Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-22T18:52:49.570Z Has data issue: false hasContentIssue false

Validation of the Chinese Version of the Relevant Outcome Scale for Alzheimer’s Disease (CROSA)

Published online by Cambridge University Press:  24 March 2021

Shuying Zhang*
Affiliation:
Tongji University School of Medicine, Tongji University, Shanghai, China
Jianing Qi
Affiliation:
Tongji University School of Medicine, Tongji University, Shanghai, China
Qing Yang
Affiliation:
Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
Qihao Guo*
Affiliation:
Department of Gerontology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, China
*
Correspondence should be addressed to: Shuying Zhang, Tongji University School of Medicine, Tongji University, 1239 Si Ping Road, Shanghai200092, China. Phone: +86 21 66051211. Email: [email protected]; Qihao Guo, Department of gerontology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai200233, China. Phone: +86 13 817741448. Email: [email protected]
Correspondence should be addressed to: Shuying Zhang, Tongji University School of Medicine, Tongji University, 1239 Si Ping Road, Shanghai200092, China. Phone: +86 21 66051211. Email: [email protected]; Qihao Guo, Department of gerontology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai200233, China. Phone: +86 13 817741448. Email: [email protected]
Get access

Abstract

Objectives:

To examine the psychometric properties of the Chinese version of the Relevant Outcome Scale for Alzheimer’s disease (CROSA) among persons with AD (PWAD) and their caregivers in China.

Design:

A single-arm, open-label, multi-center study.

Setting:

Two tertiary general hospitals in Shanghai.

Participants:

A total of 336 PWAD and their family caregivers.

Intervention:

The PWAD completed a 12-week treatment with memantine after a baseline assessment.

Measurements:

The CROSA and the Chinese versions of the Mini-Mental State Examination, the Alzheimer’s Disease Assessment Scale-Cognitive Subscale, the Disability Activity of Dementia, the Neuropsychiatric Inventory Questionnaire, the Zarit Caregiver Burden Interview and the Self-Efficacy Questionnaire for Chinese Family Caregivers.

Results:

The Cronbach’s alpha for the total scale was 0.900, and the intraclass correlation coefficient and Pearson’s correlation coefficient were 0.910 (P < 0.001) and 0.836 (P < 0.001), respectively. Confirmatory factor analysis revealed the two-factor model to be consistent with the original version. For the known-group validity, the total score of the CROSA classified the PWAD into three stages and three MMSE score groups. Moderate to large correlations with the validated scales confirmed the criteria validity of the CROSA, and the convergent validity was confirmed via testing a hypothesized caregiving model; however, only minimal responsiveness was found among the deterioration group after 12 weeks of treatment with memantine.

Conclusions:

The reliability and validity of the CROSA was good or acceptable for use in daily clinical settings. Further studies are needed to examine the psychometric properties of the scale.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2021

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.)

Footnotes

These authors contributed equally to this study.

