Detection of maltreatment of people with dementia in Spain: usefulness of the Caregiver Abuse Screen (CASE)

Jesús Rivera-Navarro, Rosa Sepúlveda, Israel Contador, Bernardino Fernández-Calvo, Francisco Ramos, Miguel Ángel Tola-Arribas, Miguel Goñi

The objective of our study is to validate the Caregiver Abuse Screen (CASE) as an instrument for detecting the maltreatment of people with dementia in Spain. In total, 326 informal caregivers of people with different types of dementia were interviewed in several cities in northwest Spain. The caregivers were selected from outpatient neurology clinics and associations of relatives of people with Alzheimer's disease and other dementias. A comprehensive sociodemographic questionnaire was administered to all participants, and several standardized scales were used to assess burden, anxiety, depression, social support and resilience. The "Psychological Aggression" and "Physical Assault" dimensions of the Revised Conflicts Tactics Scale were used as risk factors of caregivers' maltreatment for the construct validation. To establish the probability of maltreatment, a latent class analysis was carried out according to the item responses obtained from the CASE. The internal consistency (Cronbach's alpha) of the CASE was 0.71. The construct validity was explored through factorial analysis, and we found that two dimensions of CASE-i.e., interpersonal abuse and neglect/dependency-explained 62.5% of the variability. According to the latent class probabilities, 20.4% of participants were categorized as possible abusers and 21.4% as non-abusers. The optimal maltreatment cutoff point was six points on the CASE. The validation of the CASE provides us a brief and easy instrument for detecting possible cases of maltreatment of Spanish people with dementia.