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This study validated a Bulgarian version of the SCCAN cognitive-communication assessment tool in 89 adults across four groups: healthy controls, mild cognitive impairment, Alzheimer's disease, and stroke patients. The instrument demonstrated high internal consistency, strong correlation with an established cognitive test, and adequate ability to distinguish between clinical groups and controls, with 70.7% sensitivity and 87.1% specificity at a cut-off score of 80.
Why it matters
Bulgaria currently has no standardized tools for assessing cognitive-communication disorders in neurological patients. This validated instrument provides Bulgarian clinicians with a preliminary screening tool to identify patients who need further cognitive-communication evaluation and intervention.
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PurposeBulgaria currently lacks standardized instruments for assessing cognitive-communicative abilities in adults with neurological disorders. This study reports preliminary validation evidence for the Bulgarian version of the Scales of Cognitive and Communicative Ability for Neurorehabilitation (SCCAN-B).MethodsEighty-nine Bulgarian-speaking adults were assessed at a tertiary university hospital in Plovdiv, Bulgaria. The main analytic sample included four separate groups: neurotypical controls, individuals with mild cognitive impairment (MCI), Alzheimer’s disease (AD) dementia, and ischemic stroke. All participants had previously received a formal diagnosis prior to being classified within one of these four groups. After informed consent was obtained, participants completed the SCCAN-B and the validated Bulgarian version of the Mini-Mental State Examination (MMSE-B). Analyses examined internal consistency, convergent validity with MMSE-B, known-groups differences, and preliminary screening classification using receiver operating characteristic analysis.ResultsThe SCCAN-B showed high internal consistency across the eight performance scales, α = 0.931. The SCCAN-B total score correlated strongly with MMSE-B scores, ρ = 0.84, p < 0.001. Significant group differences were observed for the SCCAN-B total score and all performance scales, with the largest impairments in the Alzheimer’s disease group. ROC analysis distinguishing controls from the main clinical groups yielded an AUC of 0.850. A preliminary SCCAN-B total cut-off of 80 showed 70.7% sensitivity and 87.1% specificity.ConclusionFindings provide preliminary evidence that the SCCAN-B is a clinically promising screening instrument for identifying cognitive-communicative difficulties in Bulgarian-speaking neurological populations. However, the results should be interpreted cautiously because of the modest sample size, clinical heterogeneity, limited control of confounding variables, and the need for further normative and cross-cultural validation work.