The International Dementia Alliance Instrument for Feasible and Valid Staging of Individuals with Dementia by Informal Caregivers

J Am Geriatr Soc. 2016 Aug;64(8):1674-8. doi: 10.1111/jgs.14205. Epub 2016 Jun 15.

Abstract

Objectives: To assess the feasibility and validity of the International Dementia Alliance (IDEAL) instrument for Informal Caregivers (IDEAL-IC), which is based on the IDEAL instrument for professionals (IDEAL-P), for staging individuals with dementia.

Design: Cross-sectional.

Setting: Memory clinic of a university hospital.

Participants: Informal caregivers of 73 community-dwelling elderly adults referred to a memory clinic and six geriatric registrars.

Measurements: Caregivers completed the IDEAL-IC; physicians completed the original IDEAL-P and the Clinical Dementia Rating sum of boxes (CDR-SB). Missing items and floor and ceiling effects were reviewed to assess feasibility. To test construct validity, a priori hypotheses were defined for expected correlations between IDEAL-IC, IDEAL-P, and CDR-SB scores.

Results: Seventy-three IDEAL-IC instruments were completed, 86% of which had no missing items. Three percent of all 730 individual items were missing. No floor or ceiling effects were detected. CDR scores were 0 7%, 0.5 in 33%, 1 in 27%, 2 in 10%, and unknown in 23%. IDEAL-IC scores correlated highly with IDEAL-P scores (correlation coefficient (r) = 0.70) and with CDR-SB scores (r = 0.65) as expected; the difference between these two correlations was smaller than expected. Agreement between IDEAL-IC and IDEAL-P scores was 34% within a range of 1 point difference on 36-point scales, 57% within a range of two points, and 81% within a range of five points. Correlation between IDEAL-P and CDR-SB was very high (r = 0.85).

Conclusion: Results of this study indicate good feasibility and high validity of staging dementia by informal caregivers using the IDEAL-IC.

Keywords: dementia; feasibility; informal caregiver; staging; validity.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / classification*
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / epidemiology
  • Caregivers*
  • Cross-Sectional Studies
  • Family*
  • Feasibility Studies
  • Female
  • Guideline Adherence
  • Health Surveys / statistics & numerical data*
  • Hospitals, University
  • Humans
  • Male
  • Observer Variation
  • Reproducibility of Results
  • Statistics as Topic
  • Surveys and Questionnaires*