The development and validation of a dementia behavior disturbance inventory

Objective: To develop an instrument that measures observable problematic behaviors in patients with dementia. Methodology: We used focus group interviews to identify the problematic behaviors of patients with dementia. Eighty-two behaviors grouped into 12 domains were generated from the data collected from five different focus groups. After conducting a content validation process, a 72-item Dementia Behavior Disturbance Inventory (DBDI) rated by a frequency and a disturbance scale was formed. The DBDI was administered to 200 institutionalized elderly patients with dementia by formal caregivers for psychometric evaluation. Results: Inter-item correlation of items in each domain was performed for item reduction. Forty-eight items remained after this procedure. Exploratory factor analysis obtained nine factors that explained 59.2% and 59.6% of the total variance in the frequency and disturbance scales, respectively. Cronbach's alpha of the entire 48-item frequency and disturbance scales was 0.88 and 0.91, respectively. Most of the factors had acceptable internal consistency reliability. Test-re-test reliability coefficients of the frequency and disturbance scales were 0.78 and 0.64, respectively. The DBDI was weakly but positively related to functions of daily activities and ambulation. Conclusion: The DBDI demonstrates promising psychometrical properties as an instrument to assess problematic behaviors in elderly people with dementia.