Development and psychometric validation of the Indonesian Neurocognitive Semantic Association Test for Neurodegenerative Impairment (INSANI).

Background

Primary Progressive Aphasia (PPA) is a neurodegenerative syndrome characterized by progressive language impairment, with semantic deficits as a core feature, particularly in the semantic variant. However, culturally appropriate tools for assessing semantic associations remain limited in the Indonesian context. This study aimed to develop and psychometrically validate the Indonesian Neurocognitive Semantic Association Test for Neurodegenerative Impairment (INSANI).

Methods

INSANI was developed using culturally adapted semantic association tasks across three domains: class membership, part-whole, and contiguity. Content validity was evaluated by expert neurologists and language specialists using the content validity index (CVI). A field study was conducted in 300 healthy Indonesian-speaking adults. Construct validity was assessed using confirmatory factor analysis (CFA).

Results

Of the initial 38 items, 33 were retained after content validation. CFA supported a refined 7-item model with good construct validity while maintaining representation across semantic domains. The final instrument demonstrated moderate internal consistency and high comprehensibility, indicating good psychometric performance and cultural appropriateness.

Conclusion

INSANI is a promising tool for assessing semantic associations in Indonesian-speaking populations, with potential clinical utility in diagnosing and monitoring PPA and related neurodegenerative disorders. Further validation in clinical populations is needed to establish its diagnostic performance.