References

Aalten, P. et al. (2007). Neuropsychiatric syndromes in dementia - Results from the European Alzheimer Disease Consortium: Part I. Dementia and Geriatric Cognitive Disorders, 24, 457463. doi: 10.1159/000110738 CrossRefGoogle Scholar
Birks, J. S. and Harvey, R. J. (2018). Donepezil for dementia due to Alzheimer’s disease. Cochrane Database of Systematic Reviews, 6, CD001190. doi: 10.1002/14651858.CD001190.pub3 Google ScholarPubMed
Black, R. et al. (2009). Scales as outcome measures for Alzheimer’s disease. Alzheimers and Dementia, 5, 324339. doi: 10.1016/j.jalz.2009.05.667 CrossRefGoogle ScholarPubMed
Byrne, B. M. (2016). Structural Equation Modeling with Amos: Basic Concepts, Applications, and Programming. New York: Routledge.CrossRefGoogle Scholar
Cohen, J. W. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd edn). Hillsdale, NJ: Lawrence Erlbaum Associations.Google Scholar
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. doi: 10.1212/WNL.44.12.2308 CrossRefGoogle ScholarPubMed
David, L. S., Geoffrey, R. N., and John, C. (2015). Health Measurement Scales: A Practical Guide to their Development and Use. United States of America: Oxford University Press.Google Scholar
Gelinas, I., Gauthier, L., McIntyre, M. and Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer’s disease: the disability assessment for dementia. American Journal of Occupational Therapy, 53, 471481. doi: 10.5014/ajot.53.5.471 CrossRefGoogle ScholarPubMed
Harvey, P. D. et al. (2005). The validation of a caregiver assessment of dementia - The Dementia Severity Scale. Alzheimer Disease and Associated Disorders, 19, 186194. doi: 10.1097/01.wad.0000189034.43203.60 CrossRefGoogle ScholarPubMed
Holthoff, V. A. et al. (2011). Validation of the relevant outcome scale for Alzheimer’s disease: a novel multidomain assessment for daily medical practice. Alzheimers Research and Therapy, 3. doi: 10.1186/alzrt89 CrossRefGoogle ScholarPubMed
Howard, R. et al. (2012). Donepezil and memantine for moderate-to-severe Alzheimer’s Disease. New England Journal of Medicine, 366, 893903. doi: 10.1056/NEJMoa1106668 CrossRefGoogle ScholarPubMed
Hu, L. T. and Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling-a Multidisciplinary Journal, 6, 155. doi: 10.1080/10705519909540118 CrossRefGoogle Scholar
Husted, J. A., Cook, R. J., Farewell, V. T. and Gladman, D. D. (2000). Methods for assessing responsiveness: a critical review and recommendations. Journal of Clinical Epidemiology, 53, 459468. doi: 10.1016/S0895-4356(99)00206-1 CrossRefGoogle ScholarPubMed
Ishii, S., Streim, J. E. and Saliba, D. (2012). A Conceptual framework for rejection of care behaviors: review of literature and analysis of role of dementia severity. Journal of the American Medical Directors Association, 13, 11U40. doi: 10.1016/j.jamda.2010.11.004 CrossRefGoogle ScholarPubMed
Jia, L. et al. (2020). Dementia in China: epidemiology, clinical management, and research advances. Lancet Neurology, 19, 8192. doi: 10.1016/S1474-4422(19)30290-X CrossRefGoogle ScholarPubMed
Kales, H. C., Lyketsos, C. G., Miller, E. M. and Ballard, Clive. (2019). Management of behavioral and psychological symptoms in people with Alzheimer’s disease: an international Delphi consensus. International Psychogeriatrics, 31, 8390. doi: 10.1017/S1041610218000534 CrossRefGoogle Scholar
Katzman, R. et al. (1988). A Chinese version of the Mini-Mental State Examination - impact of illiteracy in a Shanghai dementia survey. Journal of Clinical Epidemiology, 41, 971978. doi: 10.1016/0895-4356(88)90034-0 CrossRefGoogle Scholar
Lane, C. A., Hardy, J. and Schott, J. M. (2018). Alzheimer’s disease. European Journal of Neurology, 25, 5970. doi: 10.1111/ene.13439 CrossRefGoogle ScholarPubMed
Livingston, G. et al. (2017). Dementia prevention, intervention, and care. Lancet, 390, 26732734. doi: 10.1016/S0140-6736(17)31363-6 CrossRefGoogle ScholarPubMed
Lu, L., Wang, L., Yang, X. and Feng, Q. (2009). Zarit Caregiver Burden Interview: Development, reliability and validity of the Chinese version. Psychiatry and Clinical Neurosciences, 63, 730734. doi: 10.1111/j.1440-1819.2009.02019.x CrossRefGoogle ScholarPubMed
McShane, R. et al. (2019). Memantine for dementia. Cochrane Database of Systematic Reviews. doi: 10.1002/14651858.CD003154.pub6 CrossRefGoogle ScholarPubMed
Mohs, R. C. and Cohen, L. (1988). Alzheimer’s Disease Assessment Scale (ADAS). Psychopharmacology Bulletin, 24, 627628.Google Scholar
Mok, C. C. M., Siu, A. M. H., Chan, W. C., Yeung, K. M., Pan, P. C. and Li, S. W. (2005). Functional disabilities profile of Chinese elderly people with Alzheimer’s disease - A validation study on the Chinese version of the disability assessment for dementia. Dementia and Geriatric Cognitive Disorders, 20, 112119. doi: 10.1159/000086612 CrossRefGoogle ScholarPubMed
Monahan, P. O. et al. (2012). Practical clinical tool to monitor dementia symptoms: the HABC-Monitor. Clinical Interventions in Aging, 7, 143157. doi: 10.2147/CIA.S30663 CrossRefGoogle ScholarPubMed
Mori, T. et al. (2018). ABC Dementia Scale: a quick assessment tool for determining Alzheimer’s disease severity. Dementia and Geriatric Cognitive Disorders Extra, 8, 8597. doi: 10.1159/000486956 Google ScholarPubMed
Nijsten, J. M. H., Leontjevas, R., Smalbrugge, M., Koopmans, R. T. C. M. and Gerritsen, D. L. (2019). Apathy and health-related quality of life in nursing home residents. Quality of Life Research, 28, 751759. doi: 10.1007/s11136-018-2041-y CrossRefGoogle ScholarPubMed
