title: Validation of a Latent Construct for Dementia in a Population-Wide Dataset from Singapore.
abstract: The latent variable δ has been proposed as a proxy for dementia. Previous validation studies have been conducted using convenience samples. It is currently unknown how δ performs in population-wide data.
  
  
  
  To validate δ in Singapore using population-wide epidemiological study data on persons aged 60 and above.
  
  
  
  δ was constructed using items from the Community Screening Instrument for Dementia (CSI'D) and World Health Organization Disability Assessment Schedule (WHODAS II). Confirmatory factor analysis (CFA) was conducted to examine δ model fit. Convergent validity was examined with the Clinical Dementia Rating scale (CDR) and GMS-AGECAT dementia. Divergent validity was examined with GMS-AGECAT depression.
  
  
  
  The δ model demonstrated fit to the data, χ2(df) = 249.71(55), p < 0.001, CFI = 0.990, TLI = 0.997, RMSEA = 0.037. Latent variable δ was significantly associated with CDR and GMS-AGECAT dementia (range: β= 0.32 to 0.63), and was not associated with GMS-AGECAT depression. Compared to unadjusted models, δ model fit was poor when adjusted for age, gender, ethnicity, and education.
  
  
  
  The study found some support for δ as a proxy for dementia in Singapore based on population data. Both convergent and divergent validity were established. In addition, the δ model structure appeared to be influenced by age, gender, ethnicity, and education covariates.
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Chao Xu
authors: CX
authors: Peh
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Edimansyah
authors: E
authors: Abdin
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Janhavi A
authors: JA
authors: Vaingankar
authors: Early Psychosis Intervention Programme, Institute of Mental Health, Singapore, Singapore.
authors: Swapna
authors: S
authors: Verma
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Boon Yiang
authors: BY
authors: Chua
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Vathsala
authors: V
authors: Sagayadevan
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Esmond
authors: E
authors: Seow
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: YunJue
authors: Y
authors: Zhang
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Shazana
authors: S
authors: Shahwan
authors: Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore.
authors: Li Ling
authors: LL
authors: Ng
authors: Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
authors: Martin
authors: M
authors: Prince
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Siow Ann
authors: SA
authors: Chong
authors: Research Division, Institute of Mental Health, Singapore, Singapore.
authors: Mythily
authors: M
authors: Subramaniam
mesh_terms: D000368:Aged; D018672:Community Health Planning; D003704:Dementia / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D003863:Depression / Q000209:etiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012846:Singapore / Q000453:epidemiology
keywords: Cognition; Singapore; dementia; functional status; validation studies