A study of the reliability and validity of the Chinese version of Dementia Rating Scale

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A study of the reliability and validity of the Chinese version of Dementia Rating Scale


Author: Chan, Heung-lan Irene
Title: A study of the reliability and validity of the Chinese version of Dementia Rating Scale
Degree: M.Sc.
Year: 1999
Subject: Dementia -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Pages: xii, 141 p. : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1483488
URI: http://theses.lib.polyu.edu.hk/handle/200/3919
Abstract: Like many developed countries, Hong Kong has an aging population. As the prevalence of dementia increase with age, it is anticipated that the increasing number of elderly dementia will pose a significant challenge to our health care system in the coming decade. There is an increasing demand for the development of cognitive assessment instruments for dementia, which provide detailed assessment of the cognitive deficits, and serve as an aid to the diagnosis of dementia, as well as a tool for outcome evaluation. The present study aims at developing and validating a Chinese version of Dementia Rating Scale (CDRS) for use in psychogeriatric settings. The study started with the translation of the instrument to Chinese and an evaluation of the content validity, concurrent validity (using the Chinese version of Mini-mental Status Examination as standard), and reliability of the CDRS. The Chinese version of the Dementia Rating Scale was developed by forward and backward translation. An expert panel that consisted of 11 members were recruited to evaluate the content validity of the CDRS. Both quantitative and qualitative comments were collected by use of a specially-designed questionnaire. Using percentage of agreement as an indicator, 28 out of 36 items (78%) had satisfactory degree of percentage of agreement in relevance and representativeness (i.e. above 70% agreement). The items below 70% agreement were reviewed and modified based on the comments of the experts. To conduct studies of concurrent validity and reliability, 52 subjects with dementia were recruited from 5 clinical psyhogeriatric settings using a purposive sampling method. A majority of the subjects were female (65.4%), educated (65.4%), diagnosed dementia of Alzheimer type (78.9%) and had a mean age of 75.1. Results showed that the CDRS had excellent test-retest and inter-rater reliability. The ICCs of the subscales were in the range between 0.75 and 0.89 for both types of reliability. The ICCs of the test-retest and inter-rater reliability of the CDRS total score were 0.94 and 0.93 respectively. The concurrent validity of CDRS and CMMSE was also satisfactory (r=0.80; r=0.57-0.84 for subscales). The internal consistency, as measured by Cronbach's alpha of the CDRS subscales ranged from 0.56 to 0.82. The results indicated that there wass some concern about the internal consistency (alpha=0.56) and concurrent validity (r=0.57) of the Initiation/Perseveration subscale. Item analysis was carried out to analyze the item characteristics and difficulty. Eight items were found to have ceiling or flooring effect. The findings were analyzed and discussed in the light of the advantages and limitations of the instrument, and the possible application of the study. A number of suggestions were made to improve the validity and reliability of the instrument.

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