Login Register Cart 0
Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Development and Psychometric Validation of the 27 Item Zarit Caregiver Interview for Alzheimer’s Disease (ZCI-AD-27)

Author(s): Coen A. Bernaards*, Kathrin I. Fischer, Angela J. Rylands, Adam Gater, Chloe Tolley, Steven H. Zarit and Claire J. Lansdall

Volume 19, Issue 13, 2022

Published on: 13 January, 2023

Page: [878 - 891] Pages: 14

DOI: 10.2174/1567205020666221230103505

Price: $65

Abstract

Background: Caring for an individual with Alzheimer’s disease (AD) is an allencompassing challenge that affects daily life. Assessment of the care partner experience is needed to support the development and evaluation of successful interventions for people with AD and their care partners. We developed the 27-item Zarit Caregiver Interview for Alzheimer’s Disease (ZCI-AD-27) to assess the impact of informal caregiving in the context of AD.

Objective: We assessed the psychometric validity of the ZCI-AD-27 in a population of care partners for individuals with moderate AD, and established thresholds for meaningful score change.

Methods: Secondary data were obtained from informal care partners of participants in a clinical trial (NCT01677754). Psychometric analyses were conducted to assess validity, reliability, and responsiveness of the ZCI-AD-27. Anchor-based and distribution-based methods were performed to determine clinically meaningful score change.

Results: The ZCI-AD-27 had a 12-domain factor structure, including a second-order domain termed Humanistic impact that included four key domains (Physical, Emotional, Social, and Daily life) as confirmed by confirmatory factor analysis with the adequate fit. Internal consistency (Cronbach’s alpha ranging from 0.66 to 0.93 for domains), convergent validity, and discriminant validity indicated the good performance of the ZCI-AD-27. Known-groups validity analyses showed a greater impact on care partners with increasing disease severity. Responsiveness results demonstrated that the ZCI-AD- 27 is sensitive to change over time and meaningful change analyses indicated a range of meaningful score changes in this population.

Conclusion: The ZCI-AD-27 is a comprehensive, psychometrically valid measure to assess the impact of caring for individuals with moderate AD.

