Factor structure of the Community Screening Interview for Dementia (CSI-D) among Zambian adults.
7 affiliations
- 1Ciheb Zambia, Lusaka, Zambia.
- 2University of Zambia, Department of Psychiatry, Lusaka, Zambia.
- 3University of Michigan, Department of Neurology, Ann Arbor, MI USA.
- 4University of Michigan, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI USA.
- 5Ministry of Health, Chipata Level One Hospital, Lusaka, Zambia.
- 6Division of Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD USA.
- 7Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, Department of Neurology, University of Texas Health Science Center San Antonio, San Antonio, TX USA.
Abstract
The Community Screening Interview for Dementia (CSI-D) has been widely used for dementia research among aging adults in low- and middle-income countries, where few specialists are available to diagnose and manage dementia. Yet, little is known about the psychometric validity of the participant interview, particularly among low-literacy individuals. We used factor analysis methods to assess and refine theoretically driven single- and multiple-factor structural models for the CSI-D participant interview using the population-based Zambian Cohort of Healthy Aging and Dementia (Z-CHAD) in Lusaka. Trained community healthcare workers administered the CSI-D participant interview to 734 adults (68% female, mean age 66.9 years, mean education 7 years). For the four domains of cognitive functioning identified (memory, orientation, language, and visuospatial), single-factor models had satisfactory fit after the removal of five items with low factor loadings. The second-order factor model had adequate fit (confirmatory fit index = 0.96, root mean square error of approximation= 0.03, standardized root mean square residual = 0.08). This factor structure of the CSI-D participant interview reasonably summarizes cognitive domain performance in this sample, yet there is a noticeable ceiling effect in items for orientation and language. Further, domains sensitive to dementia-related impairments, namely executive function, are not assessed.
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BibTeX
@article{kalungwana2026factor,
title = {{Factor structure of the Community Screening Interview for Dementia (CSI-D) among Zambian adults.}},
author = {Lisa Kalungwana and Nicholas Heaton and Emily Briceno and Mataa M Mataa and Lottie M Hachaambwa and Linah Mwango and Jeremy A Tanner and Melissa A Elafros},
journal = {NPJ dementia},
year = {2026},
month = oct,
doi = {10.1038/s44400-026-00142-3},
url = {https://europepmc.org/article/MED/42952904},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Factor structure of the Community Screening Interview for Dementia (CSI-D) among Zambian adults.
AU - Lisa Kalungwana
AU - Nicholas Heaton
AU - Emily Briceno
AU - Mataa M Mataa
AU - Lottie M Hachaambwa
AU - Linah Mwango
AU - Jeremy A Tanner
AU - Melissa A Elafros
PY - 2026
DA - 2026/10/27
JO - NPJ dementia
DO - 10.1038/s44400-026-00142-3
UR - https://europepmc.org/article/MED/42952904
AB - The Community Screening Interview for Dementia (CSI-D) has been widely used for dementia research among aging adults in low- and middle-income countries, where few specialists are available to diagnose and manage dementia. Yet, little is known about the psychometric validity of the participant interview, particularly among low-literacy individuals. We used factor analysis methods to assess and refine theoretically driven single- and multiple-factor structural models for the CSI-D participant interview using the population-based Zambian Cohort of Healthy Aging and Dementia (Z-CHAD) in Lusaka. Trained community healthcare workers administered the CSI-D participant interview to 734 adults (68% female, mean age 66.9 years, mean education 7 years). For the four domains of cognitive functioning identified (memory, orientation, language, and visuospatial), single-factor models had satisfactory fit after the removal of five items with low factor loadings. The second-order factor model had adequate fit (confirmatory fit index = 0.96, root mean square error of approximation= 0.03, standardized root mean square residual = 0.08). This factor structure of the CSI-D participant interview reasonably summarizes cognitive domain performance in this sample, yet there is a noticeable ceiling effect in items for orientation and language. Further, domains sensitive to dementia-related impairments, namely executive function, are not assessed.
SN - 3005-1940
ER -