title: Screening for elder abuse in dementia in the LASER-AD study: prevalence, correlates and validation of instruments.
abstract: BACKGROUND
  Several studies have investigated abusive behaviour by carers towards people with dementia, most using unvalidated scales; only two reported correlates of abuse after controlling for mediators and confounders, and these controlled for different factors.
  
  
  OBJECTIVE
  To investigate the acceptability and validity of the Modified Conflict Tactics Scale (MCTS) and abuse correlates.
  
  
  METHODS
  Eighty-six people with Alzheimer's disease and their family carers, originally recruited for a representative community study were interviewed. We asked carers about acceptability of the MCTS and investigated its validity by comparing scores to the Minimum Data Set (MDS) abuse screen (an objective measure) and testing hypotheses that MCTS score would correlate with the COPE dysfunctional coping scale but not carer education.
  
  
  RESULTS
  Twenty-four (27.9%) were identified as abuse cases by interview. No care recipients (CRs) screened positive for abuse using the MDS screen. Seventy-two (83.7%) participants thought that the scale was acceptable, ten (11.6%) that it was neither acceptable nor unacceptable, and three (3.5%) that it was unacceptable. As hypothesised, MCTS scores correlated with dysfunctional coping scale score but not carer education.
  
  
  CONCLUSIONS
  This is the most comprehensive study so far in this field. The MCTS was acceptable and had convergent and discriminant validity for measuring carer abuse. The MDS failed to identify cases of abuse. Carer male gender and burden, and greater CR irritability, cognitive impairment but less functional impairment predicted carer abusive behaviour. Our findings appear to refute UK government elder abuse reduction policy which assumes that few incidents of abuse arise from carer stress.
authors.affiliation: Department of Mental Health Sciences, University College London, Archway Campus, London, UK. c.cooper@medsch.ucl.ac.uk
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
authors.forename: Monica
authors.initials: M
authors.lastname: Manela
authors.forename: Cornelius
authors.initials: C
authors.lastname: Katona
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000451:nursing* / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D004552:Elder Abuse / Q000175:diagnosis*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics