Tau estimates when
certain outcomes were excluded from Model 2. The red dot in the center
of the graph likely indicated the pooled Tau estimate when this exclusion
was applied. The fact that the estimates diverged at the extremes could
have indicated signicant variability between the excluded and included
studies, potentially reecting a high degree of heterogeneity in the data.
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Modelo 2, la varianza entre los estudios seguía siendo considerable y que los
estudios restantes no eran completamente homogéneos en términos de sus
resultados o características. La interpretación de estas estimaciones de Tau
pudo haber señalado la necesidad de explorar más a fondo las diferencias
entre los estudios o de aplicar modelos más complejos para ajustar esta hete-
rogeneidad.
Figura 6. Estimaciones de Tau con exclusión del Modelo 2 (n = 3).
Discusión
Los estudios revisados sobre la adaptación y validación de instrumentos para
medir el conocimiento sobre la demencia frontotemporal (FTD) destacan en-
foques metodológicos rigurosos y resultados psicométricos sólidos. Wynn y
Carpenter (26) desarrollaron la Frontotemporal Dementia Knowledge Scale (FTDKS)
con una consistencia interna destacada (α = .846) en una muestra de 174 per-
sonas, entre profesionales de la salud y cuidadores. Este instrumento, diseña-
do para medir el conocimiento sobre la FTD, cubre aspectos esenciales de la
enfermedad, como los factores de riesgo, síntomas, progresión y tratamiento,
y se ha convertido en una herramienta útil tanto en el ámbito clínico como en
programas educativos en Estados Unidos.
En un contexto de habla hispana, Magrath-Guimet et al. (27) adaptaron
y validaron la FTDKS en español, obteniendo una consistencia interna acep-
This suggested that, when Model 2 was excluded, the variance between
studies remained considerable and that the remaining studies were not
completely homogeneous in terms of their outcomes or characteristics.
Interpretation of these Tau estimates may have indicated the need to
further explore differences between studies or to apply more complex
models to adjust for this heterogeneity.
Figure 6. Tau estimates excluding Model 2 (n = 3).
Discussion
The reviewed studies on the adaptation and validation of instruments
to measure knowledge about frontotemporal dementia (FTD) highlight
rigorous methodological approaches and solid psychometric results.
Wynn and Carpenter (26) developed the Frontotemporal Dementia
Knowledge Scale ( FTDKS ) with outstanding internal consistency (α
= .846) in a sample of 174 people, including health professionals and
caregivers. This instrument, designed to measure knowledge about FTD,
covers essential aspects of the disease, such as risk factors, symptoms,
progression, and treatment, and has become a useful tool in both clinical
settings and educational programs in the United States.
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In a Spanish-speaking context, Magrath-Guimet et al. (27) adapted
and validated the FTDKS in Spanish, obtaining acceptable internal
consistency (α = .74) with a sample of 134 healthcare professionals. The
adaptation followed international guidelines for translation and cross-
cultural adaptation, and the results show that this version is applicable
in their setting. The usefulness of this instrument lies in its ability to
assess knowledge about FTD, which can improve the diagnosis and care
of patients with frontotemporal dementia in Spanish-speaking countries,
where knowledge about this condition is still limited.
Turró Garriga et al. (28) validated the Frontotemporal Dementia
Rating Scale (FTD-FRS) in Spanish, focusing on patients diagnosed with
FTD in Spain. This study reported high internal consistency (α = .897) and
used the Rasch model to validate the unidimensionality of the instrument.
The FTD-FRS allows the evaluation of disease progression and the clinical
status of patients, being of great value to professionals who care for people
with FTD.
In Poland, Karasiewicz and Leszko (29) adapted and validated the
FTDKS in their language, achieving adequate internal consistency in
both Cronbach’s alpha and McDonald’s omega (α = .80, ω = .80). This
study included a large sample of 869 people, which allowed evaluating
the effectiveness of the instrument in different subpopulations, such as
the general population, health professionals and caregivers. The authors
concluded that the FTDKS is effective in measuring knowledge about
dementia in various contexts, highlighting its convergent and discriminant
validity.
Finally, Lima-Silva et al. (30) validated the FTD-FRS in Brazil with
impressive results in terms of internal consistency (α = .975) and test- retest
reliability (.977). This study focused on patients with FTD and Alzheimer’s
disease, demonstrating that the FTD-FRS is a valuable tool for assessing
the status and progression of dementia. The application of this instrument
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in Brazil reinforces its usefulness for documenting changes related to
interventions and for the clinical follow-up of patients with FTD.
