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2020 Alzheimer's Association Research Grant to Promote Diversity (AARG-D)

Validity of Functional Assessment Staging by Caregivers

How can a clinical assessment tool be adapted in the Hispanic/ Latino community for use by family caregivers of individuals with Alzheimer’s?

Adriana Arcia, Ph.D., R.N.
Columbia University Medical Center
New York, NY - United States


According to the 2020 Alzheimer’s Facts and Figures report, studies indicate that Hispanics/Latinos are about one and one-half times more likely to develop dementia as older whites. 

One of the tools used by health workers is known as the Functional Assessment Staging Tool (FAST) in order to determine the stage of dementia in an individual. This questionnaire-based tool has been designed for health care professionals. However, Dr. Adriana Arcia believes that it may provide knowledge and understanding for caregivers on what to expect and how to care for their loved ones. 

Dr. Arcia proposes to build upon FAST and other tools to be more appropriate and culturally sensitive to those in the Hispanic/Latino communities, including those with limited fluency in English. The team has been developing a mobile application that may support more easy navigation to apply FAST effectively. This app, called the Interactive Functional Assessment Staging Navigator (I-FASTN), uses simple pictograms to illustrate the different stages of dementia in FAST. It also enables caregivers to answer straightforward questions in Spanish or English about their care recipient — often by clicking “yes” or “no”— in order to determine that recipient’s stage of dementia. 

Research Plan

To conduct their study, Dr. Arcia and her team will have five professional caregiving experts and 20 Hispanic/Latino caregivers (10 English-speakers and 10 Spanish-speakers) assess their app’s usability. They will then use feedback from these two groups to enhance their app. 

Once the app has been further modified and refined based on the focused input, Dr. Arcia and the research team will test it on a larger participant pool (90 Hispanic/Latino participants with dementia and their caregivers), half of whom are English-speaking and half of whom are Spanish-speaking individuals. In the first part of this experiment, a health care professional (for example, a registered nurse) will use FAST to help determine each care recipient’s stage of dementia. Then, using the new app, the family caregivers will assess the stage of dementia for the family member that they are caring. Dr. Arcia and colleagues will then compare the results obtained by the healthcare professional and the family caregivers. This information will be used to evaluate if the results are similar and to test the validity of the app.


If successful, Dr. Arcia’s app could provide groundwork of tools that could support the caregiver in the Hispanic/Latino community to provide knowledge and help with decision-making for care and resources. Further, this tool may be scaled to other communities as well.

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