Zhongguo quanke yixue (May 2022)
Development, Reliability and Validity of the Dementia Risk Reduction Lifestyle Scale
Abstract
Background Lifestyle factors are important modifiable risk factors for cognitive decline and dementia. The lifestyle intervention based on scientific assessment will be an important strategy and an orientation towards the implementation of primary prevention of dementia. So far, there is no special instrument to evaluate whether a lifestyle can help to reduce the risk of dementia in community-living residents. Objective To develop the Dementia Risk Reduction Lifestyle Scale (DRRLS) and test its reliability and validity, providing an instrument for scientifically evaluating whether a lifestyle is conducive to reducing the risk of dementia in community-living Chinese residents. Methods The item pool of the DRRLS was created based on the review of related theories of health promotion and literature analysis, then was used to form the initial version of the scale after the revision in accordance with the results of expert consultations and group discussion. After this, the initial version of the scale was pretested in a convenience sample of 30 middle-aged and elderly people in the community in January 2021, and was developed to be a revised version after revising items according to the pretest results. Then from January to October, 2021, the revised scale was tested in a large convenience sample of 506 community-dwelling middle-aged and elderly individuals. After screening items using item analysis of the test results of all 506 cases, exploratory factor analysis and confirmatory factor analysis were carried out with the test results of two randomly subdivided subsamples of the sample, subsample 1 (n=253) and subsample 2 (n=253) , respectively. Finally, the test results of the total sample were used for examining internal consistency and test-retest reliability, and the formal scale was formed eventually. Results The formal Dementia Risk Reduction Lifestyle Scale consists of 32 items. Eight common factors were extracted by exploratory factor analysis (Health responsibility, Brain strengthening exercise, Brain healthy diet, mental activity, smoking control behavior, interpersonal relationship, stress management, spiritual growth) , explaining 60.189% variance of the total. Confirmatory factor analysis showed that the goodness-of-fit indices of the formal scale were acceptable: χ2/df=1.657, RMSEA=0.051, GFI=0.852, AGFI=0.819, NFI=0.743, TLI=0.858, IFI=0.880 and CFI=0.876. The content validity index, Cronbach's α, split-half reliability (odd-even) , and test-retest reliability of the formal scale were 0.943, 0.862, 0.909, and 0.864, respectively. Conclusion Our scale has been tested with good reliability and validity, which could be used as a suitable instrument for evaluating whether a lifestyle helps to reduce the risk of dementia in middle-aged and elderly people in the community.
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