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Assessment of Behavioural and Psychological Symptoms Associated with Dementia

Published online by Cambridge University Press:  02 December 2014

David Conn  and
Lilian Thorpe
David Conn*
Affiliation:
The Departments of Psychiatry, Baycrest Centre for Geriatric Care, University of Toronto, Toronto, Ontario
Lilian Thorpe
Affiliation:
The Departments of Psychiatry, Baycrest Centre for Geriatric Care, University of Toronto, Toronto, Ontario
*
Department of Psychiatry, Baycrest Centre for Geriatric Care, Room 4C91, 3560 Bathurst Street, Toronto, Ontario, M6A 2E1, Canada.
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Abstract

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Neuropsychiatric symptoms (mood, psychotic, and behavioural) are very common in dementia and do not necessarily correlate well with other measures of cognition. However, these symptoms are of great importance, as they are a major source of excess disability, patient distress and caregiver burden and have great impact on the level of care required, and the associated costs. This paper is a review of the most useful outcome measures for behaviour and mood symptoms. Investigators who require a comprehensive instrument to measure neuropsychiatric symptoms in studies of patients with dementia should consider using the Neuropsychiatric Inventory (NPI), the Behavior Rating Scale for Dementia of the Consortium to Establish a Registry for Alzheimer's Disease (CERADBRSD) or, possibly, the Behavioral Pathology in Alzheimer's Disease Scale (BEHAVE-AD). The Cornell Scale for Depression in Dementia and the Dementia Mood Assessment Scale (DMAS) are recommended for evaluating depressive symptoms and the Cohen-Mansfield Agitation Inventory (CMAI) is very useful for evaluating the full range of agitation symptoms.

Résumé:

RÉSUMÉ:

Les symptômes neuropsychiatriques (dysthymiques, psychotiques et comportementaux) sont très fréquents dans la démence et leur corrélation aux autres mesures de la cognition n'est pas toujours bonne. Cependant, ces symptômes sont très importants parce qu'ils sont une source majeure d'invalidité supplémentaire et de détresse pour le patient, un fardeau pour les soignants et parce qu'ils ont un impact considérable sur le niveau de soins requis et les coûts qui y sont associés. Cet article revoit les mesures d'impact les plus utiles pour l'évaluation des symptômes comportementaux et thymiques. Les chercheurs qui ont besoin d'instruments détaillés pour évaluer les symptômes neuropsychiatriques au cours des études portant sur des patients déments devraient faire appel au Neuropsychiatric Inventory (NPI), au Behavior Rating Scale for Dementia of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-BRSD), ou encore au Behavioral Pathology in Alzheimer's Disease Scale (BEHAVE-AD). Le Cornell Scale for Depression in Dementia et le Dementia Mood Assessment Scale (DMAS) sont recommandés pour l'évaluation des symptômes dépressifs et le Cohen-Mansfield Agitation Inventory (CMAI) est très utile pour l'évaluation de toute la gamme des symptômes d'agitation.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue S1 , March 2007 , pp. S67 - S71
Copyright
Copyright © The Canadian Journal of Neurological 2007

