Background: North Sumatra is one of two provinces in Indonesia in which the prevalence and costs of care of dementia has been completed as part of the STrengthening Responses to dementia In Developing countries (STRiDE) program. The toolkit used in the study was developed in English and thus needed to be cross-culturally adapted into Bahasa Indonesia. Part of this process involved pre-testing as a way to maximize the cultural appropriateness of the toolkit, especially in a multi- ethnic province like North Sumatra. Here we report the adaptation process. Methods: The translated toolkit consisted of measures needed within the prevalence survey in North Sumatra. This included cognitive, functional and quality of life measures aimed at older adults and their informants (i.e., family member). The interviewer asked each component of the toolkit in full, making notes on certain questions or items that need to be clarified or rephrased for the participants. Any specific difficulty in understanding the translated sentence or any items that were culture inappropriate were also noted. Data included observation, interviews, verbatim quotes which were constructed in the form of field- notes. Results: Several questions and items needed to be paraphrased to achieve greater clarity and make sure that they were in line with the original meanings. This was mainly due to the translatability of the word from the source language to the target language with errors that could be linguistic or cultural. Translating a text from English to Bahasa Indonesia and vice versa may be affected because of the different ways of ellipsis, which is a phenomenon of missing phrasal components, operated in both languages. Although the respondents belonged to different ethnic groups, cultural background did not affect the way they responded to the questions. Conclusion: Cross-cultural adaptation and pre-testing process played an important role to ensure the toolkit measured and was interpreted as it was originally intended. The STRIDE toolkit was generally accepted and understood, although several items need further explanation or examples.

Background: Fatigue is a general term used to describe an overall feeling of tiredness. It is one of the most common complaints of people seen in primary health care. Several previous studies have evaluated the effects of fatigue on cognitive function in various clinical and population settings and yielded different results. This study aimed to investigate the effect of fatigue on cognitive performance in neurology residents of Faculty of Medicine of Universitas Sumatera UtaraMethods: This was a crosssectional study involving all of the neurology residents of faculty of medicine universitas Sumatera Utara who fulfilled the inclusion criteria. This study was conducted on November until December 2020. Fatigue was assessed using fatigue severity scale and cognitive performance was assessed using Stroop test. The data was analyse using regression linear testResults: Total subject in this study was 42 subjects consisted of 26 female and 16 male with mean age of 32.02±3.45 years. The mean of FSS score was 33.71±7.41 and the mean of Stroop test score was 46.37±9.16 second. Using regression linear test we found fatigue affect cognitive function with p=0.002; R=0.470 and R2=0.221 and after stratification analysis based on sex of the subjects found that fatigue affect cognitive function in female subjects with p=0.013; R=0.482 and R2=0.232. According to age of the subject, fatigue affect cognitive function in subject >30 years old with p=0.001; R=0.635; R2=0.403Conclusions: There is significant effect of fatigue on cognitive performance. Particularly in women and age >30 years old.