A Scoping Review of Tools for Evaluating Family-Caregiver Competence in Managing Behavioral and Psychological Symptoms of Dementia

Background:Behavioral and psychological symptoms of dementia (BPSD) affect up to 90% of individuals with dementia and represent a primary source of stress for family caregivers. Nevertheless, a systematic synthesis of validated instruments for assessing caregiver competence in BPSD management is currently lacking. This scoping review aimed to identify and evaluate tools used to measure family caregiver competence in managing BPSD.Methods:Following established scoping review methodology, we systematically searched six electronic databases: PubMed, CINAHL, Web of Science, PsycINFO, Embase, and the Cochrane Library. Eligible studies were original articles focused on the development, validation, or adaptation of assessment tools for family caregivers aged ≥18 years. Data extraction and quality assessment were performed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias Checklist and associated guidelines to evaluate methodological quality, measurement properties, and certainty of evidence.Results:From 62,892 identified records, 11 studies were included. The majority of studies received a validity rating of “doubtful”, with the exception of Competence Scale in Managing Behavioral and Psychological Symptoms of Dementia (CS-MBPSD), which received an “adequate” rating. Cross-cultural validity was not reported for any of the tools. Overall, the quality of evidence was low-to-moderate. All 11 tools received a recommendation grade of “B”, indicating potential suitability for use; however, they require further validation.Conclusions:The CS-MBPSD may represent the most suitable tool for evaluating family caregiver competence in managing BPSD; however, its measurement properties require further testing. Future tool development should adhere to COSMIN standards, incorporate cross-cultural validation, and prioritize responsiveness and real-world applicability.Registration:The study has been registered on https://www.crd.york.ac.uk/PROSPERO/ (registration number: CRD420261364464; registration link: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261364464).