Taken together, these studies demonstrate that the adaptations and
validations of the FTDKS and FTD-FRS instruments are psychometrically
sound and applicable across diverse cultural contexts. These instruments
allow for the assessment of knowledge and progression of frontotemporal
dementia, which is critical for improving the diagnosis, care, and
management of this disease in different populations.
Table 6 presents a comparison of studies on the reliability of
instruments for measuring knowledge about frontotemporal dementia
(FTD) in different cultural contexts. First, the study by Wynn and Carpenter
(26) stands out for its focus on health professionals and caregivers in the
United States, although it does not specify the validation method used;
however, it is considered effective in a context where knowledge about
FTD is already more advanced. On the other hand, Magrath-Guimet et
al. (27) adapted the instrument to Spanish-speaking countries through
translation and cross-cultural adaptation, obtaining lower consistency,
which highlights the importance of cultural adaptation to improve
the effectiveness of the instrument. In contrast, the work of Turró-
Garriga et al. (28) uses the Rasch model to validate their instrument in
patients diagnosed with FTD in Spain, reporting high consistency and
unidimensionality , making it a robust tool for clinical assessment. In
Poland, Karasiewicz and Leszko (29) evaluated the FTDKS in a diverse
context including the general population, healthcare professionals and
caregivers, although they did not specify the validation method; their study
highlights the effectiveness of the instrument and the need to explore its
applicability in different subpopulations. Finally, the study by Lima-Silva
et al. (30) focuses on patients with FTD and Alzheimer’s in Brazil, obtaining
outstanding results in internal consistency, suggesting that it is a useful
tool for clinical follow-up and documentation of changes. Taken together,
these studies highlight the variability in the reliability of the instruments
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according to the cultural context and the target population, underlining
the need for careful adaptation and validation in different settings.
Table 6. Comparison of studies on instruments for measuring knowledge
about frontotemporal dementia.
Investigation Population Validation
Method
Cultural
Context Observations
Wynn and
Carpenter (26)
Health
professionals
and
caregivers
not specied USA
Effective tool,
but focused on a
context with greater
knowledge about
FTD.
Magrath-
Guimet et al.
(27)
Health
professionals
Translation
and cross-
cultural
adaptation
Spanish-
speaking
countries
Inferior consistency;
highlights the
need for cultural
adaptation.
Turró-Garriga
et al. (28)
Patients
diagnosed
with FTD
Rasch model Spain
High consistency and
unidimensionality ,
robust instrument to
assess clinical status.
Karasiewicz
and Leszko
(29)
General
population,
health
professionals
and
caregivers
not specied Poland
An effective
instrument in
various contexts;
it highlights the
need to evaluate
its applicability
in different
subpopulations.
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Revisión sistemática y metaanálisis de abilidad de los instrumentos
de evaluación para la Demencia Frontotemporal 201 - 208
(FTDKS) como la Frontotemporal Dementia Rating Scale (FTD-FRS) son herramien-
tas válidas y conables. Estos instrumentos permiten evaluar, de manera
efectiva, tanto el conocimiento sobre la enfermedad en profesionales de la
salud y cuidadores, como el estado clínico y la progresión de la FTD en los pa-
cientes. En cada estudio, las adaptaciones culturales y lingüísticas siguieron
procedimientos rigurosos, garantizando que las versiones locales de estos
instrumentos conserven sus propiedades psicométricas originales.
La validación de la FTDKS en distintos contextos culturales, como Es-
tados Unidos, España, Polonia y países de habla hispana, demuestra su ver-
satilidad y aplicabilidad. Los resultados obtenidos en diferentes estudios
sugieren que la FTDKS puede ser utilizada ecazmente para aumentar el co-
nocimiento sobre la FTD, una condición que a menudo se diagnostica erró-
neamente debido a la falta de información entre los profesionales de la salud.
Esto refuerza la importancia de contar con herramientas como la FTDKS para
mejorar la precisión diagnóstica y optimizar la atención de los pacientes con
FTD.
Por otro lado, la FTD-FRS ha mostrado ser una herramienta valiosa para
la evaluación del estado y la progresión de la FTD en pacientes en entornos
clínicos. Su capacidad para documentar cambios en el estado de la enferme-
dad y medir la efectividad de las intervenciones es esencial para la atención
continua de los pacientes. Las adaptaciones realizadas en Brasil y España
subrayan la relevancia de esta escala en el contexto clínico, destacando su
solidez psicométrica y su contribución al manejo de la FTD. En síntesis, tanto
la FTDKS como la FTD-FRS son instrumentos clave para mejorar la atención
de los pacientes con FTD y para formar a los profesionales de la salud y cuida-
dores. Su validación en diversos entornos culturales demuestra su robustez
y aplicabilidad global, permitiendo una mejor comprensión y manejo de la
demencia frontotemporal en distintos contextos clínicos y educativos.