References

1. Spalletta, G, Baldinetti, F, Buccione, I, Fadda, L, Perri, R, Scalmana, S, et al. Cognition and behaviour are independent and heterogeneous dimensions in Alzheimer’s disease. J Neurol. 2004; 251(6): 688–95.Google Scholar
2. Perrault, A, Oremus, M, Demers, L, Vida, S, Wolfson, C. Review of outcome measurement instruments in Alzheimer’s disease drug trials: psychometric properties of behaviour and mood scales. J Geriatr Psychiatry Neurol. 2000; 13(4): 181–96.Google Scholar
3. Courtney, C, Farrell, D, Gray, R, Hills, R, Lynch, L, Sellwood, E, et al. Long-term donepezil treatment in 565 patients with Alzheimer’s disease (AD2000): randomised double-blind trial. Lancet. 2004; 363(9427): 2105–15.Google ScholarPubMed
4. Lyketsos, CG, Sheppard, JM, Steinberg, M, Tschanz, JA, Norton, MC, Steffens, DC, et al. Neuropsychiatric disturbance in Alzheimer’s disease clusters into three groups: the Cache County study. Int J Geriatr Psychiatry. 2001; 16(11): 1043–53.Google Scholar
5. Olin, JT, Schneider, LS, Katz, IR, Meyers, BS, Alexopoulos, GS, Breitner, JC, et al. Provisional diagnostic criteria for depression of Alzheimer’s disease. Am J Geriatr Psychiatry. 2002; 10(2): 125–8.CrossRefGoogle Scholar
6. Schneider, LS, Dagerman, KS. Psychosis of Alzheimer’s disease: clinical characteristics and history. J Psychiatr Res. 2004; 38(1): 105–11.Google Scholar
7. Reisberg, B, Auer, SR, Monteiro, I, Boksay, I, Sclan, SG. Behavioural disturbances of dementia: an overview of phenomenology and methodologic concerns. Int Psychogeriatr. 1996; 8 Suppl 2: 169–82.Google Scholar
8. Tariot, PN, Mack, JL, Patterson, MB, Edland, SD, Weiner, MF, Fillenbaum, G, et al. The Behaviour Rating Scale for Dementia of the Consortium to Establish a Registry for Alzheimer’s Disease: The Behavioral Pathology Committee of the Consortium to Establish a Registry for Alzheimer’s Disease. Am J Psychiatry. 1995; 152: 1349–59.Google Scholar
9. Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatr. 1960; 23: 56–62.CrossRefGoogle ScholarPubMed
10. Montgomery, SA, Asberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatr. 1979; 134: 382–9.Google Scholar
11. Zung, WWK. A self-rating depression scale. Arch Gen Psychiatr. 1965; 12: 63–70.CrossRefGoogle ScholarPubMed
12. Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatr. 1961; 4: 53–63.Google Scholar
13. Olin, JT, Katz, IR, Meyers, BS, Schneider, LS, Lebowitz, BD. Provisional diagnostic criteria for depression of Alzheimer’s disease. Rationale and background. Am J Geriatr Psychiatry. 2002; 10(2): 129–41.Google Scholar
14. Yesavage, JA, Brink, TL, Rose, TL, Lum, O, Huang, V, Adey, M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-83; 17(1): 37–49.CrossRefGoogle Scholar
15. Sunderland, T, Minichiello, M. Dementia Mood Assessment Scale. Int Psychogeriatr. 1996; 8 Suppl 3: 329–31.CrossRefGoogle ScholarPubMed
16. Alexopoulos, GS, Abrams, RC, Young, RC, Shamoian, CA. Cornell Scale for Depression in Dementia. Biol Psychiatry. 1988; 23: 271–84.Google Scholar
17. Feighner, JP, Robins, E, Guze, SB, Woodruff, RA, Winokur, G, Munoz, R. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry. 1972; 26(1): 57–63.CrossRefGoogle ScholarPubMed
18. Burns, A, Lawlor, B, Craig, S. Cornell Scale for depression in dementia. In: Assessment Scales in Old Age Psychiatry. London: Martin Dunitz; 1999.Google Scholar
19. Sunderland, T, Alterman, IS, Yount, D, Hill, JL, Tariot, PN, Newhouse, PA, et al. A new scale for the assessment of depressed mood in demented patients. Am J Psychiatry. 1988; 145(8): 955–9.Google Scholar
