The Dementia Coding System (DeCS): Development and initial evaluation of a coding system to assess positive, challenging, and music-related behaviors of people with dementia

Introduction The Dementia Coding System (DeCS), an observational assessment tool to measure positive, challenging, and music-related behaviors in people with dementia, was developed and psychometrically evaluated to assess effects of non-pharmacological interventions (for example, individualized music interventions). Method Data from N = 114 people with dementia were analyzed for factorial validity, internal consistencies, and test-retest reliability. Factorial validity was analyzed using explorative factor analysis (EFA). Results The results indicate a single factor including nine items that represent "Positive Behaviors". Internal consistency and test-retest reliability were also acceptable for this single factor. Two exploratory factors ("Challenging Behaviors", "Musical Engagement") were proposed for behaviors that could not be included in the EFA due to insufficient variability. Here again, internal consistency and test-retest reliability were calculated with acceptable results. Discussion In conclusion, DeCS is a useful coding system to assess effects of non-pharmacological interventions, especially music-based interventions for people with dementia, across a variety of behavioral indicators of negative and positive aspects of quality of life.