# A Confirmatory Factor Analysis of the Dementia Attitude Scale (DAS) in a European Case Series of Caregivers of People with Dementia Enrolled in the RECage Study

## TL;DR

This study analyzed attitudes of dementia caregivers in Europe and found a three-factor model better represents their perspectives than the original two-factor model.

## Contribution

The study introduces a revised three-factor structure of the Dementia Attitude Scale based on European caregiver data.

## Key findings

- The original two-factor DAS model showed poor fit with the data.
- A three-factor model emerged, capturing social comfort, discomfort, and dementia knowledge.
- The three factors explained significant variance in caregiver attitudes toward people with dementia.

## Abstract

Background: The Dementia Attitude Scale (DAS) is a validated instrument used to capture the affective, behavioural, and cognitive components of attitudes toward people living with dementia (PLwD). This study conducts confirmatory and exploratory factor analyses (CFA and EFA) of the DAS assessed by caregivers of PLwD and BPSD enrolled in the RECage multicentre clinical trial. Methods: The baseline questionnaire was completed by 485 caregivers (29.7% male, 70.3% female), from six European countries, reflecting diverse cultural contexts. CFA tested the two-factor structure of the original model, while EFA thoroughly explored the factor structure. Results: The CFA results showed a poor model fit, with significant deviations from ideal values for RMSEA (0.0861), SRMSR (0.0781), and CFI (0.7117), showcasing an inadequate representation of the data. EFA revealed a three-factor structure, explaining the 45.2% variance for social comfort, 28.8% for social discomfort, and 25.9% for dementia knowledge. The social comfort items reflected positive caregiver attitudes toward PLwD, while social discomfort captured feelings of discomfort and uncertainty about caregiving. Dementia knowledge included items related to understanding dementia’s symptoms and needs. Conclusions: The three-factor model highlights the importance of emotional comfort, knowledge of dementia, and social discomfort as key dimensions in caregiver attitudes.