20. Cummings, JL, Mega, MS, Gray, K, Rosenberg-Thompson, S, Carusi, DA, Gornbein, J. The Neuropsychiatric Inventory: comprehensive assessment in psychopathology in dementia. Neurology. 1994; 44: 2308–14.CrossRefGoogle ScholarPubMed
21. Cummings, JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997; 48 Suppl 6: S10–16.CrossRefGoogle ScholarPubMed
22. Frisoni, GB, Rozzini, L, Gozzetti, A, Binetti, G, Zanetti, O, Bianchetti, A, et al. Behavioral syndromes in Alzheimer’s disease: description and correlates. Dement Geriatr Cogn Disord. 1999; 10: 130–8.CrossRefGoogle ScholarPubMed
23. Lange, RT, Hopp, GA, Kang, N. Psychometric properties and factor structure of the Neuropsychiatric Inventory Nursing Home version in an elderly neuropsychiatric population. Int J Geriatr Psychiatry. 2004; 19(5): 440–8.Google Scholar
24. Iverson, GL, Hopp, GA, DeWolfe, K, Solomons, K. Measuring change in psychiatric symptoms using the Neuropsychiatric Inventory: Nursing Home version. Int J Geriatr Psychiatry. 2002; 17(5): 438–43.CrossRefGoogle ScholarPubMed
25. Politis, AM, Mayer, LS, Passa, M, Maillis, A, Lyketsos, CG. Validity and reliability of the newly translated Hellenic Neuropsychiatric Inventory (H-NPI) applied to Greek outpatients with Alzheimer’s disease: a study of disturbing behaviours among referrals to a memory clinic. Int J Geriatr Psychiatry. 2004; 19(3): 203–8.Google Scholar
26. Boada, M, Cejudo, JC, Tarraga, L, Lopez, OL, Kaufer, D. Neuropsychiatric inventory questionnaire (NPI-Q): Spanish validation of an abridged form of the Neuropsychiatric Inventory (NPI). Neurologia. 2002; 17(6): 317–23.Google Scholar
27. de Jonghe, JF, Kat, MG, Kalisvaart, CJ, Boelaarts, L. Neuropsychiatric Inventory Questionnaire (NPI-Q): a validity study of the Dutch form. Tijdschr Gerontol Geriatr. 2003; 34(2): 74–7.Google ScholarPubMed
28. Kat, MG, de Johghe, JF, Aalten, P, Kalisvaart, CJ, Droes, RM, Verhey, FR. Neuropsychiatric symptoms of dementia: psychometric aspects of the Dutch Neuropsychiatric Inventory (NPI). Tijdschr Gerontol Geriatr. 2002; 33(4): 150–5.Google Scholar
29. Choi, SH, Na, DL, Kwon, HM, Yoon, SJ, Jeong, JH, Ha, CK. The Korean version of the neuropsychiatric inventory: a scoring tool for neuropsychiatric disturbance in dementia patients. J Korean Med Sci. 2000; 15(6): 609–15.CrossRefGoogle ScholarPubMed
30. Leung, VP, Lam, LC, Chiu, HF, Cummings, JL, Chen, QL. Validation study of the Chinese version of the neuropsychiatric inventory (CNPI). Int J Geriatr Psychiatry. 2001; 16(8): 789–93.Google Scholar
31. Kaufer, DI, Cummings, JL, Ketchel, P, Smith, V, MacMillan, A, Shelley, T, et al. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci. 2000; 12(2): 233–9.CrossRefGoogle ScholarPubMed
32. Forester, BP, Oxman, TE. Measures to Assess the Noncognitive Symptoms of Dementia in the Primary Care Setting. Prim Care Companion J Clin Psychiatry. 2003; 5(4): 158–63.Google ScholarPubMed
33. Morris, JC, Mohs, RC, Rogers, H, Fillenbaum, G, Heyman, A. Consortium to Establish a Registry for Alzheimer’s Disease (CERAD): clinical and neuropsychological assessment of Alzheimer’s disease. Psychopharmacol Bull. 1988; 24: 641–52.Google Scholar
34. Weiner, MF, Tractenberg, R, Teri, L, Logsdon, R, Thomas, RG, Gamst, A, et al. Quantifying behavioural disturbances in Alzheimer’s disease patients. J Psychiatr Res. 2000; 34(2): 163–7.Google Scholar
