Abstract
Objective The Dental Activities Test (DAT) was developed to be used by dental, nursing, and other health professionals to assess the ability of persons with dementia to perform oral health-related activities and aid care planning. The instrument was designed as a unitary scale and has excellent internal consistency, test-retest reliability, interrater reliability, and construct validity. This study examines the underlying factor structure of the DAT among older adults in assisted living settings. Methods In a secondary analysis of the data from the original study, the results of testing of 90 older adults with normal to severely impaired cognition from three assisted living communities in North Carolina from March 2013 to February 2014 were studied. An exploratory factor analysis was used to assess the dimensionality of the presumed unitary assessment scale. Results Two-factor structures were explored. A one-factor model demonstrated acceptably mixed model fit, and a two-factor model had good model fit with moderate correlation between the two factors (r = 0.667, p < 0.05). All the items in the one-factor model demonstrated significant factor loadings (loadings ≥ 0.39, all p < 0.05), while the loadings of some items in the two-factor model (nonsignificant or cross-loadings, loadings < 0.40) did not meet the criteria of factor selection. The one-factor structure was preferred based on the criteria of Scree Plot, eigenvalue, and factor interpretability in relation to clinical relevance. Conclusions The study provided preliminary evidence that the Dental Activities Test has a unidimensional construct among older adults with cognitive impairment. It suggested that this instrument can be used as a unitary scale to assess dental-related function in persons with dementia. Future testing, including using a confirmatory factor analysis, in a new sample is needed to further assess the usefulness and psychometric properties of this instrument.
Highlights
Functional impairment is a characterized symptom of dementia [1]
We preliminarily examined the construct validity and underlying structure of this presumed unitary scale using an exploratory factor analysis
The distribution of item responses indicated that item 3 was most frequently endorsed among participants, followed by item 7, indicating that these items were relatively easy to perform among this population
Summary
The Dental Activities Test (DAT) was developed to be used by dental, nursing, and other health professionals to assess the ability of persons with dementia to perform oral health-related activities and aid care planning. This study examines the underlying factor structure of the DAT among older adults in assisted living settings. In a secondary analysis of the data from the original study, the results of testing of 90 older adults with normal to severely impaired cognition from three assisted living communities in North Carolina from March 2013 to February 2014 were studied. The one-factor structure was preferred based on the criteria of Scree Plot, eigenvalue, and factor interpretability in relation to clinical relevance. The study provided preliminary evidence that the Dental Activities Test has a unidimensional construct among older adults with cognitive impairment. It suggested that this instrument can be used as a unitary scale to assess dental-related function in persons with dementia. Future testing, including using a confirmatory factor analysis, in a new sample is needed to further assess the usefulness and psychometric properties of this instrument
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