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352 Reliability and Validity of the Dementia Care Assessment Packet – Instrumental Activities of Daily Living (DCAP-IADL)
Poster presentations / Asian Journal of Psychiatry 4S1 (2011) S41–S90
are familiar, coloured, and with realistic features. For visuospatial construction, manipulating wood block instead of drawing. Results and Conclusion: The interaction between literacy and dementia were significant (p < 0.05). The illiterate NC got lower score than the literate NC. However, the illiterate NC group was not different from the literate AD except for visuospatial construction. These findings suggest that it is more likely that the cognitive functioning of uneducated elderly people is in fact inferior than is underestimated. Therefore, it is required to develop neuropsychological tests suitable for the illiterate. 267 Dementia: Positive Aspects of Caregiving and Indian Culture 1
2
1
P.R. Jathanna , K.S. Latha . Health Information Management, Manipal College of Allied Health Sciences, Manipal University, 2 Psychiatry, Kasturba Medical College, Manipal, Udupi, India Research on family caregivers usually focuses on burden and coping, especially in the context of looking after a person with dementia. This leads to fewer considerations of positive aspects of caregiving. Literature focusing on the positive aspects of caregiving, alternatively labeled “caregiver satisfaction” is on the rise. Positive aspects of caregiving (PAC) may reduce the stresses of caregiving and improve outcomes for caregivers. The aim of the study is to enumerate the PAC in Indian caregiving perspective. This is a cross sectional study of a long term project by the author (RJ), involves face-to-face interview with questionnaires with family caregivers of patients with dementia. Caregiver’s attitude towards care giving was analyzed. Twenty seven (21.6%) care givers said that they could identify at least one PAC i.e. a feeling of satisfaction. Of the total of 68 caregivers fifteen (44.1%) were children reported being satisfied with caring. Of the 37 spouses eight (43.6%) reported being satisfied caring for their loved ones. Further analysis was done which will be discussed highlighting the importance of cultural values. This study proposes a conceptual framework of the positive aspects of care giving based on a cultural context. This empirical study provides an insight into the cultural factors leading to positive aspects of care giving. It could also contribute to the development of innovative support programs based on the positive aspects instead of the negative aspects of care giving. 328 The Reliability and Validation of the Short Cued Recall Test J.C. Youn1 , E.H. Park2 , C.S. Jung1 , S.A. Lee1 . 1 Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, 2 Department of Clinical Psychology, Hallym University Sacred Heart Hospital, PyungChon, Republic of Korea Objectives: We developed two parallel versions of short cued recall tests (SCRT A and B) and tested its reliability and validity for dementia screening in community setting. Methods: Total 337 elderly subjects consisted of 109 normal controls, 116 patients with mild cognitive impairment, and 112 dementia patients. Geriatric psychiatrists who are experts in dementia research made the diagnosis of dementia based on CERAD protocol. Reliabilities were tested. To determine the construct validity, the participants received the standardized Korean-version of Neuropsychological Assessment Battery in CERAD(CERAD-K-N) and the results were compared using Multivariate Analysis of Variance (MANOVA). To measure the diagnostic accuracy, the receiver operator characteristic (ROC) analysis was used. Results: Three groups did not show significant differences in demographic variables. Significant correlations were found between two alternative forms and between test-retest scores of SCRT. The SCRT scores were significantly correlated with memory measures of the CERAD-K-N(r = 0.540–0.609, p < 0.01). According to MANOVA results, the performances on the SCRT were significantly differentiated among three groups (Walks
S55
Lamda = 0.134, F(4,316) = 510.55, p < 0.001). The area under the ROC curve (AUC) of each SCRT A and B was 0.871 and 0.934, indicating the overall diagnostic accuracy of the SCRT is fairly high. The optimal cut off score for detecting dementia on the SCRT was 5/6. Conclusion: Our results indicate that the SCRT is a very brief and valid memory screening instrument for evaluating memory deficits of dementia patients while showing high sensitivity and specificity. 352 Reliability and Validity of the Dementia Care Assessment Packet – Instrumental Activities of Daily Living (DCAP-IADL) S.B. Lee1 , J.R. Park2 , J.H. Park3 , J.J. Lee4 , K.W. Kim5 . 1 Psychiatry, College of Medicine, Dankook University, 2 Psychiatry, Dankook University Hospital, Cheonan, 3 Psychiatry, Jeju National University Hospital, Jeju, 4 Psychiatry, Kyungbook National University Hospital, Daegu, 5 Neuropsychiatry, Seoul National University Bundang Hospital, Seongnamsi, Republic of Korea Background: Instrumental activities of daily living (IADL) are not necessary for fundamental functioning, but enable the individual to live independently within a community. Objective: We evaluate the psychometric properties of the Dementia Care Assessment Packet-Instrumental Activities of Daily Living (DCAP-IADL). Methods: The participants consisted of 112 dementia patients and 546 non-demented controls that were aged 60 years or older. The non-demented subjects were community-dwelling elders who participated in the Korean Longitudinal Study for Health and Aging (KLoSHA). The dementia patients were recruited from either the visitors to the Dementia Clinic of Dankook University Hospital(N = 58) or the participants of the KLoSHA(N = 54). Assessments were Korean version of CERAD Clinical and Neuropsychological Assessment Battery, K-IADL, and DCAP-IADL. Results: Chronbach’s coefficients alpha for observed and predicted score in dementia patients were above 0.9. Inter-rater reliabilities and test-retest reliabilities were significant(p < 0.05, Pearson correlation). Mean scores of dementia patients were significantly higher than those of the non-demented group after controlling age, sex and education level(p < 0.0001, ANCOVA). Pearson correlation coefficients between DCAP-IADL, BDS-ADL, MMSE-KC and CDRSOB were statistically significant(p < 0.01). AUC of observed score was 0.926 (Optimal cut-off point = 7/8, sensitivity = 0.902, and specificity = 0.837). AUC of predicted score was 0.931 (Optimal cut-off point = 6/7, sensitivity = 0.902, and specificity = 0.841). Conclusions: DCAP-IADL was found to be a reliable and valid test for assessing the instrumental activities of daily living of Korean elders. Especially, application of predicted score was revealed to be useful in evaluating dementia patients. 495 Effectiveness of Group Music Intervention against Agitated Behavior in Elderly Persons with Dementia K.-R. Chou1 , Y. Lin2 . 1 Graduate Institute of Nursing, College of Nursing, Taipei Medical University, 2 Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan R.O.C. Objectives: This study explored the effectiveness of group music intervention against agitated behavior in elderly persons with dementia. Methods: This was an experimental study using repeated measurements. Subjects were elderly persons who suffered from dementia and resided in nursing facilities. In total, 104 participants were recruited by permuted block randomization and of the 100 subjects who completed this study, 49 were in the experimental group and 51 were in the control group. The experimental group
are familiar, coloured, and with realistic features. For visuospatial construction, manipulating wood block instead of drawing. Results and Conclusion: The interaction between literacy and dementia were significant (p < 0.05). The illiterate NC got lower score than the literate NC. However, the illiterate NC group was not different from the literate AD except for visuospatial construction. These findings suggest that it is more likely that the cognitive functioning of uneducated elderly people is in fact inferior than is underestimated. Therefore, it is required to develop neuropsychological tests suitable for the illiterate. 267 Dementia: Positive Aspects of Caregiving and Indian Culture 1
2
1
P.R. Jathanna , K.S. Latha . Health Information Management, Manipal College of Allied Health Sciences, Manipal University, 2 Psychiatry, Kasturba Medical College, Manipal, Udupi, India Research on family caregivers usually focuses on burden and coping, especially in the context of looking after a person with dementia. This leads to fewer considerations of positive aspects of caregiving. Literature focusing on the positive aspects of caregiving, alternatively labeled “caregiver satisfaction” is on the rise. Positive aspects of caregiving (PAC) may reduce the stresses of caregiving and improve outcomes for caregivers. The aim of the study is to enumerate the PAC in Indian caregiving perspective. This is a cross sectional study of a long term project by the author (RJ), involves face-to-face interview with questionnaires with family caregivers of patients with dementia. Caregiver’s attitude towards care giving was analyzed. Twenty seven (21.6%) care givers said that they could identify at least one PAC i.e. a feeling of satisfaction. Of the total of 68 caregivers fifteen (44.1%) were children reported being satisfied with caring. Of the 37 spouses eight (43.6%) reported being satisfied caring for their loved ones. Further analysis was done which will be discussed highlighting the importance of cultural values. This study proposes a conceptual framework of the positive aspects of care giving based on a cultural context. This empirical study provides an insight into the cultural factors leading to positive aspects of care giving. It could also contribute to the development of innovative support programs based on the positive aspects instead of the negative aspects of care giving. 