Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-05T08:09:06.089Z Has data issue: false hasContentIssue false

Development and preliminary evaluation of the anxiety in cognitive impairment and dementia (ACID) scales

Published online by Cambridge University Press:  15 July 2015

Lindsay A. Gerolimatos*
Affiliation:
Department of Psychology, West Virginia University, Morgantown, WV, USA
Caroline M. Ciliberti
Affiliation:
Department of Psychology, West Virginia University, Morgantown, WV, USA
Jeffrey J. Gregg
Affiliation:
Department of Psychology, West Virginia University, Morgantown, WV, USA
Sarra Nazem
Affiliation:
Department of Psychology, West Virginia University, Morgantown, WV, USA
Patricia M. Bamonti
Affiliation:
Department of Psychology, West Virginia University, Morgantown, WV, USA
Casey E. Cavanagh
Affiliation:
Department of Psychology, West Virginia University, Morgantown, WV, USA
Barry A. Edelstein
Affiliation:
Department of Psychology, West Virginia University, Morgantown, WV, USA
*
Correspondence should be addressed to: Lindsay Gerolimatos, Veterans Affairs Boston Healthcare System, 940 Belmont Street (35 C), 02301, Brockton, MA, USA. Phone: +774-826-2501; Fax: +774-826-2580. Email: [email protected].

Abstract

Background:

Although rates of anxiety tend to decrease across late life, rates of anxiety increase among a subset of older adults, those with mild cognitive impairment (MCI) or dementia. Our understanding of anxiety in dementia is limited, in part, by a lack of anxiety measures designed for use with this population. This study sought to address limitations of the literature by developing a new measure of anxiety for cognitively impaired individuals, the anxiety in cognitive impairment and dementia (ACID) Scales, which includes both proxy (ACID-PR) and self-report (ACID-SR) versions.

Methods:

The ACID-SR and ACID-PR were administered to 45 residents, aged 60 years and older, of three long-term care (LTC) facilities, and 38 professional caregivers at these facilities. Other measures of anxiety, and measures of depression, functional ability, cognition, and general physical and mental health were also administered.

Results:

Initial evaluation of its psychometric properties revealed adequate to good internal consistency for the ACID-PR and ACID-SR. Evidence for convergent validity of measures obtained with the ACID-SR and ACID-PR was demonstrated by moderate-to-strong associations with measures of worry, depressive symptoms, and general mental health. Discriminant validity of measures obtained with the ACID-SR and ACID-PR was demonstrated by weak correlations with measures of cognition, functional ability, and general physical well-being.

Conclusions:

The preliminary results suggest that the ACID-SR and ACID-PR can obtain reliable and valid measures of anxiety among individuals with cognitive impairment. Given the subjective nature of anxiety, it may be prudent to collect self-report of anxiety symptoms even among those with moderate cognitive impairment.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271284.CrossRefGoogle ScholarPubMed
Andreescu, C., Teverovsky, E., Fu, B., Hughes, T. F., Chang, C. H. and Ganguli, M. (2014). Old worries and new anxieties: behavioral symptoms and mild cognitive impairment in a population study. The American Journal of Geriatric Psychiatry, 22, 274284. doi:10.1016/j.jagp.2012.09.010.CrossRefGoogle ScholarPubMed
Ayers, C. R., Sorrell, J. T., Thorp, S. R. and Wetherell, J. (2007). Evidence-based psychological treatments for late-life anxiety. Psychology and Aging, 22, 817. doi:10.1037/0882-7974.22.1.8.CrossRefGoogle ScholarPubMed
Beaudreau, S. A. and O’Hara, R. (2008). Late-life anxiety and cognitive impairment: a review. The American Journal of Geriatric Psychiatry, 16, 790803. doi:10.1097/JGP.0b013e31817945c3.CrossRefGoogle ScholarPubMed
Bedard, M. et al. (2003). Validity of self-reports in dementia research: the geriatric depression scale. Clinical Psychologist, 26, 155162. doi: 10.1300/J018v26n03_13.Google Scholar
Boddice, G., Pachana, N. A. and Byrne, G. J. (2008). The clinical utility of the geriatric anxiety inventory in older adults with cognitive impairment. Nursing Older People, 20, 3639.CrossRefGoogle ScholarPubMed
Brenes, G. A. et al. (2005). The influence of anxiety on the progression of disability. Journal of the American Geriatrics Society, 53, 3439. doi:10.1111/j.1532-5415.2005.53007.x.CrossRefGoogle ScholarPubMed
Campbell, D. T. and Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81105.CrossRefGoogle ScholarPubMed
Clark, L. A. and Watson, D. (1995). Constructing validity: basic issues in objective scale development. Psychological Assessment, 7, 309319.CrossRefGoogle Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.Google Scholar
Cummings, J. L. (1997). The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology, 48, S11S16.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.CrossRefGoogle ScholarPubMed
Diefenbach, G. J. et al. (2003). ‘Minor GAD’: characteristics of subsyndromal GAD in older adults. Behaviour Research and Therapy, 41, 481487. doi: 10.1016/S0005-7967(02)00130-4.CrossRefGoogle ScholarPubMed
Edelstein, B. A., Bamonti, P. M., Gregg, J. J., and Gerolimatos, L. A. (2015). Depression in later life. In Lichtenberg, P. A., Mast, B. T., Carpenter, B. D., and Wetherell, J. L. (eds.), APA Handbook on Clinical Geropsychology, Vol 2: Assessment, Treatment, and Issues of Later Life (pp. 347). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Ferketich, S. (1991). Focus on psychometrics: aspects of item analysis. Research in Nursing & Health, 14, 165168.CrossRefGoogle ScholarPubMed
Furr, R. M. and Bacharach, V. R. (2014). Psychometrics: An Introduction, 2nd edn. Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Garin, O. et al. (2010). Validation of the “world health organization disability assessment schedule, WHODAS-2” in patients with chronic disease. Health and Quality of Life Outcomes, 8, 115.CrossRefGoogle Scholar
Geda, Y. E. et al. (2008). The prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: a population based study. Archives of General Psychiatry, 65, 11931198. doi: 10.1001/archpsyc.65.10.1193.CrossRefGoogle Scholar
Gerolimatos, L. A., Gregg, J. J. and Edelstein, B. A. (2013). Assessment of anxiety in long-term care: an examination of the geriatric anxiety inventory (GAI) and its short form. International Psychogeriatrics, 25, 15331542. doi: 10.1017/S1041610213000847.CrossRefGoogle ScholarPubMed
Gibbons, L. E., Teri, L., Logsdon, R. G. and McCurry, S. M. (2006). Assessment of anxiety in dementia: an investigation into the association of different methods of measurement. Journal of Geriatric Psychiatry And Neurology, 19, 202208. doi:10.1177/0891988706292758.CrossRefGoogle ScholarPubMed
Gill, D. J., Freshman, A., Blender, J. A. and Ravina, B. (2008). The Montreal cognitive assessment as a screening tool for cognitive impairment in Parkinson's disease. Movement Disorders, 23, 10431046. doi: 10.1002/mds.22017.CrossRefGoogle ScholarPubMed
Gould, C. E., Segal, D. L., Yochim, B. P., Pachana, N. A., Byrne, G. J. and Beaudreau, S. A. (2014). Measuring anxiety in late life: a psychometric examination of the geriatric anxiety inventory and the geriatric anxiety scale. Journal of Anxiety Disorders, 28, 804811.CrossRefGoogle ScholarPubMed
Gum, A. M., King-Kallimanis, B. and Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorder for older Americans in the national comorbidity survey-replication. The American Journal of Geriatric Psychiatry, 17, 769781.CrossRefGoogle ScholarPubMed
Hancock, G. A., Woods, B., Challis, D. and Orrell, M. (2006). The needs of older people with dementia in residential care. International Journal of Geriatric Psychiatry, 21, 4349.CrossRefGoogle ScholarPubMed
