The Spanish Translation and Adaptation of the Functional External Memory Aid Tool.

Purpose: Older Hispanic adults (OHAs) in the United States are at increased risk for Alzheimer's disease and related dementias (ADRDs), driven by factors such as diabetes, hypertension, and socioeconomic disparities. To support this population, culturally grounded and linguistically appropriate tools are essential for delivering effective risk reduction interventions. The Functional External Memory Aid Tool (FEMAT) is a performance-based measure used to assess compensatory strategies in daily life to guide person-centered cognitive treatment planning. This study describes the cultural and linguistic adaptation of the FEMAT-English-US, Version 2.0 into FEMAT-Spanish-US for Spanish-speaking OHAs. Method: A six-stage cross-cultural adaptation process was followed: preparation, forward adaptation of source to target, back adaptation from target to source, committee review, field testing, and final review. Adaptations focused on cultural relevance, dialect neutrality, idiomatic equivalence, and address formality. Acceptability and feasibility were measured using Spanish versions of the Acceptance and Feasibility of Intervention Measures. Results: Adaptations included modifying daily activities, translating content into dialect-neutral Spanish, substituting culturally familiar names, and translating idioms. Field testing with participants (M_age = 67 years; eight females, two males) from diverse Hispanic backgrounds demonstrated high acceptability and feasibility. Participant feedback affirmed the tool's clarity and usability. Conclusions: The FEMAT-Spanish-US v2.0 is a culturally and linguistically adapted tool for evaluating external memory aid use in Spanish-speaking OHAs. It supports person-centered cognitive intervention and addresses equity in ADRD care. The adaptation framework offers a model example for tailoring clinical tools across languages and cultures.