{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:47:01Z","timestamp":1789688821876,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,1,7]],"date-time":"2014-01-07T00:00:00Z","timestamp":1389052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J intellect Disabil Res"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Abstract<\/jats:title>Purpose<\/jats:title>(a) A psychometric validation of an Italian version of the A<\/jats:styled-content>lzheimer's F<\/jats:styled-content>unctional A<\/jats:styled-content>ssessment T<\/jats:styled-content>ool scale (AFAST\u2010I<\/jats:styled-content>), designed for informant\u2010based assessment of the degree of impairment and of assistance required in seven basic daily activities in adult\/elderly people with intellectual disabilities (ID<\/jats:styled-content>) and (suspected) dementia; (b) a pilot analysis of its clinical significance with traditional statistical procedures and with an artificial neural network.<\/jats:p><\/jats:sec>Methods<\/jats:title>AFAST\u2010I<\/jats:styled-content> was administered to the professional caregivers of 61 adults\/seniors with ID<\/jats:styled-content> with a mean age (\u00b1\u2009SD<\/jats:styled-content>) of 53.4 (\u00b1\u20097.7) years (36% with D<\/jats:styled-content>own syndrome). Internal consistency (C<\/jats:styled-content>ronbach's \u03b1 coefficient), inter\/intra\u2010rater reliabilities (intra\u2010class coefficients, ICC<\/jats:styled-content>) and concurrent, convergent and discriminant validity (P<\/jats:styled-content>earson's r<\/jats:italic> coefficients) were computed. Clinical significance was probed by analysing the relationships among AFAST\u2010I<\/jats:styled-content> scores and the S<\/jats:styled-content>um of C<\/jats:styled-content>ognitive S<\/jats:styled-content>cores (SCS<\/jats:styled-content>) and the S<\/jats:styled-content>um of S<\/jats:styled-content>ocial S<\/jats:styled-content>cores (SOS<\/jats:styled-content>) of the D<\/jats:styled-content>ementia Q<\/jats:styled-content>uestionnaire for P<\/jats:styled-content>ersons with I<\/jats:styled-content>ntellectual D<\/jats:styled-content>isabilities (DMR<\/jats:styled-content>\u2010I) after standardisation of their raw scores in equivalent scores (ES<\/jats:styled-content>). An adaptive artificial system (A<\/jats:styled-content>utoC<\/jats:styled-content>ontractive M<\/jats:styled-content>aps, AutoCM<\/jats:styled-content>) was applied to all the variables recorded in the study sample, aimed at uncovering which variable occupies a central position and supports the entire network made up of the remaining variables interconnected among themselves with different weights.<\/jats:p><\/jats:sec>Results<\/jats:title>AFAST\u2010I<\/jats:styled-content> shows a high level of internal homogeneity with a C<\/jats:styled-content>ronbach's \u03b1 coefficient of 0.92. Inter\u2010rater and intra\u2010rater reliabilities were also excellent with ICC<\/jats:styled-content> correlations of 0.96 and 0.93, respectively. The results of the analyses of the different AFAST\u2010I<\/jats:styled-content> validities all go in the expected direction: concurrent validity (r<\/jats:italic>\u2009=\u2009\u22120.87 with ADL<\/jats:styled-content>); convergent validity (r<\/jats:italic>\u2009=\u20090.63 with SCS<\/jats:styled-content>; r<\/jats:italic>\u2009=\u20090.61 with SOS<\/jats:styled-content>); discriminant validity (r<\/jats:italic>\u2009=\u20090.21 with the frequency of occurrence of dementia\u2010related B<\/jats:styled-content>ehavioral E<\/jats:styled-content>xcesses of the A<\/jats:styled-content>ssessment for A<\/jats:styled-content>dults with D<\/jats:styled-content>evelopmental D<\/jats:styled-content>isabilities, AADS\u2010I<\/jats:styled-content>). In our sample age and gender do not correlate with the scale and comparing the distribution of the AFAST\u2010I<\/jats:styled-content> and DMR<\/jats:styled-content>\u2010SCS<\/jats:styled-content> and DMR<\/jats:styled-content>\u2010SOS<\/jats:styled-content> expressed as ES<\/jats:styled-content>, it appears that memory disorders and temporal and spatial disorientation (SCS<\/jats:styled-content>) precede the loss of functional abilities, whereas changes in social behaviour (SOS<\/jats:styled-content>) are less specific in detecting cognitive deterioration sufficient to provoke functional disability and vice versa. The results of AutoCM<\/jats:styled-content> analysis reveal that the hub (core) of the entire network is represented by the functional domain \u2018personal\/oral hygiene\u2019 in the entire study sample and \u2018use of toilet\u2019 in a subgroup of subjects who obtained an ES<\/jats:styled-content> equal to 0 at DMR<\/jats:styled-content>\u2010SCS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>These results confirm the reliability and validity of AFAST\u2010I<\/jats:styled-content> and emphasise the complexity of the relationship among functional status, cognitive functioning and behaviour also in adults\/seniors with ID<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jir.12113","type":"journal-article","created":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T01:56:54Z","timestamp":1389146214000},"page":"370-384","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Functional abilities and cognitive decline in adult and aging intellectual disabilities. Psychometric validation of an Italian version of the A<\/scp>lzheimer's F<\/scp>unctional A<\/scp>ssessment T<\/scp>ool (AFAST<\/scp>): analysis of its clinical significance with linear statistics and artificial neural networks"],"prefix":"10.1111","volume":"59","author":[{"given":"L. P.","family":"De Vreese","sequence":"first","affiliation":[{"name":"Local Health Agency Dementia Project Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Gomiero","sequence":"additional","affiliation":[{"name":"ANFFAS Trentino Onlus Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Uberti","sequence":"additional","affiliation":[{"name":"Sospiro Foundation Cremona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"De Bastiani","sequence":"additional","affiliation":[{"name":"ANFFAS Trentino Onlus Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Weger","sequence":"additional","affiliation":[{"name":"ANFFAS Trentino Onlus Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Mantesso","sequence":"additional","affiliation":[{"name":"ANFFAS Trentino Onlus Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Marangoni","sequence":"additional","affiliation":[{"name":"ANFFAS Trentino Onlus Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,7]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"211","article-title":"La differenza che fa la differenza: dalla significativit\u00e0 statistica alla significativit\u00e0 pratica [The difference that makes the difference: from statistical significance to practical significance]","volume":"2","author":"Agnoli F.","year":"2008","journal-title":"Psicologia Clinica e dello Sviluppo"},{"key":"e_1_2_8_3_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders \u2013 Text Revised","author":"American Psychiatric Association","year":"2000"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1994.tb06509.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.1997.tb00692.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1352\/0895-8017(2005)110[268:AIAWID]2.0.CO;2"},{"key":"e_1_2_8_7_1","unstructured":"BuscemaM.(ed.) 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