Health-related quality-of-life assessment in dementia: evidence of cross-cultural validity in Latin America

TY - JOUR

T1 - Health-related quality-of-life assessment in dementia

T2 - evidence of cross-cultural validity in Latin America

AU - Chua, Kia-Chong

AU - Böhnke, Jan

AU - Prince, Martin

AU - Banerjee, Sube

N1 - The 10/66 Dementia Research Group's research (www.alz.co.uk/1066) has been funded by the Wellcome Trust Health Consequences of Population Change Programme (GR066133–Prevalence phase in Cuba and Brazil; GR08002–Incidence phase in Peru, Mexico, Argentina, Cuba, Dominican Republic, Venezuela and China), the World Health Organisation (India, Dominican Republic and China), the US Alzheimer's Association (IIRG–04–1286–Peru, Mexico and Argentina), and FONACIT/ CDCH/ UCV (Venezuela). The Rockefeller Foundation supported a dissemination meeting at their Bellagio Centre. Alzheimer's Disease International has provided support for networking and infrastructure.

PY - 2019/10

Y1 - 2019/10

N2 - All health-related quality-of-life (HRQL) measures for dementia have been developed in high-income countries and none were validated for cross-cultural use. Yet, the global majority of people living with dementia reside in low- and middle-income countries. We therefore investigated the measurement invariance of a set of self- and informant-report HRQL measures developed in the United Kingdom when used in Latin America. Self-reported HRQL was obtained using (DEMQOL) at a memory assessment service in the United Kingdom (n = 868) and a population cohort study in Latin America (n = 417). Informant reports were collected using DEMQOL-Proxy at both sites (n = 909 and n = 495). Multiple-group confirmatory bifactor models for ordered categorical item responses were estimated to evaluate measurement invariance. Results support configural, metric, and scalar invariance for the concept of general HRQL in DEMQOL and DEMQOL-Proxy. The dominant impact of general HRQL on item responses was evident across U.K. English and Ibero American Spanish versions of DEMQOL (ω h = 0.87-0.90) and DEMQOL-Proxy (ω h = 0.88 -0.89). Ratings of "positive emotion" did not show a major impact on general HRQL appraisal, particularly for Latin American respondents. Item information curves show that self- and informant-reports were highly informative about the presence rather than the absence of HRQL impairment. We found no major difference in conceptual meaning, sensitivity, and relevance of DEMQOL and DEMQOL-Proxy for older adults in the United Kingdom and Latin America. Further replication is needed for consensus over which HRQL measures are appropriate for making cross-national comparisons in global dementia research.

AB - All health-related quality-of-life (HRQL) measures for dementia have been developed in high-income countries and none were validated for cross-cultural use. Yet, the global majority of people living with dementia reside in low- and middle-income countries. We therefore investigated the measurement invariance of a set of self- and informant-report HRQL measures developed in the United Kingdom when used in Latin America. Self-reported HRQL was obtained using (DEMQOL) at a memory assessment service in the United Kingdom (n = 868) and a population cohort study in Latin America (n = 417). Informant reports were collected using DEMQOL-Proxy at both sites (n = 909 and n = 495). Multiple-group confirmatory bifactor models for ordered categorical item responses were estimated to evaluate measurement invariance. Results support configural, metric, and scalar invariance for the concept of general HRQL in DEMQOL and DEMQOL-Proxy. The dominant impact of general HRQL on item responses was evident across U.K. English and Ibero American Spanish versions of DEMQOL (ω h = 0.87-0.90) and DEMQOL-Proxy (ω h = 0.88 -0.89). Ratings of "positive emotion" did not show a major impact on general HRQL appraisal, particularly for Latin American respondents. Item information curves show that self- and informant-reports were highly informative about the presence rather than the absence of HRQL impairment. We found no major difference in conceptual meaning, sensitivity, and relevance of DEMQOL and DEMQOL-Proxy for older adults in the United Kingdom and Latin America. Further replication is needed for consensus over which HRQL measures are appropriate for making cross-national comparisons in global dementia research.

KW - Cross-cultural validation

KW - Dementia

KW - Health-related quality-of-life

KW - Measurement invariance

KW - measurement invariance

KW - health-related quality-of-life

KW - cross-cultural validation

KW - dementia

UR - https://www.scopus.com/pages/publications/85068927001

U2 - 10.1037/pas0000743

DO - 10.1037/pas0000743

M3 - Article

C2 - 31282701

SN - 1040-3590

VL - 31

SP - 1264

EP - 1277

JO - Psychological Assessment

JF - Psychological Assessment

IS - 10

ER -