Oksnebjerg, L., Janbek, J., Woods, B. and Waldemar, G. (2020). Assistive technology designed to support self-management of people with dementia: user involvement, dissemination, and adoption. A scoping review. International Psychogeriatrics, 32, 937953. doi: 10.1017/S1041610219001704 CrossRefGoogle ScholarPubMed
Pardo, C. C., Alcalde, S. l., Garcia, M. E., Magro, I. S. and Estudio, R. G. (2017). Validation of the Spanish-language version of the Relevant Outcome Scale for Alzheimer’s Disease. Neurologia, 32, 417423. doi: 10.1016/j.nrl.2015.12.007 CrossRefGoogle Scholar
Preacher, K. J. and Hayes, A. F. (2008). Asymptoticand resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879891. doi: 10.3758/BRM.40.3.879 CrossRefGoogle ScholarPubMed
Rausch, A., Caljouw, M. A. A. and van der Ploeg, E. S. (2017). Keeping the person with dementia and the informal caregiver together: a systematic review of psychosocial interventions. International Psychogeriatrics, 29, 583593. doi: 10.1017/S1041610216002106 CrossRefGoogle ScholarPubMed
Reisberg, B. and Ferris, S. H. (1994). Clinician’s Interview-based Impression of Change-plus. In Guide to Assessment Scales in Dementia. London: Science Press.Google Scholar
Robert, P., Ferris, S., Gauthier, S., Ihl, R., Winblad, B. and Tennigkeit, F. (2010). Review of Alzheimer’s disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimers Research and Therapy, 2. doi: 10.1186/alzrt48 CrossRefGoogle Scholar
Roehr, S. et al. (2017). Subjective cognitive decline is longitudinally associated with lower health-related quality of life. International Psychogeriatrics, 29, 19391950. doi: 10.1017/S1041610217001399 CrossRefGoogle ScholarPubMed
Saari, T., Hallikainen, I., Hintsa, T. and Koivisto, A. M. (2020). Neuropsychiatric symptoms and activities of daily living in Alzheimer’s disease: ALSOVA 5-year follow-up study. International Psychogeriatrics, 32, 741751. doi: 10.1017/S1041610219001571 CrossRefGoogle ScholarPubMed
Sijtsma, K. (2009). On the use, the misuse, and the very limited usefulness of Cronbach’s alpha. Psychometrika, 74, 107120. doi: 10.1007/s11336-008-9101-0 CrossRefGoogle ScholarPubMed
Smith, K J., George, C. and Ferriera, N. (2018). Factors emerging from the “Zarit Burden Interview” and predictive variables in a UK sample of caregivers for people with dementia. International Psychogeriatrics, 30, 16711678. doi: 10.1017/S1041610218000315 CrossRefGoogle Scholar
Vaingankar, J. A. et al. (2016). Care participation and burden among informal caregivers of older adults with care needs and associations with dementia. International Psychogeriatrics, 28, 221231. doi: 10.1017/S104161021500160X CrossRefGoogle ScholarPubMed
Volicer, L., Bass, E. A. and Luther, S. L. (2007). Agitation and resistiveness to care are two separate behavioral syndromes of dementia. Journal of the American Medical Directors Association, 8, 527532. doi: 10.1016/j.jamda.2007.05.005 CrossRefGoogle ScholarPubMed
Wang, G. B., Albayrak, A. and van der Cammen, T. J. M. (2019). A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia: from a perspective of ergonomics. International Psychogeriatrics, 31, 11371149. doi: 10.1017/S1041610218001679 CrossRefGoogle ScholarPubMed
Wang, H., Yu, X., Li, S. R., Chen, Y. F., Li, H. D. and He, J. (2004). The cognitive subscale of Alzheimer’s disease assessment scale, Chinese version in staging of Alzheimer disease. Alzheimer Disease and Associated Disorders, 18, 231235.Google ScholarPubMed
Wong, A. et al. (2014). Validity and reliability of the Neuropsychiatric Inventory Questionnaire version in patients with stroke or transient ischemic attack having cognitive impairment. Journal of Geriatric Psychiatry and Neurology, 27, 247252. doi: 10.1177/0891988714532017 CrossRefGoogle ScholarPubMed
Ydstebo, A. E., Bergh, S., Selbaek, G., Benth, J. S., Bronnick, K., Vossius, C. (2018). Longitudinal changes in quality of life among elderly people with and without dementia. International Psychogeriatrics, 30, 16071618. doi: 10.1017/S1041610218000352 CrossRefGoogle ScholarPubMed
Zhang, S. Y., Edwards, H., Yates, P., Li, C. and Guo, Q. H. (2014a). Self-efficacy partially mediates between social support and health-related quality of life in family caregivers for dementia patients in Shanghai. Dementia and Geriatric Cognitive Disorders, 37, 3444. doi: 10.1159/000351865 CrossRefGoogle ScholarPubMed
Zhang, S. Y., Guo, Q. H., Edwards, H., Yates, P. and Li, C. (2014b). Self-efficacy moderation and mediation roles on BPSD and social support influences on subjective caregiver burden in Chinese spouse caregivers of dementia patients. International Psychogeriatrics, 26, 14651473. doi: 10.1017/S1041610214000994 CrossRefGoogle Scholar
Zhang, S. Y., Edwards, H., Yates, P., Ruth, E. and Guo, Q. H. (2013). Preliminary reliability and validity testing of a Self-Efficacy Questionnaire for Chinese Family Caregivers. Aging & Mental Health, 17, 630637. doi: 10.1080/13607863.2013.771615 CrossRefGoogle ScholarPubMed
Zhang, S. Y. et al. (2020). Pilot testing the caregiver self-management intervention for caregivers of relatives with dementia. Geriatric Nursing, 41, 147157. doi: 10.1016/j.gerinurse.2019.08.006 CrossRefGoogle ScholarPubMed
Supplementary material: File

Zhang et al. supplementary material

Zhang et al. supplementary material

Download Zhang et al. supplementary material(File)
File 47.6 KB