Development of an International Schedule for the Assessment and Staging of Care for Dementia

Article type: Research Article

Authors: Semrau, Maya^{a; *} | Burns, Alistair^b | Djukic-Dejanovic, Slavica^c | Eraslan, Defne^d | Han, Changsu^e | Lecic-Tosevski, Dusica^f | Lobo, Antonio^g | Mihai, Adriana^h | Morris, Julieⁱ | Palumbo, Claudia^j | Robert, Philippe^k | Stiens, Gerthild^l | Stoppe, Gabriela^m | Volpe, Umbertoⁿ | Rikkert, Marcel Olde^o | Sartorius, Norman^p | on behalf of the International Dementia Alliance (IDEAL) study group

Affiliations: [a] King's College London, Institute of Psychiatry, London, UK | [b] University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK | [c] School of Medicine, University of Kragujevac, Kragujevac, Serbia | [d] Istanbul Psikiyatri Enstitüsü, Istanbul, Turkey | [e] Department of Psychiatry, Korea University College of Medicine, Seoul, Korea | [f] School of Medicine, University of Belgrade, Serbian Academy of Sciences and Arts, Belgrade, Serbia | [g] Department of Psychiatry, Universidad Zaragoza and Instituto de Investigación Sanitaria de Aragón, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain | [h] Department of Psychiatry, University of Medicine and Pharmacy, Tg Mures, Romania | [i] University Hospital of South Manchester, Manchester, United Kingdom | [j] Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy | [k] Memory CenterCHU – CoBTeK Research, University of Nice Sophia Antipolis, Nice, France | [l] Center for Old Age Psychiatry, LVR Hospitals Bonn, Bonn, Germany | [m] MentAge Consulting – Practice-Research, Basel, Switzerland | [n] Department of Psychiatry, University of Naples SUN, Naples, Italy | [o] Radboud Alzheimer Centre/Department Geriatrics, Radboud University Medical Centre, Nijmegen, The Netherlands | [p] Association for the Improvement of Mental Health Programmes, Geneva, Switzerland

Correspondence: [*] Correspondence to: Dr. Maya Semrau, Institute of Psychiatry, King's College London, Box P029, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. E-mail: maya.semrau@kcl.ac.uk.

Abstract: Background:A reliable and valid global staging scale has been lacking within dementia care. Objective:To develop an easy-to-use multi-dimensional clinical staging schedule for dementia. Methods:The schedule was developed through: i) Two series of focus groups (40 and 48 participants, respectively) in Denmark, France, Germany, Netherlands, Spain, Switzerland, and UK with a multi-disciplinary group of professionals working within dementia care, to assess the need for a dementia-staging tool and to obtain suggestions on its design and characteristics; ii) A pilot-study over three rounds to test inter-rater reliability of the newly developed schedule using written case histories, with five members of the project's steering committee and 27 of their colleagues from Netherlands, France, and Spain as participants; and iii) A field-study to test the schedule's inter-rater reliability in clinical practice in France, Germany, Netherlands, Spain, Italy, Turkey, South Korea, Romania, and Serbia, which included 209 dementia patients and 217 of their caregivers as participants. Results:Focus group participants indicated a clear need for a culture-fair international dementia staging scale and reached consensus on face validity and content validity. Accordingly, the schedule has been composed of seven dimensions including behavioral, cognitive, physical, functional, social, and care aspects. Overall, the schedule showed adequate face validity, content validity, and inter-rater reliability; in the nine field-sites, intraclass correlation coefficients (ICCs; absolute agreement) for individual dimensions ranged between 0.38 and 1.0, with 84.4% of ICCs over 0.7. ICCs for total sum scores ranged between 0.89 and 0.99 in the nine field-sites. Conclusion:The IDEAL schedule looks promising as tool for the clinical and social management of people with dementia globally, though further reliability and validity testing is needed.

Keywords: Dementia, mental status schedule, patient schedule, psychometrics, reliability, validity

DOI: 10.3233/JAD-141599

Journal: Journal of Alzheimer's Disease, vol. 44, no. 1, pp. 139-151, 2015