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Cross-Cultural Construct Validity of the Ageism Scale for Dental Students: A Narrative Review
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DOI：10.1111/eje.70123.png)
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Abstract
En 中文
Introduction: Ageism among dental and dental hygiene students is a barrier to appropriate oral healthcare for older adults. The 27-item Ageism Scale for Dental Students (ASDS) assesses dental-specific ageist attitudes. It has been translated into multiple languages, but its cross-cultural construct validity and optimal educational use remain unclear. The objective of this narrative review was to examine the cross-cultural construct validity of the ASDS and to clarify its implications for educational evaluation and intervention. Methods: Using the original ASDS as a reference, we conducted a narrative review of international translation and validation studies. We included English-language peer-reviewed studies of undergraduate or postgraduate dental/dental hygiene trainees using the ASDS, and extracted factor structures, internal consistency and associations with external variables, and synthesised findings into recurring attitudinal domains. Results: Across countries, items reflecting perceived non-compliance, clinical complexity and time burden, and cost-benefit or worthwhileness calculations for treating older adults showed substantial convergence and acceptable reliability, suggesting a shared core of dental ageism. In contrast, value-laden items and those assessing preparedness and training showed marked cultural variability and sometimes weaker subscales. ASDS scores were moderately associated with general ageism and with intention to provide care for older adults, and improved after structured geriatric teaching and positive contact, whereas unstructured, stressful exposure to highly dependent patients could worsen general ageism while ASDS scores remained stable. Conclusion: The ASDS combines cross-culturally stable and context-specific elements. Core items on compliance, complexity and treatment barriers support its use as an indicator of attitudinal obstacles to geriatric dental care, while value-and training-related items require cultural adaptation. When evaluating the impact of dental education, the ASDS may be most informative alongside a general ageism scale and if cross-national comparisons follow tests of measurement invariance.
Keywords:
ageism
cross-cultural validation
dental students
geriatric dentistry
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