The validity and reliability of chinese frontal assessment battery in evaluating executive dysfunction among Chinese patients with small subcortical infarct

Alzheimer Dis Assoc Disord. Apr-Jun 2004;18(2):68-74. doi: 10.1097/01.wad.0000126617.54783.7.


Objectives: Frontal Assessment Battery (FAB) is a valid and reliable screening test for evaluating executive dysfunction among whites with frontal and subcortical degenerative lesions. We studied the properties of a Chinese version of FAB (CFAB) in evaluating executive dysfunction among Chinese stroke patients with small subcortical infarct.

Methods: Concurrent validity was evaluated using Wisconsin Card Sorting Tst (WCST) and Mattis Dementia Rating Scale-Initiation/Perseveration Subset (MDRS I/P) among 41 controls and 30 stroke patients with small subcortical infarct. Discriminant validities of CFAB and its subitems were compared with those of Mini-Mental State Examination (MMSE). Internal consistency, test-retest, and interrater reliability of CFAB were evaluated.

Results: The CFAB had low to good correlation with various executive measures: MDRS I/P (r = 0.63, p < 0.001), number of category completed (r = 0.45, p < 0.001), and number of perseverative errors (r = -0.37, p < 0.01) of WCST. Among the executive measures, only number of category completed had significant but small contribution (6.5%, p = 0.001) to the variance of CFAB. A short version of CFAB using three items yielded higher overall classification accuracy (86.6%) than that of CFAB full version (80.6%) and MMSE (77.6%). Internal consistency (alpha = 0.77), test-retest reliability (rho = 0.89, p < 0.001), and interrater reliability (rho = 0.85, p < 0.001) of CFAB were good.

Conclusion: Although CFAB is reliable, it is only moderately valid in evaluating executive dysfunction among Chinese stroke patients with small subcortical infarct. The clinical use of CFAB in the evaluation of executive dysfunction among this group of patients cannot be recommended at this stage.

MeSH terms

  • Aged
  • Asian Continental Ancestry Group*
  • Brain / pathology
  • Brain / physiopathology
  • Cerebral Infarction / diagnosis*
  • Cerebral Infarction / ethnology
  • Cerebral Infarction / physiopathology
  • Cross-Cultural Comparison*
  • Dementia, Multi-Infarct / diagnosis*
  • Dementia, Multi-Infarct / ethnology
  • Dementia, Multi-Infarct / physiopathology
  • Diagnosis, Differential
  • Female
  • Frontal Lobe / pathology
  • Frontal Lobe / physiopathology*
  • Hong Kong
  • Humans
  • Language
  • Magnetic Resonance Imaging
  • Male
  • Mental Status Schedule / statistics & numerical data
  • Middle Aged
  • Neurodegenerative Diseases / diagnosis
  • Neurodegenerative Diseases / ethnology
  • Neurodegenerative Diseases / physiopathology
  • Neuropsychological Tests* / statistics & numerical data
  • Observer Variation
  • Problem Solving / physiology*
  • Psychometrics
  • Reference Values
  • Reproducibility of Results
  • Statistics as Topic
  • Tomography, X-Ray Computed