Preliminary testing using Mokken scaling of an Italian translation of the Edinburgh Feeding Evaluation in Dementia (EdFED-I) scale

Purpose: To study the psychometric properties of an Italian version of the Edinburgh Feeding Evaluation in Dementia (EdFED-I) Scale. Background: The EdFED Scale is the only validated instrument that measures difficulty with feeding in older people with dementia. The original English version of the EdFED had three factors measuring: behavioral aspects of feeding difficulty (obstinacy/passivity); indicators of feeding difficulty; and nursing interventions. Methods: Participants affected by dementia and living in nursing homes (n = 210) were selected. Data collectors were trained to observe the residents' eating problems and their food intake. The data were analyzed using Mokken scaling and Pearson's correlation. Results: The Italian version of the EdFED Scale formed a Mokken scale which correlated in the expected direction with measures of residents' weight, Body Mass Index, time taken to eat, Mini Mental State Examination score and Barthel Index according to the unmet needs model of Cohen-Mansfield. Conclusions: The EdFED-I shows reasonable psychometric properties and can be used for the assessment of feeding difficulty in Italian samples of older people with dementia. However, further work with larger samples is required to test the utility of the whole range of items and the necessity of their inclusion in the EdFED-I.