Lima-Silva et
al. (30)
Patients with
FTD and
Alzheimer’s
not specied Brazil
Exceptional internal
consistency; useful
for clinical follow-up
and documenting
changes.
Conclusions
The ndings of studies on the adaptation and validation of
instruments to measure knowledge and progression of frontotemporal
dementia (FTD) show that both Frontotemporal Dementia Knowledge
Both the Frontotemporal Dementia Rating Scale (FTDKS) and the
Frontotemporal Dementia Rating Scale (FTD-FRS) are valid and reliable
tools. These instruments effectively assess both the disease knowledge
of healthcare professionals and caregivers, as well as the clinical status
and progression of FTD in patients. In each study, cultural and linguistic
adaptations followed rigorous procedures, ensuring that the local versions
of these instruments retain their original psychometric properties.
The validation of the FTDKS in diverse cultural contexts, including
the United States, Spain, Poland, and Spanish-speaking countries,
demonstrates its versatility and applicability. The results obtained
in various studies suggest that the FTDKS can be effectively used to
increase awareness of FTD, a condition that is often misdiagnosed due to
a lack of information among healthcare professionals. This reinforces the
importance of having tools like the FTDKS to improve diagnostic accuracy
and optimize the care of patients with FTD.
Furthermore, the FTD-FRS has proven to be a valuable tool for
assessing the status and progression of FTD in patients in clinical
settings. Its ability to document changes in disease status and measure
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the effectiveness of interventions is essential for ongoing patient care.
Adaptations in Brazil and Spain underscore the relevance of this scale
in the clinical context, highlighting its psychometric robustness and
contribution to FTD management. In summary, both the FTDKS and the
FTD-FRS are key instruments for improving the care of patients with FTD
and for training healthcare professionals and caregivers. Their validation
in diverse cultural settings demonstrates their robustness and global
applicability, allowing for a better understanding and management of
frontotemporal dementia in different clinical and educational contexts.
Limitations and future research
Studies on the adaptation and validation of Frontotemporal
Dementia Knowledge The Frontotemporal Dementia Rating Scale (FTDKS)
and the Frontotemporal Dementia Rating Scale (FTD-FRS) present several
limitations that should be considered. First, many of these studies were
conducted with relatively small and specic samples, such as healthcare
professionals or caregivers, which limits the generalizability of the results
to other populations, such as the general public or patients with different
educational levels. The external validity of the instruments could be
improved with additional studies that include larger and more diverse
samples, both geographically and sociodemographically.
Another common limitation is that most adaptations have focused
on specic countries, such as the United States, Spain, Poland, and Brazil,
leaving a gap in the validation of these instruments in other regions of the
world, especially in developing countries or those with fewer resources
for dementia care. This raises the need for additional studies to adapt and
validate the scales in other cultural and linguistic contexts, ensuring their
applicability in a variety of clinical and educational settings.
Furthermore, although the reviewed studies demonstrated
good internal consistency and test- retest reliability, some did not
comprehensively assess other important aspects of validity, such as
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convergent and discriminant validity, or the scales’ sensitivity to detect
longitudinal changes in knowledge or disease progression. This limits the
instruments’ ability to measure the impact of educational interventions
or treatments over time.
Regarding future research, it would be valuable to conduct
longitudinal studies examining how knowledge about frontotemporal
dementia varies in response to educational interventions, as well as
to investigate the sensitivity of the FTD-FRS to detect clinical changes
across different stages of the disease. It would also be useful to explore
the relationship between knowledge measured by the FTDKS and clinical
outcomes in patients with FTD, such as caregiver quality of life and more
informed clinical decision-making.
Finally, it would be pertinent to incorporate innovative technologies,
such as virtual reality or mobile applications, to complement the use of
these scales in the training of healthcare professionals and caregivers.
This would allow for greater dissemination and accessibility of the tools,
enhancing their usefulness in different contexts and fostering research on
their effectiveness in digital environments.
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Vanessa Quito-Calle, Sofía Vintimilla, Esteban Cañizares
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Revista multidisciplinaria
Investigación Contemporánea 07 - 2025 Vol. 3 - No. 2 ISSN-e: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Leucemia de células dendríticas plasmocitoides
- estudio y diagnóstico de un caso 49 -49
Copyright (c) 2025 Faicán Rocano Pedro Fernando, Dután Pérez Ibelice Salomé,
González González Camila Raquel, Matute Aguiar Joselyn Nayeli, Rodríguez Ver-
dugo Alejandra Valentina.
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