To evaluate psychometric properties and response patterns of the Care-giver Assessment of Function and Upset (CAFU), a 15-item multidimensional measure of dependence in dementia patients and caregiver reaction. Method: 640 families were administered the CAFU (53% White, 43% African American, and 4% mixed race and ethnicity). We created a random split of the sample and conducted exploratory factor analyses on Sample 1 and confirmatory factor analyses on Sample 2. Convergent and discriminant validity were evaluated using Spearman rank correlation coefficients. Results: A two-factor structure for functional items was derived, and excellent factorial validity was obtained. Convergent and discriminant validity were obtained for function and upset measures. Differential response patterns for dependence and caregiver upset were found for caregiver race, relationship, and care recipient gender but not for caregiver gender. Discussion: The CAFU is easily administered, reliable, and valid for evaluating appraisals of dependencies and upsetting care areas.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
Argüelles, S., Loewenstein, D. A., Eisdorfer, C., & Argüelles, T. (in press). Caregivers’ judgements of the functional abilities of the Alzheimer’s disease patient. The impact of caregivers’ depression and perceived burden. Journal of Geriatric Psychiatry and Neurology, 14(2).
3.
Carswell, A., & Spiegal, R. (1999). Functional assessment. In G. Wilcock, R. Bucks, & K. Rockwood (Eds.), Diagnosis and management of dementia: A manual for memory disorders teams. Oxford, UK: Oxford University Press.
4.
Cotter, E. M., Burgio, L. D., Stevens, A. B., Roth, D. L., & Gitlin, L. N. (2002). Correspondence of the Functional Independence Measure (FIM) self-care subscale with real-tine observations of dementia patients’ ADL performance in the home. Clinical Rehabilitation, 16, 36-45.
5.
Folstein, M., Folstein, S., & McHugh, P. (1975). Mini-mental state: A practical method for grading cognitive state of care recipients for the clinician. Journal of Psychiatry Research, 12, 189-198.
6.
Gitlin, L. N. (in press). Physical function in the elderly: A comprehensive guide to its measurement. Austin, TX: ProPress.
7.
Gitlin, L. N., Corcoran, M., Winter, L., Boyce, A., & Hauck, W. (2001). A randomized, controlled trial of a home environmental intervention: Effect on efficacy and upset in caregivers and on daily function of persons with dementia. The Gerontologist, 41, 4-14.
8.
Haley, W. E., Gitlin, L. N., Wisniewski, S. R., Mahoney, D. F., Coon, D. W., Winter, L., et al. (in press). Well-being, appraisal, and coping in African American and Caucasian dementia care-givers: Findings from the REACH study. Aging & Mental Health.
9.
Haley, W. E., Roth, D. L., Coleton, M. I., Ford, G. R., West, C. A. C., Collins, R. P., et al. (1996). Appraisal, coping, and social support as mediators of well-being in black and white family caregivers of patients with Alzheimer’s Disease. Journal of Consulting and Clinical Psychology, 64, 121-129.
10.
Hamilton, B. B., & Fuhrer, M. J. (Eds.). (1987). Rehabilitation outcomes: Analysis and measurement. Baltimore: Brooks.
11.
Jöreskog, K. G., & Sörbom, D. G. (1993a). LISREL 8 user’s reference guide. Chicago: Scientific Software International.
12.
Jöreskog, K. G., & Sörbom, D. G. (1993b). PRELIS 2 user’s reference guide. Chicago: Scientific Software International.
13.
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged, the index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914-919.
14.
Kiyak, H. A., Teri, L., & Borson, S. (1994). Physical and functional health assessment in normal aging and in Alzheimer’s disease: Self reports versus family reports. The Gerontologist, 34, 324-330.
15.
Lawton, M. P., & Brody, E. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179-186.
16.
Loewenstein, D. A., & Mogosky, B. (1999). Functional assessment of the older adult patient. In P. Lichtenberg (Ed.), Handbook of assessment in clinical gerontology (pp. 529-554). New York: John Wiley.
17.
Loewenstein, D. A., Ownby, R., Schram, L., Acevedo, A., Rubert, M., & Argüelles, T. (in press). An evaluation of the NINCDS-ADRDA neuropsychological criteria for the assessment of Alzheimer’s disease: A confirmatory factor analysis of single versus multi-factor models. Journal of Clinical & Experimental Neuropsychology.
18.
Magaziner, J., Simonsick, E. M., Kashner, T. M., & Hebel, J. R. (1988). Patient-proxy comparability on measures of patient health and functional status. Journal of Clinical Epidemiology, 41, 1065-1074.
19.
Mahoney, D. F., Jones, R. N., Coon, D., Mendelsohn, A. B., Gitlin, L. N., & Ory, M. (2003). The Caregiver Vigilance Scale: Application and validation in the Resources for Enhancing Alzheimer’s Caregiver (REACH) project. American Journal of Alzheimer’s Disease and Other Dementias, 18, 39-48.
20.
McClendon, M. J., Smyth, K. A., & Neundorfer, M. M. (2004). Survival of persons with Alzheimer’s disease: Caregiver coping matters. The Gerontologist, 44, 508-519.
21.
Ostbye, T., Tyas, S., McDowell, I., & Koval, J. (1997). Reported activities of daily living: Agreement between elderly subjects with and without dementia and their caregivers. Age and Aging, 26, 99-106.
22.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measures, 1, 385-401.
23.
Roth, D. L., Burgio, L. D., Gitlin, L. N., Gallagher-Thompson, D., Coon, D. W., Belle, S. H., et al. (2003). Psychometric analysis of the Revised Memory and Behavior Problems Checklist: Factor structure of occurrence and reaction ratings. Psychology and Aging, 18(4), 906-915.
24.
Rubenstein, L. Z., Schairer, C., Wieland, G. D., & Kane, R. (1984). Systematic biases in the functional status of elderly adults: Effects of different data sources. Journal of Gerontology, 39, 686-691.
25.
Switzer, G. E., Wisniewski, S. R., Belle, S. H., Dew, M. A., & Schulz, R. (1999). Selecting, developing, and evaluating research instruments. Social Psychiatry Epidemiology, 34, 399-409.
26.
Teri, L.Truax, P., Logsdon, R., Uomoto, J., Zarit, S., & Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: The Revised Memory and Behavior Problems Checklist. Psychology and Aging, 7, 622-631.
27.
Vitaliano, P. P., Russo, J., Young, H. M., Becker J., & Maiuro, R. D. (1991). The screen for care-giver burden. The Gerontologist, 31, 76-83.
28.
Weinberger, M., Samsa, G., Schmader, K., Greenberg, S., Carr, D., & Wildman, D. S. (1992). Comparing proxy and patients’ perceptions of patients’ functional status: Results from a geriatric outpatient clinic. Journal of the American Geriatrics Society, 40, 585-588.
29.
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20, 649-655.
30.
Zimmerman, S. I., & Magaziner, J. (1994). Methodological issues in measuring the functional status of cognitively impaired nursing home residents: The use of proxies and performance-based measures. Alzheimer Disease and Associated Disorders, 8(1), S281-S290.
