Development and Validation of a Culturally Adapted Nursing Assessment Tool for Dementia in Elderly Yoruba Populations in South West Nigeria

Background: Dementia assessment tools developed in Western contexts are culturally and linguistically inappropriate for Yoruba-speaking elderly populations, leading to systematic under-diagnosis and under-nursing of this condition in South West Nigeria. Aim: This study developed and validated a culturally adapted nursing assessment tool for dementia in elderly Yoruba populations in Oyo and Osun States. Methods: A multi-phase instrument development design was employed. Phase one involved a systematic review of dementia assessment tools used in African contexts. Phase two used cognitive interviews and expert panel consultations to develop and adapt items. Phase three validated the tool in a sample of 220 community-dwelling Yoruba elders aged 65 and above using confirmatory factor analysis, Rasch modelling, and receiver operating characteristic analysis. Results: The finalised 22-item tool demonstrated excellent internal consistency (Cronbach's alpha = 0.87), acceptable construct validity, and area under the ROC curve of 0.91 for discriminating dementia from normal ageing. The tool was positively received by community nurses for usability. Conclusion: This validated tool fills a critical diagnostic gap for dementia nursing in Yoruba-speaking communities. Its adoption in community and primary care nursing practice will improve early detection and care planning for dementia in South West Nigeria. Keywords: dementia, assessment tool, Yoruba, South West Nigeria, instrument validation.