A qualitative assessment of the concept of dependence in Alzheimer's disease.
BACKGROUND
The Dependence Scale (DS) was designed to assess levels of patient need for care due to deficits typical of Alzheimer's disease (AD). This study examined content validity of the DS based on input from patients, caregivers, and clinicians.


METHODS
Qualitative interviews with experts, patients, and caregivers were used to collect information on the concept of dependence and to assess content validity.


RESULTS
Nine clinicians rated item relevance ''high'' with consensus on the primacy of functional abilities and dependence in the measurement of AD progression. Twenty-two US, 11 UK, and 14 informal caregivers from Spain participated in focus groups; 18 patients participated in 3 separate focus groups. Discussion supported DS hierarchy of dependence, capture of mild-to-severe dependence, suitability of response options, and short recall time frame.


CONCLUSIONS
Clinicians, caregivers, and patients support content validity of the DS in mild-to-moderate AD. The DS may be valuable to capture dependence within future clinical dementia trials.
Center for Health Outcomes Research, Health Care Analytics Group, United BioSource Corporation, Bethesda, MD 20814, USA.
Lori
L
Frank
Kellee
K
Howard
Roy
R
Jones
Loretto
L
Lacey
Chris
C
Leibman
Alberto
A
Lleo
Sally
S
Mannix
Lisa
L
Mucha
Trent
T
McLaughlin
Steve
S
Zarit
D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000523:psychology*; D003858:Dependency, Psychological; D005260:Female; D006801:Humans; D008297:Male; D011582:Psychological Theory; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology