VIDESTA: Adaptation of the BSL-CST for cognitive screening in the Austrian deaf sign language community

Background Improving dementia diagnosis is a global health priority. Neuropsychological assessments often overlook minority groups, such as persons who are culturally Deaf. a In this community measurement of cognitive performance may be affected by communicative, linguistic and cultural barriers rather than cognitive deficits. Objective The study aimed to develop and provide initial validation data for a neuropsychological screening test for early detection of acquired cognitive decline tailored to the linguistic and cultural needs of the Austrian Deaf community. Methods The British-Sign-Language-Cognitive-Screening-Test (BSL-CST) was translated and culturally adapted for Austria. Instructions were recorded as video clips by native Austrian Sign Language (ÖGS) signers and an online platform was created for test administration. A sample of 71 Deaf individuals aged 50 and older and a clinical group of 10 Deaf individuals with acquired cognitive decline provided preliminary data on sensitivity, specificity, internal consistency, convergent validity and inter-rater reliability. Results The resulting ÖGS-adapted version of the BSL-CST, named VIDESTA (Vienna Sign Language Cognitive Assessment), is an ÖGS-based screening tool assessing neuropsychological areas affected in Alzheimer's disease and can be completed in under 60 min. Preliminary analyses demonstrated promising psychometric properties including split-half reliability (r = 0.77), Cronbach α = 0.76) and an AUC of 0.971 (p < 0.001). Conclusions The present findings provide initial evidence for the potential utility of VIDESTA as a cognitive screening tool for detecting mild-moderate cognitive decline in the Austrian Deaf community. Results should be interpreted cautiously given the small sample sizes. Research in larger samples is needed to establish normative data and confirm validity.