« Previous Next »
[1]
Alzheimer’s Association. 2021 Alzheimer’s disease facts and figures. Alzheimers Dement 2021; 17(3): 327-406.
[http://dx.doi.org/10.1002/alz.12328] [PMID: 33756057]
[2]
Van Durme T, Macq J, Jeanmart C, Gobert M. Tools for measuring the impact of informal caregiving of the elderly: A literature review. Int J Nurs Stud 2012; 49(4): 490-504.
[http://dx.doi.org/10.1016/j.ijnurstu.2011.10.011] [PMID: 22078211]
[3]
Deeken JF, Taylor KL, Mangan P, Yabroff KR, Ingham JM. Care for the caregivers: A review of self-report instruments developed to measure the burden, needs, and quality of life of informal caregivers. J Pain Symptom Manage 2003; 26(4): 922-53.
[http://dx.doi.org/10.1016/S0885-3924(03)00327-0] [PMID: 14527761]
[4]
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist 1980; 20(6): 649-55.
[http://dx.doi.org/10.1093/geront/20.6.649] [PMID: 7203086]
[5]
Zarit SH, Orr NK, Zarit JM. The hidden victims of Alzheimer’s disease: Families under stress. New York: NYU Press 1985.
[6]
Bédard M, Pedlar D, Martin NJ, Malott O, Stones MJ. Burden in caregivers of cognitively impaired older adults living in the community: Methodological issues and determinants. Int Psychogeriatr 2000; 12(3): 307-32.
[http://dx.doi.org/10.1017/S1041610200006426] [PMID: 11081952]
[7]
Gater A, Rofail D, Marshall C, et al. Assessing the impact of caring for a person with schizophrenia: Development of the schizophrenia caregiver questionnaire. Patient 2015; 8(6): 507-20.
[http://dx.doi.org/10.1007/s40271-015-0114-3] [PMID: 25680337]
[8]
Rajabi-Mashhadi MT, Mashhadinejad H, Ebrahimzadeh MH, Golhasani-Keshtan F, Ebrahimi H, Zarei Z. The zarit caregiver burden interview short form (ZBI-12) in spouses of veterans with chronic spinal cord injury, validity and reliability of the Persian version. Arch Bone Jt Surg 2015; 3(1): 56-63.
[PMID: 25692171]
[9]
Springate BA, Tremont G. Dimensions of caregiver burden in dementia: Impact of demographic, mood, and care recipient variables. Am J Geriatr Psychiatry 2014; 22(3): 294-300.
[http://dx.doi.org/10.1016/j.jagp.2012.09.006] [PMID: 23567422]
[10]
Flynn Longmire CV, Knight BG. Confirmatory factor analysis of a brief version of the Zarit Burden Interview in Black and White dementia caregivers. Gerontologist 2011; 51(4): 453-62.
[http://dx.doi.org/10.1093/geront/gnr011] [PMID: 21402646]
[11]
Gonçalves-Pereira M, González-Fraile E, Santos-Zorrozúa B, et al. Assessment of the consequences of caregiving in psychosis: a psychometric comparison of the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). Health Qual Life Outcomes 2017; 15(1): 63.
[http://dx.doi.org/10.1186/s12955-017-0626-8] [PMID: 28381222]
[12]
Rofail D, Regnault A, le Scouiller S, Lambert J, Zarit SH. Assessing the impact on caregivers of patients with schizophrenia: Psychometric validation of the Schizophrenia Caregiver Questionnaire (SCQ). BMC Psychiatry 2016; 16(1): 245.
[http://dx.doi.org/10.1186/s12888-016-0951-1] [PMID: 27431493]
[13]
Nave S, Doody RS, Boada M, et al. Sembragiline in moderate Alzheimer’s disease: Results of a randomized, double-blind, placebo-controlled phase II trial (MAyflOwer RoAD). J Alzheimers Dis 2017; 58(4): 1217-28.
[http://dx.doi.org/10.3233/JAD-161309] [PMID: 28550255]
[14]
Mohs RC, Knopman D, Petersen RC, et al. Development of cognitive instruments for use in clinical trials of antidementia drugs: additions to the Alzheimer’s Disease Assessment Scale that broaden its scope. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl. 2): 13-21.
[http://dx.doi.org/10.1097/00002093-199700112-00003] [PMID: 9236948]
[15]
Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141(11): 1356-64.
[http://dx.doi.org/10.1176/ajp.141.11.1356] [PMID: 6496779]
[16]
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. J Psychiatr Res 1975; 12(3): 189-98.
[http://dx.doi.org/10.1016/0022-3956(75)90026-6] [PMID: 1202204]
[17]
Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl. 2): S33-9.
[http://dx.doi.org/10.1097/00002093-199700112-00005] [PMID: 9236950]
[18]
Kahle-Wrobleski K, Coley N, Lepage B, et al. Understanding the complexities of functional ability in Alzheimer’s disease: More than just basic and instrumental factors. Curr Alzheimer Res 2014; 11(4): 357-66.
[http://dx.doi.org/10.2174/1567205011666140317101419] [PMID: 24635843]
[19]
Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the apathy evaluation scale. Psychiatry Res 1991; 38(2): 143-62.
[http://dx.doi.org/10.1016/0165-1781(91)90040-V] [PMID: 1754629]
[20]
Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell scale for depression in dementia. Biol Psychiatry 1988; 23(3): 271-84.
