BACKGROUND/OBJECTIVES: Caregiving for persons with dementia (PWD) results in a variety of psychological symptoms ranging from strain to depression. To better capture the scope of caregiver burden, we created a composite from 3 existing measures that assess different domains. DESIGN: Prospective follow-up study. SETTING: University-based dementia care management program PARTICIPANTS: 1091 caregivers of PWD. MEASUREMENTS: The Dementia Burden Scale - Caregiver (DBS-CG) composite measure was based on the Modified Caregiver Strain Index, Neuropsychiatric Inventory Questionnaire Distress Scale, and Patient Health Questionnaire (PHQ-9). ANALYSIS: Alternative measure structures were evaluated with two confirmatory factor analysis (CFA) models: 1) bifactor model and 2) a correlated 3 factor model. Good model fit was defined as a root mean squared error of approximation (RMSEA) value of < 0.06 and comparative fit index (CFI) value of >0.95. ω was calculated as an estimate of the scale reliability. Minimally important differences (MIDs) were estimated by anchoring the magnitude of DBS-CG change to change in caregiver self-efficacy and functional ability of PWD. RESULTS: The bifactor CFA model fit best, with RMSEA = 0.04 and CFI = 0.95. Based on this model, a DBS-CG scale was created wherein all items were transformed to a 0–100 possible range and then averaged. Higher scores indicate higher burden. The mean DBS-CG score was 27.3. The ω reliability was 0.93, indicating excellent reliability. MID estimates ranged from 4–5 points (effect sizes: 0.20 ≤ d < 0.50). CONCLUSIONS: This study provides support for the reliability and validity of the DBS-CG. It can be used as an outcome measure to assess the effect of interventions to reduce dementia caregiver burden.
