{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T23:37:59Z","timestamp":1769643479106,"version":"3.49.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Measuring disease severity in persons with severe dementia is essential for clinical care and research. Most instruments encounter issues, for example floor effects in characterising persons with severe dementia. We aimed to evaluate the psychometric properties of the Bedford Alzheimer Nursing\u2010Severity Scale (BANS) and its short version, BANS\u20106, in community\u2010dwelling persons with severe dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used baseline data from a multi\u2010centre prospective longitudinal study. 215 caregivers of community\u2010dwelling persons with severe dementia (\u2265\u00a0FAST stage 6c) were recruited (mean age 83.6\u00a0\u00b1\u00a08.2). We evaluated BANS\u2019 construct validity with exploratory factor analysis, correlation with other established measures, and predictive validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Factor analysis revealed a two\u2010factor solution (variance 58.35%) with item\u20102 (sleep\u2010wake cycle) not loading onto any factor. Dropping item\u20102 (BANS\u20106) revealed a single\u2010factor solution (variance 49.26%) and Cronbach's\n                      <jats:italic>\u03b1<\/jats:italic>\n                      improved from 0.701 to 0.782. FAST did not correlate with the Cohen\u2010Mansfield Agitation Inventory and Quality of Life in Late\u2010Stage Dementia Scale, but both BANS and BANS\u20106 did. For predictive validity, after adjusting for age, sex and comorbidities, BANS\u20106 remained significantly associated with key clinical complications of severe dementia: pneumonia (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a02.09, 95% CI\u00a0=\u00a00.13\u20134.05), fever episodes (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a01.24, 95% CI\u00a0=\u00a00.10\u20132.40) and oral antibiotic use (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a01.33, 95%CI\u00a0=\u00a00.11\u20132.55), tube feeding (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a04.42, 95% CI\u00a0=\u00a02.62\u20136.22), pressure sores (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a02.51, 95% CI\u00a0=\u00a00.85\u20134.18), eating problems (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a03.27, 95%CI\u00a0=\u00a02.20\u20134.34), and malnutrition (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a01.63, 95% CI\u00a0=\u00a00.24\u20133.02) in the last 4\u00a0months. BANS was not significantly associated with pneumonia, oral antibiotics, and pressure sores, and FAST was not significantly associated with any outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BANS and its short version, BANS\u20106, are valid, reliable, and clinically relevant tools for assessing dementia severity in community\u2010dwelling persons with severe dementia, warranting further exploration in diverse population settings. The findings suggest that BANS\u20106 has better psychometrics and clinical utility than BANS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps.70187","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T06:00:21Z","timestamp":1767938421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychometric Validation of the Bedford Alzheimer Nursing\u2010Severity Scale in Community\u2010Dwelling Persons With Severe Dementia"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7591-1699","authenticated-orcid":false,"given":"Chin Yee","family":"Cheong","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine Khoo Teck Puat Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine Khoo Teck Puat Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tze Pin","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine Khoo Teck Puat Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boon Yeow","family":"Tan","sequence":"additional","affiliation":[{"name":"St Luke's Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chetna","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Lien Centre for Palliative Care Duke\u2010NUS Medical School  Singapore"},{"name":"Health Services and System Research Duke\u2010NUS Medical School  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12068"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3233\/jad\u2010200786"},{"key":"e_1_2_12_4_1","unstructured":"P.Mo\u00efse M.Schwarzinger M.Um \u201cDementia Care in 9 OECD Countries: A Comparative Analysis \u201d13(2004)."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468\u20101331.2002.00356.x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/singaporemedj.SMJ\u20102021\u2010320"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/s1041610297004870"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022\u20103956(75)90026\u20106"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/s1041610292001157"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2007.693"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470669600.ch31"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000119124"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.22.2734"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533317511418954"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216312465649"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201090746\u2010x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195\u2010021\u201000936\u2010y"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/49.5.m223"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1406"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533317513506777"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1618"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16054"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000320260"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2014.02.006"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3233\/jad\u2010190897"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1572"},{"key":"e_1_2_12_27_1","volume-title":"Instruction Manual for the Cohen\u2010Mansfield Agitation Inventory (CMAI)","author":"Cohen\u2010Mansfield J.","year":"1991"},{"issue":"3","key":"e_1_2_12_28_1","first-page":"114","article-title":"The Quality of Life in Late\u2010Stage Dementia (QUALID) Scale","volume":"1","author":"Myron F. 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