title: Development of an international schedule for the assessment and staging of care for dementia.
abstract: BACKGROUND
  A reliable and valid global staging scale has been lacking within dementia care.
  
  
  OBJECTIVE
  To develop an easy-to-use multi-dimensional clinical staging schedule for dementia.
  
  
  METHODS
  The schedule was developed through: i) Two series of focus groups (40 and 48 participants, respectively) in Denmark, France, Germany, Netherlands, Spain, Switzerland, and UK with a multi-disciplinary group of professionals working within dementia care, to assess the need for a dementia-staging tool and to obtain suggestions on its design and characteristics; ii) A pilot-study over three rounds to test inter-rater reliability of the newly developed schedule using written case histories, with five members of the project's steering committee and 27 of their colleagues from Netherlands, France, and Spain as participants; and iii) A field-study to test the schedule's inter-rater reliability in clinical practice in France, Germany, Netherlands, Spain, Italy, Turkey, South Korea, Romania, and Serbia, which included 209 dementia patients and 217 of their caregivers as participants.
  
  
  RESULTS
  Focus group participants indicated a clear need for a culture-fair international dementia staging scale and reached consensus on face validity and content validity. Accordingly, the schedule has been composed of seven dimensions including behavioral, cognitive, physical, functional, social, and care aspects. Overall, the schedule showed adequate face validity, content validity, and inter-rater reliability; in the nine field-sites, intraclass correlation coefficients (ICCs; absolute agreement) for individual dimensions ranged between 0.38 and 1.0, with 84.4% of ICCs over 0.7. ICCs for total sum scores ranged between 0.89 and 0.99 in the nine field-sites.
  
  
  CONCLUSIONS
  The IDEAL schedule looks promising as tool for the clinical and social management of people with dementia globally, though further reliability and validity testing is needed.
authors.affiliation: King's College London, Institute of Psychiatry, London, UK.
authors.forename: Maya
authors.initials: M
authors.lastname: Semrau
authors.affiliation: University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK.
authors.forename: Alistair
authors.initials: A
authors.lastname: Burns
authors.affiliation: School of Medicine, University of Kragujevac, Kragujevac, Serbia.
authors.forename: Slavica
authors.initials: S
authors.lastname: Djukic-Dejanovic
authors.affiliation: Istanbul Psikiyatri Enstitüsü, Istanbul, Turkey.
authors.forename: Defne
authors.initials: D
authors.lastname: Eraslan
authors.affiliation: Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.
authors.forename: Changsu
authors.initials: C
authors.lastname: Han
authors.affiliation: School of Medicine, University of Belgrade, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
authors.forename: Dusica
authors.initials: D
authors.lastname: Lecic-Tosevski
authors.affiliation: Department of Psychiatry, Universidad Zaragoza and Instituto de Investigación Sanitaria de Aragón, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lobo
authors.affiliation: Department of Psychiatry, University of Medicine and Pharmacy, Tg Mures, Romania.
authors.forename: Adriana
authors.initials: A
authors.lastname: Mihai
authors.affiliation: University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Julie
authors.initials: J
authors.lastname: Morris
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Palumbo
authors.affiliation: Memory CenterCHU - CoBTeK Research, University of Nice Sophia Antipolis, Nice, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Robert
authors.affiliation: Center for Old Age Psychiatry, LVR Hospitals Bonn, Bonn, Germany.
authors.forename: Gerthild
authors.initials: G
authors.lastname: Stiens
authors.affiliation: MentAge Consulting - Practice-Research, Basel, Switzerland.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Stoppe
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Volpe
authors.affiliation: Radboud Alzheimer Centre/Department Geriatrics, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Marcel Olde
authors.initials: MO
authors.lastname: Rikkert
authors.affiliation: Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.
authors.forename: Norman
authors.initials: N
authors.lastname: Sartorius
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005060:Europe; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D013223:Statistics as Topic
keywords: Dementia; mental status schedule; patient schedule; psychometrics; reliability; validity