328 The Reliability and Validation of the Short Cued Recall Test J.C. Youn1 , E.H. Park2 , C.S. Jung1 , S.A. Lee1 . 1 Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, 2 Department of Clinical Psychology, Hallym University Sacred Heart Hospital, PyungChon, Republic of Korea Objectives: We developed two parallel versions of short cued recall tests (SCRT A and B) and tested its reliability and validity for dementia screening in community setting. Methods: Total 337 elderly subjects consisted of 109 normal controls, 116 patients with mild cognitive impairment, and 112 dementia patients. Geriatric psychiatrists who are experts in dementia research made the diagnosis of dementia based on CERAD protocol. Reliabilities were tested. To determine the construct validity, the participants received the standardized Korean-version of Neuropsychological Assessment Battery in CERAD(CERAD-K-N) and the results were compared using Multivariate Analysis of Variance (MANOVA). To measure the diagnostic accuracy, the receiver operator characteristic (ROC) analysis was used. Results: Three groups did not show significant differences in demographic variables. Significant correlations were found between two alternative forms and between test-retest scores of SCRT. The SCRT scores were significantly correlated with memory measures of the CERAD-K-N(r = 0.540–0.609, p < 0.01). According to MANOVA results, the performances on the SCRT were significantly differentiated among three groups (Walks
S55
Lamda = 0.134, F(4,316) = 510.55, p < 0.001). The area under the ROC curve (AUC) of each SCRT A and B was 0.871 and 0.934, indicating the overall diagnostic accuracy of the SCRT is fairly high. The optimal cut off score for detecting dementia on the SCRT was 5/6. Conclusion: Our results indicate that the SCRT is a very brief and valid memory screening instrument for evaluating memory deficits of dementia patients while showing high sensitivity and specificity. 352 Reliability and Validity of the Dementia Care Assessment Packet – Instrumental Activities of Daily Living (DCAP-IADL) S.B. Lee1 , J.R. Park2 , J.H. Park3 , J.J. Lee4 , K.W. Kim5 . 1 Psychiatry, College of Medicine, Dankook University, 2 Psychiatry, Dankook University Hospital, Cheonan, 3 Psychiatry, Jeju National University Hospital, Jeju, 4 Psychiatry, Kyungbook National University Hospital, Daegu, 5 Neuropsychiatry, Seoul National University Bundang Hospital, Seongnamsi, Republic of Korea Background: Instrumental activities of daily living (IADL) are not necessary for fundamental functioning, but enable the individual to live independently within a community. Objective: We evaluate the psychometric properties of the Dementia Care Assessment Packet-Instrumental Activities of Daily Living (DCAP-IADL). Methods: The participants consisted of 112 dementia patients and 546 non-demented controls that were aged 60 years or older. The non-demented subjects were community-dwelling elders who participated in the Korean Longitudinal Study for Health and Aging (KLoSHA). The dementia patients were recruited from either the visitors to the Dementia Clinic of Dankook University Hospital(N = 58) or the participants of the KLoSHA(N = 54). Assessments were Korean version of CERAD Clinical and Neuropsychological Assessment Battery, K-IADL, and DCAP-IADL. Results: Chronbach’s coefficients alpha for observed and predicted score in dementia patients were above 0.9. Inter-rater reliabilities and test-retest reliabilities were significant(p < 0.05, Pearson correlation). Mean scores of dementia patients were significantly higher than those of the non-demented group after controlling age, sex and education level(p < 0.0001, ANCOVA). Pearson correlation coefficients between DCAP-IADL, BDS-ADL, MMSE-KC and CDRSOB were statistically significant(p < 0.01). AUC of observed score was 0.926 (Optimal cut-off point = 7/8, sensitivity = 0.902, and specificity = 0.837). AUC of predicted score was 0.931 (Optimal cut-off point = 6/7, sensitivity = 0.902, and specificity = 0.841). Conclusions: DCAP-IADL was found to be a reliable and valid test for assessing the instrumental activities of daily living of Korean elders. Especially, application of predicted score was revealed to be useful in evaluating dementia patients. 495 Effectiveness of Group Music Intervention against Agitated Behavior in Elderly Persons with Dementia K.-R. Chou1 , Y. Lin2 . 1 Graduate Institute of Nursing, College of Nursing, Taipei Medical University, 2 Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan R.O.C. Objectives: This study explored the effectiveness of group music intervention against agitated behavior in elderly persons with dementia. Methods: This was an experimental study using repeated measurements. Subjects were elderly persons who suffered from dementia and resided in nursing facilities. In total, 104 participants were recruited by permuted block randomization and of the 100 subjects who completed this study, 49 were in the experimental group and 51 were in the control group. The experimental group