Construct and concurrent validity of the Dementia Rating Scale-2 Alternate Form.

The Dementia Rating Scale-2: Alternate Form (DRS-2: AF) was developed by Schmidt (2004) for use in serial neuropsychological assessments with the original DRS-2 (Jurica, Leitten, & Mattis, 2001). Results from two preliminary validation studies of the DRS-2: AF are presented here. In Study 1, the DRS-2: AF and four additional neuropsychological measures were administered to 49 healthy, community-dwelling participants without dementia; convergent and discriminant correlational analyses provide evidence for the construct validity of four DRS-2: AF subscales (Attention, Initiation/ Perseveration, Conceptualization, Memory). In Study 2, the DRS-2: AF and Mini-Mental State Examination (MMSE) were administered to a sample of 65 residents living in a continuing care retirement community (30 residents with dementia, 35 residents without dementia) to demonstrate the construct and concurrent validity of the DRS-2: AF Total Score. A strong correlation was found between the MMSE and DRS-2: AF Total Score. When DRS-2: AF Total Scores were subjected to a discriminant function analysis, Total Scores accurately classified 61 of the 65 participants into the appropriate patient group (dementia vs. comparison). The results of these preliminary validation studies are robust, and suggest that the DRS-2: AF may be a useful measure when serial assessments with the DRS-2 are needed.

Reduced ability to self-administer medication is associated with assisted living placement in a continuing care retirement community.

OBJECTIVE: To examine whether reduced ability to self-administer medication can accurately classify living placement (independent or assisted living) in a continuing care retirement community (CCRC). DESIGN: Convenience sample of consecutive patients seen in a medical clinic. SETTING: An outpatient medical clinic at a CCRC. PARTICIPANTS: A group of 78 consecutive patients (aged 68-98 years) scheduled for a geriatric medical evaluation between May 1, 2001, and August 31, 2001, residing in an independent (IL) or assisted living (AL) apartment. MEASUREMENTS: Ability to self-administer medication was assessed by asking residents to respond to a medication administration question based on a 5-point Likert scale. Residents were also given measures of cognitive status (MMSE), activities of daily living (ADL), and depression (GDS). Further, age of residents as well as number of falls within the previous 6 months were recorded. RESULTS: A discriminant function analysis accurately classified living placement (IL or AL) in 89.7% of the cases based on the ability of residents to self-administer medication. The additions of MMSE score, ADL performance, GDS score, number of falls, and age of the residents to the analyses did not improve the number of cases that were correctly classified. CONCLUSION: Ability to self-administer medication emerged as the main predictor of current living environment within the CCRC in the present study. These results underscore the importance of considering a resident's ability to independently manage his or her medications when placement decisions are being made within CCRCs.

Validity of the Medication Administration Test among older adults with and without dementia.

BACKGROUND: Impairments in everyday activities (ie, using the telephone, driving, managing medication) have been associated with increasing age as well as dementia severity. One of the initial functional losses among older adults both with and without dementia is impaired medication self-management skills. In fact, reduced ability to self administer medication has been identified as a significant predictor of an assisted living (AL) placement (vs an independent living [IL] placement) among older adults. We recently developed a Medication Administration Test (MAT) to aid in placement decisions regarding level of care (eg, IL, AL). OBJECTIVE: The purpose of this study was to examine the construct and concurrent validity of the MAT in a sample of older adults residing in a continuing care retirement facility. METHODS: IL and AL participants were administered the MAT along with a brief neuropsychological battery that included the Naturalistic Action Test, the Mini-Mental State Examination, and the Instrumental Activities of Daily Living scale. The construct validity of the MAT was assessed by correlating MAT scores with the other neuropsychological instruments of cognition and function. With respect to the MAT's concurrent validity, a discriminant function analysis was run to determine the classification accuracy (IL vs AL) of the newly developed MAT. RESULTS: Sixty-two white participants were included in the study (mean age, 85.56 years); 34 participants were residing in an AL setting and 28 were residing in an IL setting. Evidence for construct validity was relatively robust, as performance on the MAT was moderately correlated with scores on the Mini-Mental State Examination, the Naturalistic Action Test, and the Instrumental Activities of Daily Living scale. When MAT scores were subjected to a discriminant function analysis to assess concurrent validity, MAT performance accurately classified 79.03% of the participants into the appropriate level of care (IL or AL). CONCLUSION: This project provides preliminary evidence for the validity of the MAT when used for placement decisions within continuing care retirement communities. Given the current need for objective measures to aid in level of care decision making, the MAT may be useful in both clinical and research arenas.