Reliability and validity of the international dementia alliance schedule for the assessment and staging of care in China

BACKGROUND Clinical and social services both are important for dementia care. The International Dementia Alliance (IDEAL) Schedule for the Assessment and Staging of Care was developed to guide clinical and social care for dementia. Our study aimed to assess the validity and reliability of the IDEAL schedule in China. METHODS Two hundred eighty-two dementia patients and their caregivers were recruited from 15 hospitals in China. Each patient-caregiver dyad was assessed with the IDEAL schedule by a rater and an observer simultaneously. The Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), and Caregiver Burden Inventory (CBI) were assessed for criterion validity. IDEAL repeated assessment was conducted 7-10 days after the initial interview for 62 dyads. RESULTS Two hundred seventy-seven patient-caregiver dyads completed the IDEAL assessment. Inter-rater reliability for the total score of the IDEAL schedule was 0.93 (95%CI = 0.92-0.95). The inter-class coefficient for the total score of IDEAL was 0.95 for the interviewers and 0.93 for the silent raters. The IDEAL total score correlated with the global CDR score (ρ = 0.72, p < 0.001), the CDR-sum of box (CDR-SOB, ρ = 0.74, p < 0.001), the total score of MMSE (ρ = -0.65, p < 0.001) and CBI (ρ = 0.70, p < 0.001). All item scores of the IDEAL schedule were associated with the CDR-SOB (ρ = 0.17 ~ 0.79, all p < 0.05). CONCLUSION The IDEAL schedule is a valid and reliable tool for the staging of care for dementia in the Chinese population.