THE CAREGIVER ACTIVITY SURVEY (CAS) - DEVELOPMENT AND VALIDATION OF ANEW MEASURE FOR CAREGIVERS OF PERSONS WITH ALZHEIMERS-DISEASE

Background. Most instruments that measure the impairments associated w ith Alzheimer's disease assess symptom severity. Little attention has been paid to the illness's impact on the time formal and informal care givers spend caring for Alzheimer's individuals. A tool that measures the time spent caregiving would help to determine the economic impact of the illness, The Caregiver Activity Survey (CAS) was developed to m easure the time caregivers spend aiding Alzheimer's patients with thei r day-to-day activities. Methods. The test-retest reliability of the C AS was assessed during a 3-week study with 42 Alzheimer's patients and their caregivers. The CAS was validated with the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog), the Mini Mental State Exam (MMSE) and the Physical Self Maintenance Scale (PSMS). Results. T he final version of the CAS consists of six items (communicating with the person, using transportation, eating, dressing, looking after one' s appearance and supervising the person). The six-item CAS total score has high test-retest reliability, with ICC = 0.88 between weeks 1 and 3. The scale has strong convergent validity with the ADAS-Cog (r = 0. 61), MMSE (r = -0.57) and PSMS (r = 0.43). Efforts to include a dimens ion that reflect caregiver burden were not successful, in part due to the reluctance of caregivers to acknowledge that caregiving is bothers ome. Conclusions. The CAS provides a new tool that measures time spent caring for Alzheimer's individuals. The instrument may be used to aug ment existing clinical assessments that measure the efficacy of potent ially therapeutic agents for persons with Alzheimer's disease. (C) 199 7 John Wiley & Sons, Ltd.