Psychometric properties and clinical usability of the cognition in daily life scale in patients with acquired brain injury in clinical care settings

Objective Evaluate the internal consistency, inter-rater and test-retest reliability, convergent and divergent validity and clinical usability of the Cognition in Daily Life scale for patients with acquired brain injury.Design Validation study.Participants A total of 75 patients with acquired brain injury (mostly male [n = 47, 68%]; mean age 67 years) were recruited from inpatient care facilities. Sixty participants (81%) had sustained a stroke.Main measures Outcome measure: Cognition in Daily Life scale. Reference measures: Utrecht Scale for Rehabilitation-Cognition subscale, Montreal Cognitive Assessment, Barthel Index, Hospital Anxiety and Depression Scale and Fatigue Severity Scale.Results After removing redundant items, all subscales of the Cognition in Daily Life scale demonstrated satisfactory internal consistency. Test-retest reliability was good (intraclass correlation coefficient [ICC] = 0.847), and inter-rater reliability was moderate (ICC = 0.615). Convergent validity was confirmed through moderately strong correlations between most subscales of the Cognition in Daily Life Scale and other measures of cognition. Cognition in Daily Life subscales generally did not correlate with the Hospital Anxiety and Depression Scale and Fatigue Severity Scale, indicating divergent validity. Moderate correlations with the Barthel Index suggested related, but distinct constructs. Clinicians found the Cognition in Daily Life scale easy to administer and relevant for practice, though time-consuming. They suggested layout improvements for greater usability.Conclusion The Cognition in Daily Life scale is adequately valid, reliable and clinically usable for assessing cognition in daily life in patients with acquired brain injury in a clinical setting. Future research needs to evaluate the scale's sensitivity to change and its performance in other settings and populations.