Validation of the Arabic Cognitive Functioning Self-Assessment Scale (CFSS): a large multinational study

Abstract

BACKGROUND: The Cognitive Functioning Self-assessment Scale (CFSS) is specifically designed for the self-report measurement of various domains of cognitive functioning (memory, spatio-temporal orientation, and attention). The objective of this study was to validate the CFSS in the Modern Standard Arabic. METHODS: A community-based, multinational study of cross-sectional design was conducted during September-October 2025 among 4092 adults from Egypt, Jordan, Lebanon, Oman, and Palestine. A combined non-probability convenience and snowball sampling strategy was used to recruit the study participants. RESULTS: = 0.93). Evidence of measurement invariance for the CFSS was established on the basis of sex, educational level and country status at metric, configural and scalar levels. Females, those with secondary educational level or less, and Palestinians showed higher cognitive functioning impairment scores compared to males, those with university educational level, and those from other origins. Greater impairment in cognitive functioning positively correlated with insomnia, depression and anxiety symptoms. CONCLUSION: It is hoped that the new scale will expand the applications of and interests in the cognitive assessment outside the restricted clinical neurology field to include broader non-clinical populations, and ultimately enrich the global cognition research by contributing new data from the largely understudied Arabic-speaking region.