[http://dx.doi.org/10.1016/0006-3223(88)90038-8] [PMID: 3337862]
[21]
Reisberg B, Borenstein J, Salob SP, Ferris SH, Franssen E, Georgotas A. Behavioral symptoms in Alzheimer's disease: Phenomenology and treatment. J Clin Psychiatry 1987; 48: 9-15.
[22]
Reisberg B, Monteiro I, Torossian C, et al. The Behave-AD assessment system: A perspective, a commentary on new findings, and a historical review. Dement Geriatr Cogn Disord 2014; 38(1-2): 89-146.
[http://dx.doi.org/10.1159/000357839] [PMID: 24714384]
[23]
Reisberg B, Ferris SH, de Leon MJ, Crook T. The global deterioration scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139(9): 1136-9.
[http://dx.doi.org/10.1176/ajp.139.9.1136] [PMID: 7114305]
[24]
Brod M, Stewart AL, Sands L, Walton P. Conceptualization and measurement of quality of life in dementia: The dementia quality of life instrument (DQoL). Gerontologist 1999; 39(1): 25-36.
[http://dx.doi.org/10.1093/geront/39.1.25] [PMID: 10028768]
[25]
Knekta E, Runyon C, Eddy S. One size doesn’t fit all: Using factor analysis to gather validity evidence when using surveys in your research. CBE Life Sci Educ 2019; 18(1): rm1-1.
[http://dx.doi.org/10.1187/cbe.18-04-0064] [PMID: 30821600]
[26]
Bandalos DL, Finney SJ. Factor analysis: Exploratory and confirmatory The reviewer’s guide to quantitative methods in the social science. New York: Routledge 2010; pp. 93-114.
[27]
Marsh HW, Hau KT, Wen Z. In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Struct Equ Model 2004; 11(3): 320-41.
[http://dx.doi.org/10.1207/s15328007sem1103_2]
[28]
DeVon HA, Block ME, Moyle-Wright P, et al. A psychometric toolbox for testing validity and reliability. J Nurs Scholarsh 2007; 39(2): 155-64.
[http://dx.doi.org/10.1111/j.1547-5069.2007.00161.x] [PMID: 17535316]
[29]
Palmer CE, Langbehn D, Tabrizi SJ, Papoutsi M. Test-retest reliability of measures commonly used to measure striatal dysfunction across multiple testing sessions: A longitudinal study. Front Psychol 2018; 8: 2363.
[http://dx.doi.org/10.3389/fpsyg.2017.02363] [PMID: 29375455]
[30]
Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 1994; 6(4): 284-90.
[http://dx.doi.org/10.1037/1040-3590.6.4.284]
[31]
Cicchetti DV, Sparrow SS. Assessment of adaptive behavior in young children Developmental assessment in clinical child psychology: A handbook. New York: Pergamon Press 1990; pp. 222-39.
[32]
Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 2010; 63(7): 737-45.
[http://dx.doi.org/10.1016/j.jclinepi.2010.02.006] [PMID: 20494804]
[33]
Crosby RD, Kolotkin RL, Williams GR. Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol 2003; 56(5): 395-407.
[http://dx.doi.org/10.1016/S0895-4356(03)00044-1] [PMID: 12812812]
[34]
Balsis S, Benge JF, Lowe DA, Geraci L, Doody RS. How do scores on the ADAS-Cog, MMSE, and CDR-SOB correspond? Clin Neuropsychol 2015; 29(7): 1002-9.
[http://dx.doi.org/10.1080/13854046.2015.1119312] [PMID: 26617181]
[35]
O’Bryant SE, Lacritz LH, Hall J, et al. Validation of the new interpretive guidelines for the clinical dementia rating scale sum of boxes score in the national Alzheimer’s coordinating center database. Arch Neurol 2010; 67(6): 746-9.
[http://dx.doi.org/10.1001/archneurol.2010.115] [PMID: 20558394]
[36]
Alsaeed D, Orlu M, Smith F. Optimising medication use along dementia progression: Recommendations from a qualitative study. Healthcare (Basel) 2021; 9(8): 982.
[http://dx.doi.org/10.3390/healthcare9080982] [PMID: 34442119]
[37]
Jones RW, Lebrec J, Kahle-Wrobleski K, et al. Disease progression in mild dementia due to Alzheimer disease in an 18-month observational study (GERAS): The impact on costs and caregiver outcomes. Dement Geriatr Cogn Disord Extra 2017; 7(1): 87-100.
[http://dx.doi.org/10.1159/000461577] [PMID: 28611822]
[38]
Carlozzi NE, Sherman CW, Angers K, Belanger MP, Austin AM, Ryan KA. Caring for an individual with mild cognitive impairment: a qualitative perspective of health-related quality of life from caregivers. Aging Ment Health 2018; 22(9): 1196-204.
[http://dx.doi.org/10.1080/13607863.2017.1341468] [PMID: 28699777]
[39]
Dhikav V, Anand KS, Sachdeva A, Mishra P. Perceived caregiver stress in Alzheimer′s disease and mild cognitive impairment: A case control study. Ann Indian Acad Neurol 2016; 19(1): 58-62.
[http://dx.doi.org/10.4103/0972-2327.167695] [PMID: 27011630]
[40]
Fischer KI, Bernaards CA, Holt T, McDougall F, Lansdall CJ. Psychometric validation of the 27-item zarit caregiver interview for Alzheimer’s disease (ZCI-AD-27) for prodromal-to-mild Alzheimer’s disease. Qual Life Res 2022; 31(2): S143.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy