The ASDS combines cross-culturally stable and context-specific elements. Core items on compliance, complexity and treatment barriers support its use as an indicator of attitudinal obstacles to geriatric dental care, while value- and training-related items require cultural adaptation. When evaluating the impact of dental education, the ASDS may be most informative alongside a general ageism scale and if cross-national comparisons follow tests of measurement invariance.
Izumi et al. (Tue,) studied this question.