140Profiling Communication Ability in Dementia (P-CAD): Validation of a Functional Cognitive-Communication Assessment

Abstract

Background: Cognitive communication difficulties are characteristic of dementia with negative impact. Yet, clinicians have few options for standardized assessment of cognitive communication skills in people with dementia. The newly devised P-CAD facilitates evaluation of functional communication abilities of individuals with dementia, with a specific focus on conversational skills. It guides intervention, providing measurement of change over time. The aim was to validate the P-CAD with the objective of providing clinicians with a much needed psychometrically sound assessment for individuals with dementia. Methods: 100 people with dementia and their communication partners were recruited over 12 months. The P-CAD was validated against MMSE-2, Global Deterioration Scale (GDS) and Functional Linguistic Communication Inventory (FLCI)1. Inter-rater reliability and sensitivity to change over time (3 months) were also tested on a sub group of individuals. Participants with dementia were at different stages of dementia and presented with a range of dementia subtypes. Results: Statistically significant correlations were found between P-CAD scores, MMSE-2 scores (r = 0.830, p < 0.001) and FLCI scores (r = 0.863, p < 0.001). There were no significant changes over time in any of the 3 scales for the participants (N = 11) who completed follow-up measures. Interrater reliability for the P-CAD (N = 20) was strong between the two raters for all measures; GDS (ICC = 0.969, p < 0.001); MMSE-2 (ICC = 0.997, p < 0.001); FLCI (ICC = 0.999, p < 0.001). There were significant correlations between the level of communication support on the P-CAD and GDS (rho = -0.580, p < 0.001) and MMSE-2 (rho = 0.633, p < 0.001) scores. Conclusion: The P-CAD is a valid reliable cognitive communication assessment, appropriate for use with people across all subtypes and stages of dementia. It is now ready for use in clinical practice, informing interventions aimed at improving conversations between people with dementia and their communication partners.