Validation of a Malayalam Version of the Apathy Evaluation Scale

Background: The apathy evaluation scale (AES) measures apathy, but its usefulness as a screening tool in diverse populations is limited without translation into more languages. To date, there is no reported translation of the AES into Malayalam, a language spoken by over 32 million people in the southern Indian state of Kerala. In the present study, we aimed to validate the Malayalam version of the AES. Methods: Six hundred sixty-one community-dwelling older adults without dementia participating in the Kerala Einstein study completed the Malayalam AES. We assessed the internal consistency and the validity of the Malayalam AES, using another measure of apathy, as well as measures of depression and anxiety. We also used principal component analysis (PCA) to determine the dimensionality of the Malayalam AES. Finally, we assessed possible sex differences in apathy. Results: The Malayalam AES demonstrated high internal consistency and good validity, and the results of our PCA indicate that it has a three-component structure, as in the original English version and other translated versions. We found that while overall apathy scores were similar, the relationship with other neuropsychiatric symptoms differed by sex, with stronger relationships found in male participants compared to female participants. Conclusion: Our study provides another tool to screen for apathy in non-English-speaking populations, an important early risk factor for cognitive and functional decline, and enables future research across diverse cultures.