Kurlowicz, L. H., Evans, L. K., Strumpf, N. E. and Maislin, G. (2002). A psychometric evaluation of the Cornell scale for depression in dementia in a frail, nursing home population. The American Journal of Geriatric Psychiatry, 10, 600608.CrossRefGoogle Scholar
Nasreddine, Z. A. et al. (2005). The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 695699.CrossRefGoogle Scholar
Novella, J. L., Jochum, C., Ankri, J., Morrone, I., Jolly, D. and Blanchard, F. (2001). Measuring general health status in dementia: practical and methodological issues in using the SF-36. Aging (Milano), 13, 362369.Google ScholarPubMed
Nunnally, J. C. and Bernstein, I. H. (1994). Psychometric Theory. Sydney: McGraw-Hill.Google Scholar
Orrell, M. and Bebbington, P. (1996). Psychosocial stress and anxiety in senile dementia. Journal of Affective Disorders, 39, 165173.CrossRefGoogle ScholarPubMed
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the geriatric anxiety inventory. International Psychogeriatrics, 19, 103114.CrossRefGoogle ScholarPubMed
Petersen, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L. and DeKosky, S. T. (2001). Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review): report of the quality standards subcommittee of the American academy of neurology. Neurology, 56, 11331142.CrossRefGoogle Scholar
Reisberg, B., Auer, S. R. and Monteiro, I. M. (1996). Behavioral pathology in Alzheimer's disease (BEHAVE-AD) rating scale. International Psychogeriatrics, 8 (Suppl. 3), 301308.CrossRefGoogle ScholarPubMed
Resnick, B. and Nahm, E. S. (2001). Reliability and validity testing of the revised 12-item Short-Form health survey in older adults. Journal of Nursing Measurement, 9, 151161.CrossRefGoogle ScholarPubMed
Ribeiro, O., Paúl, C., Simões, M. R. and Firmino, H. (2011). Portuguese version of the geriatric anxiety inventory: transcultural adaptation and psychometric validation. Aging and Mental Health, 11, 742748. doi: 10.1080/13607863.2011.562177.CrossRefGoogle Scholar
Segal, D. L., Qualls, S. H. and Smyer, M. A. (2010). Aging and Mental Health. 2nd edn. Hoboken, NJ: Wiley Blackwell.Google Scholar
Seignourel, P. J., Kunik, M. E., Snow, L., Wilson, N. and Stanley, M. (2008). Anxiety in dementia: a critical review. Clinical Psychology Review, 28, 10711082.CrossRefGoogle ScholarPubMed
Shankar, K. K., Walker, M., Frost, D. and Orrell, M. W. (1999). The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging and Mental Health, 3, 3949.CrossRefGoogle Scholar
Shear, M. K. et al. (2001). Reliability and validity of a structured interview guide for the Hamilton Anxiety rating scale (SIGH-A). Depression and Anxiety, 13, 166178.CrossRefGoogle ScholarPubMed
Sim, J. and Wright, C. C. (2005). The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Physical Therapy, 85, 257268.CrossRefGoogle ScholarPubMed
Snow, A. L., Cook, K. F., Lin, P. S., Morgan, R. O. and Magaziner, J. (2005). Proxies and other external raters: methodological considerations. Health Services Research, 40, 16761693.CrossRefGoogle Scholar
Snow, A. L. et al. (2005). Accuracy of self-reported depression in persons with dementia. Journal of the American Geriatrics Society, 53, 389396. doi:10.1111/j.1532-5415.2005.53154.x.CrossRefGoogle ScholarPubMed
Snow, A. et al. (2012). Psychometric properties of a structured interview guide for the rating for anxiety in dementia. Aging & Mental Health, 16, 592602. doi:10.1080/13607863.2011.644518.CrossRefGoogle ScholarPubMed
Spielberger, C., Gorsuch, R. and Lushene, R. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press, Inc.Google Scholar
Streiner, D. L. and Norman, G. R. (1995). Health Measurement Scales: A Practical Guide to Their Development and Use. New York: Oxford University Press.Google Scholar
Tabachnick, B. G. and Fidell, L. S. (2007). Using Multivariate Statistics, 5th edn. Boston, MA: Allyn and Bacon.Google Scholar
Towsley, G., Neradilek, M. B., Snow, A. L. and Ersek, M. (2012). Evaluating the Cornell scale for depression in dementia as proxy measure in nursing home residents with and without dementia. Aging and Mental Health, 16, 892901. doi: 10.1080/13607863.2012.667785.CrossRefGoogle ScholarPubMed
Ustun, T. B. et al. (2010). Developing the world health organization disability assessment schedule. Bulletin of the World Health Organization, 88, 815823.CrossRefGoogle ScholarPubMed
Ware, J. E., Kosinski, M. and Keller, S. (1996). A 12-item short-form health survey (SF-12): construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220233.CrossRefGoogle ScholarPubMed
Ware, J. E., Kosinski, M. and Keller, S. D. (1998). How to Score the SF-12 Physical and Mental Health Summary Scales, 3rd edn. Boston: The Health Institute, New England Medical Center.Google Scholar
Ware, J. E. and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Medical Care, 30, 473483.CrossRefGoogle ScholarPubMed
Wetherell, J. L., Le Roux, H. and Gatz, M. (2003). DSM-IV criteria for generalized anxiety disorder in older adults: distinguishing the worried from the well. Psychology and Aging, 18, 622627.CrossRefGoogle ScholarPubMed
Wood, S. et al. (2000). The use of the neuropsychiatric inventory in nursing home residents. Characterization and measurement. The American Journal of Geriatric Psychiatry, 8, 7583.CrossRefGoogle ScholarPubMed