Psychometric evaluation of the Alzheimer's Disease Knowledge Scale in Ecuadorian university students

Background: Alzheimer's disease (AD) is the leading cause of dementia worldwide, with rising prevalence, high costs, and significant impact in Ecuador. Awareness and validated tools like the Alzheimer's Disease Knowledge Scale (ADKS) are crucial to improve training and early care. Objective: To evaluate the reliability and factorial structure of the ADKS in Ecuadorian university students enrolled in health science programs. Methods: A total of 1089 students completed the ADKS. Internal consistency was assessed using Cronbach's alpha and McDonald's omega coefficients. Confirmatory factor analysis (CFA) was conducted using a Diagonally Weighted Least Squares (DWLS) estimator to evaluate the scale's structure. Results: The ADKS demonstrated acceptable internal consistency (α = 0.767, ω = 0.770). CFA supported the original one-factor model with strong fit indices (RMSEA = 0.047, SRMR = 0.012, CFI = 0.987, TLI = 0.973, RNI = 0.987, NFI = 0.986, RFI = 0.972, IFI = 0.987). These results confirm the scale's internal validity in this population. Conclusions: The ADKS is a reliable and valid instrument for assessing knowledge of Alzheimer's disease among Ecuadorian university students. Its use is recommended for both clinical training and public health education strategies focused on dementia awareness.