35. Patterson, MB, Mack, JL, Mackell, JA, Thomas, R, Tariot, P, Weiner, M, et al. A longitudinal study of behavioural pathology across five levels of dementia severity in Alzheimer’s disease: the CERAD Behaviour Rating Scale for Dementia. Alzheimer Dis Assoc Disord. 1997; 11 Suppl 2: S40–4.Google Scholar
36. Weiner, MF, Koss, E, Patterson, M, Jin, S, Teri, L, Thomas, R, et al. A comparison of the Cohen-Mansfield agitation inventory with the CERAD behavioural rating scale for dementia in communitydwelling persons with Alzheimer’s disease. J Psychiatr Res. 1998; 32: 347–51.Google Scholar
37. Mack, JL, Patterson, MB, Tariot, PN. Behaviour rating scale for dementia: development of test scales and presentation of data for 555 individuals with Alzheimer’s disease. J Geriatr Psychiatry Neurol. 1999; 12: 211–13.Google Scholar
38. Reisberg, B, Borenstein, J, Salob, SP, Ferris, SH, Franssen, E, Georgotas, A. Behavioural symptoms in Alzheimer’s disease: phenomenology and treatment. J Clin Psychiatry. 1987; 48(Suppl): 9–15.Google ScholarPubMed
39. Ferris, SH, Mackell, JA, Mohs, R, Schneider, LS, Galasko, D, Whitehouse, PJ, et al. A multicentre evaluation of new treatment efficacy instruments for Alzheimer’s disease clinical trials: overview and general results. Alzheimer Dis Assoc Disord. 1997; 11 Suppl 2: S1–12.Google Scholar
40. Auer, SR, Montiero, IM, Reisberg, B. The Empirical Behavioral Pathology in Alzheimer’s Disease (E-BEHAVE-AD) Rating Scale. Int Psychogeriatr. 1996; 8(2): 247–66.Google Scholar
41. Monteiro, IM, Boksay, I, Auer, SR, Torossian, C, Ferris, SH, Reisberg, B. Addition of a frequency-weighted score to the Behavioral Pathology in Alzheimer’s Disease Rating Scale: the BEHAVEAD-FW: methodology and reliability. Eur Psychiatry. 2001; 16 Suppl 1: 5s–24s.Google Scholar
42. Lam, LC, Tang, WK, Leung, V, Chiu, HF. Behavioral profile of Alzheimer’s disease in Chinese Elderly: a validation study of the Chinese version of the Alzheimer’s disease behavioural pathology rating scale. Int J Ger Psychiatry. 2001; 16(4): 368–73.Google Scholar
43. Mohs, RC, Rosen, WG, Davis, KL. The Alzheimer’s Disease Assessment Scale: an instrument for assessing treatment efficacy. Psychopharmacol Bull. 1983; 19: 448–50.Google Scholar
44. Rosen, WG, Mohs, RC, Davis, K. A new rating scale for Alzheimer’s disease. Am J Psychiatry. 1984; 141: 1356–64.Google Scholar
45. Overall, JE, Beller, SA. The Brief Psychiatric Rating Scale (BPRS) in geropsychiatric research: I. Factor structure in an inpatient unit. J Gerontol. 1984; 39: 187–93.CrossRefGoogle Scholar
46. Overall, JE, Gorham, DR. The Brief Psychiatric Rating Scale. Psychol Rep. 1962; 10: 799–812.Google Scholar
47. Cohen-Mansfield, J, Billig, N. Agitated behaviours in the elderly: I. A conceptual review. J Am Geriatr Soc. 1986; 34: 711–21.CrossRefGoogle Scholar
48. Cohen-Mansfield, J. Agitated behaviours in the elderly: II. Preliminary results in the cognitively deteriorated. J Am Geriatr Soc. 1986; 34: 722–7.Google Scholar
49. Finkel, S, Lyons, JS, Anderson, RL. Reliability and validity of the Cohen-Mansfield Agitation Inventory in institutionalized elderly. Int J Geriatr Psychiatry. 1992; 7: 487–90.CrossRefGoogle Scholar
50. Koss, E, Weiner, M, Ernesto, C, Cohen-Mansfield, J, Ferris, SH, Grundman, M, et al, and the Alzheimer’s Disease Cooperative Study. Assessing patterns of agitation in Alzheimer’s disease patients with the Cohen-Mansfield Agitation Inventory. Alzheimer Dis Assoc Disord. 1997; 11 Suppl 2: S45–50.CrossRefGoogle ScholarPubMed