# Measuring dementia-related stigma in the Dutch general public: Translation and validation of the dementia public stigma scale

## TL;DR

This study translated and validated a scale to measure dementia-related stigma in the Dutch population, showing it works well for future research and interventions.

## Contribution

The Dutch version of the DePSS was validated, adding to its cross-cultural applicability for measuring dementia-related stigma.

## Key findings

- The Dutch DePSS showed good internal consistency (α = 0.82) and test-retest reliability (ICC = 0.82).
- Confirmatory factor analysis confirmed acceptable fit (CFI = 0.988, RMSEA = 0.073).
- Open-ended responses supported the content validity of the DePSS items.

## Abstract

People with Alzheimer's disease or other types of dementia may experience stigma, which can influence their quality of life. Valid measurement instruments of public dementia-related stigma are lacking.

We aimed to translate and validate the 16-item Dementia Public Stigma Scale (DePSS) in Dutch.

A survey was conducted among a nationally representative sample of the Dutch population (n = 524). A subset (n = 145) completed the DePSS again after one month. Following validation guidelines, floor and ceiling effects, structural validity, internal consistency, and test-retest reliability were assessed. We used open-ended questions to investigate content validity. The responses provided insights into respondents’ perceptions of dementia and their interactions with people with dementia.

Forward-backward translation required minor adaptations. No floor or ceiling effects were observed. Confirmatory factor analysis indicated an acceptable fit (CFI = 0.988, RMSEA = 0.073, SRMR = 0.065). Internal consistency (α = 0.82, ω = 0.79) and test-retest reliability (ICC = 0.82, 95%CI 0.76–0.89) were good, with no significant differences between test and retest scores (t(144) = 0.135, p = .893). Responses to open-ended questions were largely clustered under DePSS items, indicating good content validity. Additional themes were disconnection from present reality; feeling pity for people with dementia; and manifestations of negative emotions.

The Dutch DePSS demonstrated good psychometric properties. Together with other versions, these findings enhance the generalizability of the DePSS across diverse populations. Further validation and application of the DePSS will help deepen our understanding of dementia-related stigma and may also inform stigma reduction interventions.