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Measuring consumer access, appraisal and application of services and information for dementia (CAAASI-Dem): a key component of dementia literacy


Doherty, KV and Nguyen, H and Eccleston, CEA and Tierney, L and Mason, RL and Bindoff, A and Robinson, A and Vickers, J and McInerney, F, Measuring consumer access, appraisal and application of services and information for dementia (CAAASI-Dem): a key component of dementia literacy, BMC Geriatrics, 20 Article 484. ISSN 1471-2318 (2020) [Refereed Article]


Copyright Statement

Copyright 2020 the authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1186/s12877-020-01891-3



The ability to locate, navigate and use dementia services and information, either for oneself or in providing care for others, is an essential component of dementia literacy. Despite dementia literacy being understood to be inadequate in many settings, no validated instrument exists to measure these elements. Here we describe the development and preliminary validation of the Consumer Access, Appraisal and Application of Services and Information for Dementia (CAAASI-Dem) tool.


Items were adapted from existing health literacy tools and guided by discussion posts in the Understanding Dementia Massive Open Online Course (UDMOOC). Following expert review and respondent debriefing, a modified CAAASI-Dem was administered to UDMOOC participants online. On the basis of descriptive statistics, inter-item and item total correlations and qualitative feedback, this was further refined and administered online to a second cohort of UDMOOC participants. Exploratory factor analysis identified underlying factor structure. Items were retained if they had significant factor loadings on one factor only. Each factor required at least three items with significant factor loadings. Internal consistency of factors in the final model was evaluated using Cronbach’s alpha coefficients.


From a pool of 70 initial items with either a 5-point Likert scale (Not at all confident – Extremely confident; or Strongly agree – Strongly disagree) or a binary scale (Yes – No), 65 items were retained in CAAASI-Dem-V1. Statistical and qualitative analysis of 1412 responses led to a further 34 items being removed and 11 revised to improve clarity. The 31 item CAAASI-Dem-V2 tool was subsequently administered to 3146 participants, one item was removed due to redundancy and EFA resulted in the removal of an additional 4 items and determination of a five factor structure: Evaluation and engagement; Readiness; Social supports; Specific dementia services; and Practical aspects.


The five factors and 26 constituent items in CAAASI-Dem align with functional, critical, and communicative aspects of dementia health literacy from the perspective of the carer. As a screening tool for people living with dementia and their carers, CAAASI-Dem potentially provides a means to determine support needs and may be a key component of the dementia literacy assessment toolbox.

Item Details

Item Type:Refereed Article
Keywords:dementia, literacy, support, carer, services, measurement
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Aged health care
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Health related to ageing
UTAS Author:Doherty, KV (Dr Kathleen Doherty)
UTAS Author:Nguyen, H (Dr Hoang Nguyen)
UTAS Author:Eccleston, CEA (Dr Claire Eccleston)
UTAS Author:Tierney, L (Mrs Laura Tierney)
UTAS Author:Mason, RL (Mr Ron Mason)
UTAS Author:Bindoff, A (Mr Aidan Bindoff)
UTAS Author:Robinson, A (Professor Andrew Robinson)
UTAS Author:Vickers, J (Professor James Vickers)
UTAS Author:McInerney, F (Professor Fran McInerney)
ID Code:142288
Year Published:2020
Web of Science® Times Cited:2
Deposited By:Wicking Dementia Research and Education Centre
Deposited On:2021-01-06
Last Modified:2021-05-26
Downloads:17 View Download Statistics

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