P4-114: Validity and reliability of the neuropsychiatric inventory-clinician rating scale (NPI-C)© in a Brazilian multicenter study: Assessment of neuropsychiatric symptoms in dementia

2013 ◽  
Vol 9 ◽  
pp. P745-P746
Author(s):  
Florindo Stella ◽  
Orestes Forlenza ◽  
Jerson Laks ◽  
Larissa Andrade ◽  
Michelle Avendaño ◽  
...  
2018 ◽  
Vol 8 (3) ◽  
pp. 306-320 ◽  
Author(s):  
Francesca Morganti ◽  
Alex Soli ◽  
Paola Savoldelli ◽  
Gloria Belotti

Background: In health-care settings, the use of the Neuropsychiatric Inventory-Nursing Home (NPI-NH) may not always be consistent with the authors’ guidelines, which affects its reliability. To avoid this bias, a diary version of the NPI (NPI-Diary) was developed. Aims: This study aimed to evaluate the psychometric properties (internal consistency and reliability) of the NPI-Diary, and examined its convergence with the NPI-NH. Methods: Two raters administered the NPI-NH and NPI-Diary to 40 participants with Alzheimer’s disease, selected randomly from a hospital’s weekly turnover. Results: The NPI-Diary exhibited adequate internal consistency (total: α = 0.581) and test-retest reliability (total: ρ = 0.711; p < 0.01). The interrater reliability values (ICC) for the NPI-NH and NPI-Diary differed significantly (Total: NPI-NH ICC = 0.506, NPI-Diary ICC = 0.879; Frequency: NPI-NH ICC = 0.51, NPI-Diary ICC = 0.798; Severity: NPI-NH ICC = 0.491, NPI-Diary ICC = 0.809). The convergent validity between the two inventories was also significant (total: ρ = 0.48; p < 0.01). Conclusions: The NPI-Diary showed more appropriate validity and reliability compared to the NPI-NH, when administered in a highly variable sample, as is generally the case in the current health-care setting.


2013 ◽  
Vol 25 (9) ◽  
pp. 1503-1511 ◽  
Author(s):  
Florindo Stella ◽  
Orestes Vicente Forlenza ◽  
Jerson Laks ◽  
Larissa Pires de Andrade ◽  
Michelle A. Ljubetic Avendaño ◽  
...  

ABSTRACTBackground:Patients with dementia may be unable to describe their symptoms, and caregivers frequently suffer emotional burden that can interfere with judgment of the patient's behavior. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C) was therefore developed as a comprehensive and versatile instrument to assess and accurately measure neuropsychiatric symptoms (NPS) in dementia, thereby using information from caregiver and patient interviews, and any other relevant available data. The present study is a follow-up to the original, cross-national NPI-C validation, evaluating the reliability and concurrent validity of the NPI-C in quantifying psychopathological symptoms in dementia in a large Brazilian cohort.Methods:Two blinded raters evaluated 312 participants (156 patient-knowledgeable informant dyads) using the NPI-C for a total of 624 observations in five Brazilian centers. Inter-rater reliability was determined through intraclass correlation coefficients for the NPI-C domains and the traditional NPI. Convergent validity included correlations of specific domains of the NPI-C with the Brief Psychiatric Rating Scale (BPRS), the Cohen-Mansfield Agitation Index (CMAI), the Cornell Scale for Depression in Dementia (CSDD), and the Apathy Inventory (AI).Results:Inter-rater reliability was strong for all NPI-C domains. There were high correlations between NPI-C/delusions and BPRS, NPI-C/apathy-indifference with the AI, NPI-C/depression-dysphoria with the CSDD, NPI-C/agitation with the CMAI, and NPI-C/aggression with the CMAI. There was moderate correlation between the NPI-C/aberrant vocalizations and CMAI and the NPI-C/hallucinations with the BPRS.Conclusion:The NPI-C is a comprehensive tool that provides accurate measurement of NPS in dementia with high concurrent validity and inter-rater reliability in the Brazilian setting. In addition to universal assessment, the NPI-C can be completed by individual domains.


