Cross-cultural Validation of the Sinhala Version of the Attitudes to Aging Questionnaire.

Abstract

Background: The individual’s social and cultural background affects attitudes towards aging. The Attitudes to Aging Questionnaire (AAQ) is a widely used 24-item tool to measure attitudes toward aging among older adults that include three subscales, namely psychological growth, psychosocial loss, and physical change. Objective: To validate the Sinhala version of the AAQ cross-culturally Methods: The Sinhala version of the AAQ was cross-culturally adapted following standard methods including forward and backward translations, expert committee review, and pre-testing. The questionnaire was administered among 185 Sinhala-speaking older adults residing in residential care facility homes in Colombo district together with the previously validated WHOQOL-BREF questionnaire. Psychometric properties (internal consistency, convergent validity, divergent validity, and construct validity) were assessed using SPSS version 26.0. Results: The mean±SD age of the sample was 72.35±6.61 years. Majority (56.80%) were females. Internal consistency measured by Cronbach’s alpha for Psychological loss, Psychological growth and Physical change subscales were 0.81, 0.77 and 0.74, respectively. There were significant correlations showed in Pearsons’ correlation between AAQ subscales and WHOQOL BREF domains indicating convergent validity; AAQ psychological loss subscale with physical (r=0.80, p<0.001) and psychological (r=0.90, p<0.001) domains, psychological growth with physical (r=0.89, p<0.001), psychological (r=0.85, p<0.001) domains, physical change with physical (r=0.93, p<0.001), psychological (r=0.79, p<0.001) domains. The mean value for married individuals is significantly higher in psychological loss (32.70±3.60, t=3.96, p<0.001), psychological growth (32.16±3.88, t=3.48, p<0.001) and physical change (32.67±3.50, t=3.30, p=0.001) subscales. Individuals diagnosed with chronic disease conditions also scored significantly higher means for psychological loss (32.95±2.88, t=4.48, p<0.001), psychological growth (32.19±3.72, t=3.06, p=0.003) and physical change (32.83±3.33, t=3.56, p<0.001) subscales showing divergent validity of AAQ. In exploratory factor analysis, KMO=0.703 and the Bartlett test of Sphericity was significant (p<0.001) showing underlying factor structure. Three factors were observed in principal component analysis. Conclusions: The Sinhala version of the AAQ has sound psychometric characteristics and it is a culturally appropriate and reliable measure to assess attitudes toward aging among older adults in Sri Lanka.