Development and Psychometric Properties of a Friendly Dietary Function Assessment Scale for Home-dwelling People with Dementia

Abstract

Background Mealtime difficulties related to cognitive functioning exert a negative impact on a patient’s life during the different stages of dementia, and they typically cause burden and stress on family caregivers. The majority of people with dementia live at home alone or are cared by informal caregivers who are typically their spouse or other family members. However, no suitable screening tools for home-dwelling patients with dementia have been developed, nor have measurements been focused on executive functions and self-eating functions. The purposes of this study were to develop and evaluate the psychometric properties of the Dietary Function Assessment Scale (DFAS) for community-dwelling persons with dementia. Methods The instrument development design was adopted to develop and test the psychometrics of the proposed scale. Convenience sampling was used to recruit 190 persons with dementia. The psychometric properties tests included an item analysis, a factor analysis, criterion-related validity testing, internal consistency reliability testing, and defining the optimal cut-off values. Results Items were generated based on an extensive literature review and pre-existing scales related to mealtime and executive functions in persons with dementia. The S-CVI/ave of the DFAS was 0.89. A Principal Component factor analysis demonstrated 7 items, with a two-factor structure accounting for 56.94%% of the total variance. The confirmatory factor analysis indicated a good model fit. The criterion-related validity was adequate (r = -0.528, p < 0.01), and the Cronbach’s alpha internal consistency was .74; the optimal cut-off value of 13 points with an AUC of 0.74 was established to determine poor dietary functioning in persons with dementia Conclusion The DFAS was shown not only to be simple and user-friendly but was also shown to be a valid and reliable instrument to assess dietary functioning in community-dwelling persons with dementia. This short scale is useful to caretakers, who can use it to identify the dietary needs of home-dwelling persons with dementia and improve both their care and eating experience.