2014 ◽  
Vol 26 (7) ◽  
pp. 1139-1145 ◽  
Author(s):  
Shirin Zaidi ◽  
Martin G. Kat ◽  
Jos F.M. de Jonghe

ABSTRACTBackground:Neuropsychiatric symptoms (NPS) are highly prevalent in dementia. The recently developed Neuropsychiatric Inventory – Clinician rating scale (NPI-C) includes clinical judgment and new symptom domains. Our objective was to evaluate NPI-C reliability and to compare caregiver and clinician ratings across the range of mild to severe cognitive impairment.Methods:This is a cross-sectional observational study. Participants were geriatric memory clinic patients and nursing-home residents (n = 30) with an established diagnosis of dementia or Mild Cognitive Impairment (MCI). A psychiatrist (MK) interviewed caregiver–patient dyads using the NPI-C. Neuropsychological tests and Mini-Mental State Examination (MMSE) were used to assess cognitive impairment. Two NPI-C caregiver interviews were videotaped and rated by psychologists and geriatricians. Intra-class correlations (ICCs) were used to examine inter-rater agreement. Correlation coefficients were calculated to evaluate caregiver and psychiatrist NPI-C ratings. Disagreement between caregiver and clinician was expressed in delta scores and examined across the range of mild to severe cognitive impairment, using Levene's homogeneity of variances tests.Results:Inter-rater agreement on ratings of two caregiver videos was high (ICC = 0.99–1.0). Clinician–caregiver concordance on NPI-C total severity ratings was high (r = 0.77). Variability in clinician–caregiver concordance was associated with cognitive impairment: MMSE (P = 0.02), CAMCOG-R (Cambridge Cognitive Examination-revised) total scores (P = 0.02), CAMCOG-R Memory scores (P = 0.04) and Language scores (P = 0.01).Conclusions:The NPI-C is a reliable measure of NPS in patients with MCI or dementia. Clinician–caregiver agreement on NPS severity may vary with cognitive impairment, underlining the importance of clinician-based measures of NPS.


2013 ◽  
Vol 7 (3) ◽  
pp. 244-251 ◽  
Author(s):  
Florindo Stella

ABSTRACT The issue of this article concerned the discussion about tools frequently used tools for assessing neuropsychiatric symptoms of patients with dementia, particularly Alzheimer's disease. The aims were to discuss the main tools for evaluating behavioral disturbances, and particularly the accuracy of the Neuropsychiatric Inventory - Clinician Rating Scale (NPI-C). The clinical approach to and diagnosis of neuropsychiatric syndromes in dementia require suitable accuracy. Advances in the recognition and early accurate diagnosis of psychopathological symptoms help guide appropriate pharmacological and non-pharmacological interventions. In addition, recommended standardized and validated measurements contribute to both scientific research and clinical practice. Emotional distress, caregiver burden, and cognitive impairment often experienced by elderly caregivers, may affect the quality of caregiver reports. The clinician rating approach helps attenuate these misinterpretations. In this scenario, the NPI-C is a promising and versatile tool for assessing neuropsychiatric syndromes in dementia, offering good accuracy and high reliability, mainly based on the diagnostic impression of the clinician. This tool can provide both strategies: a comprehensive assessment of neuropsychiatric symptoms in dementia or the investigation of specific psychopathological syndromes such as agitation, depression, anxiety, apathy, sleep disorders, and aberrant motor disorders, among others.


2018 ◽  
Vol 90 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Jee-Young Lee ◽  
Beomseok Jeon ◽  
Seong-Beom Koh ◽  
Won Tae Yoon ◽  
Ho-Won Lee ◽  
...  

ObjectiveIn this multicentre open-label trial, we compared behavioural and neuropsychiatric symptoms in Parkinson’s disease (PD) patients with impulse control disorders (ICD) treated with dopamine agonists before and 12 weeks after substituting dopamine agonists with an equivalent dose of levodopa/carbidopa slow-release formulation.MethodsBaseline characteristics of 50 PD patients with ICD were compared with those of 60 medicated and 40 drug-naive PD control groups. Neuropsychiatric trait changes in the PD-ICD group were investigated 12 weeks after the intervention. ICD behaviours were assessed via modified Minnesota Impulsive Disorders Interview (mMIDI), whereas parkinsonian severity and neuropsychiatric characters were systematically assessed with the Unified PD Rating Scale (UPDRS) and a predefined neuropsychological assessment battery.ResultsAt baseline, ICD patients showed higher scores in the Neuropsychiatric Inventory and anxiety, anger and obsessive-compulsive traits compared with both PD control groups. In contrast, the three PD groups showed indifference in the impulsivity scales. At 12 weeks post intervention, ICD behaviours significantly improved (p<0.001, Δ modified MIDI score=‒5.27 ± 5.75) along with the UPDRS II daily activity scores (p=0.02, Δ=‒2.07 ± 4.53). Behavioural disinhibition tended to improve (p=0.06), although no significant changes were observed in the Neuropsychiatric Inventory and personality trait scores. Dopamine agonist withdrawal syndrome developed in 5.3% of the PD-ICD group.ConclusionsThis study provides class IV evidence suggesting that switching from dopamine agonists to levodopa/carbidopa slow-release formulations alleviated ICD behaviours in PD patients leading to improvement in daily activities whereas neuropsychiatric traits associated with ICD persisted after the 12-week therapy.Trial registration numberNCT01683253.


