Development of the Central Africa Daily Functioning Interference Scale for Dementia Diagnosis in Older Adults: The EPIDEMCA Study

Dement Geriatr Cogn Disord. 2019;47(1-2):29-41. doi: 10.1159/000492782. Epub 2019 Jan 10.


Background: There are a few validated tools capable of assessing the dimensions essential for the diagnosis of dementia and cognitive disorders in sub-Saharan Africa.

Objectives: Our aim was to develop an adapted tool, the Central African - Daily Functioning Interference (DFI) scale.

Methods: An initial 16-item scale of activity limitations and participation restrictions was completed by 301 participants with low cognitive performances to assess their level of DFI. A psychometric evaluation was performed using Item Response Theory.

Results: A unidimensional 10-item scale emerged with a reasonable coverage of DFI (thresholds range: -1.067 to 1.587) with good item discrimination properties (1.397-4.076) and a high reliability (Cronbach's al pha = 0.92). The cutoff for detecting 96% of those with dementia was with a latent score ≥0.035 that corresponds to the LAUNDRY limitation.

Conclusions: These results provide valuable support for the reliability and internal validity of an operational 10-item scale for DFI assessment used in Central Africa for the diagnosis of dementia in the elderly.

Keywords: Activity limitations; Central Africa; Daily functioning interference; Dementia diagnosis; Item response theory; Participation restrictions; Psychometric evaluation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Africa, Central
  • Aged
  • Aged, 80 and over
  • Cognition
  • Dementia* / diagnosis
  • Dementia* / epidemiology
  • Dementia* / psychology
  • Female
  • Humans
  • Male
  • Patient Participation / psychology*
  • Psychometrics / methods*
  • Refusal to Participate
  • Reproducibility of Results