Psychiatry Investig.
2013 Sep;10(3):238-245.
Validation of the Dementia Care Assessment Packet-Instrumental Activities of Daily Living
- Affiliations
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- 1Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea.
- 2Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea.
- 3Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. kwkimmd@snu.ac.kr
- 4Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea.
- 5Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
- 6Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
- 7Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
OBJECTIVE
We aimed to evaluate the psychometric properties of the IADL measure included in the Dementia Care Assessment Packet (DCAP-IADL) in dementia patients.
METHODS
The study involved 112 dementia patients and 546 controls. The DCAP-IADL was scored in two ways: observed score (OS) and predicted score (PS). The reliability of the DCAP-IADL was evaluated by testing its internal consistency, inter-rater reliability and test-retest reliability. Discriminant validity was evaluated by comparing the mean OS and PS between dementia patients and controls by ANCOVA. Pearson or Spearman correlation analysis was performed with other instruments to assess concurrent validity. Receiver operating characteristics curve analysis was performed to examine diagnostic accuracy.
RESULTS
Chronbach's alpha coefficients of the DCAP-IADL were above 0.7. The values in dementia patients were much higher (OS=0.917, PS=0.927), indicating excellent degrees of internal consistency. Inter-rater reliabilities and test-retest reliabilities were statistically significant (p<0.05). PS exhibited higher reliabilities than OS. The mean OS and PS of dementia patients were significantly higher than those of the non-demented group after controlling for age, sex and education level. The DCAP-IADL was significantly correlated with other IADL instruments and MMSE-KC (p<0.001). Areas under the curves of the DCAP-IADL were above 0.9.
CONCLUSION
The DCAP-IADL is a reliable and valid instrument for evaluating instrumental ability of daily living for the elderly, and may also be useful for screening dementia. Moreover, administering PS may enable the DCAP-IADL to overcome the differences in gender, culture and life style that hinders accurate evaluation of the elderly in previous IADL instruments.
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