Author(s):  
David Conn ◽  
Lilian Thorpe

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.


2019 ◽  
Vol 32 (6) ◽  
pp. 733-739
Author(s):  
Wan-Chen Tsai ◽  
Hui-Chen Lin ◽  
Chiung-Chih Chang ◽  
Wen-Neng Chang ◽  
Chih-Cheng Huang ◽  
...  

ABSTRACTObjectives:The condition of caregivers is important to the quality of care received by people with Parkinson’s disease (PD), especially at the late disease stages. This study addresses the distress placed on caregivers by participants’ neuropsychiatric symptoms at different stages of PD in TaiwanMethods:This prospective study enrolled 108 people with PD. All participants were examined with the Unified Parkinson’s Disease Rating Scale (UPDRS), Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), and Clinical Dementia Rating (CDR) scale. Caregiver distress was measured using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). Statistical analysis was used to explore the PD-related factors that contribute to caregiver distress.Results:The mean follow-up interval in the 108 PD participants were 24.0 ± 10.2 months with no participant lost to follow-up due to death. NPI-distress (the sum of NPI caregiver distress scale across the 12 domains of the NPI) was positively correlated with NPI-sum (the total score across the 12 domains of the NPI) (r = 0.787, p < 0.001), CDR (r = 0.403, p < 0.001), UPRDS (r = 0.276, p = 0.004), and disease duration (r = 0.246, p = 0.002), but negatively correlated with CASI (r = −0.237, p = 0.043) and MMSE (r = −0.281, p < 0.001). Multiple linear regression analysis showed that only NPI-sum and disease duration were independently correlated with NPI-distress.Conclusion:The disease duration and NPI-sum are independent predictors of caregiver distress in Taiwanese populations with PD. Early detection and reduction of neuropsychiatric symptoms in people with PD can help decrease caregiver distress.


2012 ◽  
Vol 8 (4S_Part_4) ◽  
pp. P124-P124
Author(s):  
Florindo Stella ◽  
Larissa Andrade ◽  
Michelle Avendaño ◽  
Elisandra Sé ◽  
João Castilho Cação ◽  
...  

2017 ◽  
Vol 11 (2) ◽  
pp. 129-136 ◽  
Author(s):  
Gada Musa ◽  
Fernando Henríquez ◽  
Carlos Muñoz-Neira ◽  
Carolina Delgado ◽  
Patricia Lillo ◽  
...  

ABSTRACT The Neuropsychiatric Inventory Questionnaire (NPI-Q) is an informant-based instrument that measures the presence and severity of 12 Neuropsychiatric Symptoms (NPS) in patients with dementia, as well as informant distress. Objective: To measure the psychometric properties of the NPI-Q and the prevalence of NPS in patients with Alzheimer's disease (AD) in Chile. Methods: 53 patients with AD were assessed. Subjects were divided into two different groups: mild AD (n=26) and moderate AD (n=27). Convergent validity was estimated by correlating the outcomes of the NPI-Q with Neuropsychiatric Inventory (NPI) scores and with a global cognitive efficiency test (Addenbrooke's Cognitive Examination - Revised - ACE-R). Reliability of the NPI-Q was analysed by calculating its internal consistency. Prevalence of NPS was estimated with both the NPI and NPI-Q. Results: Positive and significant correlations were observed between the NPI-Q, the NPI, and the ACE-R (r=0.730; p<0.01 and 0.315; p<0.05 respectively). The instrument displayed an adequate level of reliability (Cronbach's alpha=0.783). The most prevalent NPS were apathy/indifference (62.3%) and dysphoria/depression (58.5%). Conclusion: The NPI-Q exhibited acceptable validity and reliability indicators for patients with AD in Chile, indicating that it is a suitable instrument for the routine assessment of NPS in clinical practice.


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