The Empirical Behavioral Pathology in Alzheimer's Disease (E-BEHAVE-AD) Rating Scale

1996 ◽  
Vol 8 (2) ◽  
pp. 247-266 ◽  
Author(s):  
Stefanie R. Auer ◽  
Isabel M. Monteiro ◽  
Barry Reisberg
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Interrater Reliability ◽  
Rating Scale ◽  
Behavioral Assessment ◽  
Reliability Study ◽  
Dementia Patients ◽  
Rating Instrument ◽  
Disease Rating ◽  
Behavioral Pathology

A clinician should not rely entirely upon a caregiver's report regarding behavioral pathology when planning a treatment strategy. Direct observational evaluation instruments as well as caregiver-based assessments are necessary. A new scale for the empirical (observational) evaluation of behavioral symptoms in Alzheimer's disease (AD) and related dementias, the Empirical Behavioral Pathology in Alzheimer's Disease Rating Scale (E-BEHAVEAD) was developed. Interrater reliability of this new assessment instrument was examined. Additionally, the relationship between the observed occurrence of behavioral symptomatology on this new rating instrument was compared with the occurrence using a similarly designed, caregiver-based instrument. The interrater reliability study consisted of two raters who simultaneously evaluated 20 dementia patients. The comparative study employed a cross-sectional design (N = 49). Individuals were evaluated in an outpatient clinic setting. The study population consisted of cognitively normal individuals and dementia patients. Evaluations included the new, observationally based behavioral assessment (the E-BEHAVE-AD), a caregiver-based behavioral assessment (the Behavioral Pathology in Alzheimer's Disease Rating Scale; BEHAVE-AD), a clinical global measure (the Global Deterioration Scale), and a mental status assessment (the Mini-Mental State Examination). The interrater reliability study revealed an intraclass correlation coefficient of .97 (p < .01) for total scores on the new E-BEHAVE-AD rating scale. The correlation coefficient for the amount of agreement on the presence of symptoms in six symptomatic categories between caregiver-based information about the patient's behavioral pathology assessed on the BEHAVE-AD and the clinician's observations assessed with the new E-BEHAVE-AD rating instrument was .51 (p < .01). The New E-BEHAVE-AD rating instrument showed excellent interrater reliability. Furthermore, there was a statistically significant relationship between clinician observation of the occurrence of behavioral pathology assessed using the E-BEHAVE-AD and caregive-reported pathology assessed with the BEHAVE-AD. However the magnitude of the correlation between these measures indicated that the majority of variance was independent and nonoverlapping. Consequently, these data support theoretical models suggesting that the assessment of behavioral pathology in dementia might ideally encompass both direct observational and caregiver-report approaches, using measures such as the E-BEHAVE-AD as well as measures such as the BEHAVE-AD.

Behavioral Pathology in Alzheimer’s Disease Rating Scale

1987 ◽  
Author(s):  
Barry Reisberg ◽  
Jeffrey Borenstein ◽  
Emile Franssen ◽  
Stacy Salob ◽  
Gertrude Steinberg ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Disease Rating ◽  
Behavioral Pathology

Addition of a frequency-weighted score to the Behavioral Pathology in Alzheimer’s Disease Rating Scale: the BEHAVE-AD-FW: methodology and reliability

2001 ◽  
Vol 16 (S1) ◽  
pp. 5s-24S ◽  
Author(s):  
I.M. Monteiro ◽  
I. Boksay ◽  
S.R. Auer ◽  
C. Torossian ◽  
S.H. Ferris ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Present Report ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Frequency Component ◽  
Validity Data ◽  
Disease Rating ◽  
Behavioral Pathology

SummaryThe Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD) is a well-established instrument, designed to assess potentially remediable behavioral symptoms in Alzheimer’s disease (AD) patients as well as to evaluate treatment outcome. It consists of 25 symptoms grouped into seven categories. Each symptom is scored on the basis of severity on a four-point scale. A knowledgeable caregiver is queried and items are scored on the basis of symptoms noted in the preceding two weeks. Reliability, construct validity and criterion validity data for the BEHAVE-AD have previously been published. Because of the significance of psychopathology in dementia, it is necessary to optimally describe and define the nature, magnitude and prevalence of behavioral symptomalogy. Accordingly, a frequency component was added to each of the 25 items of the BEHAVE-AD scale. The objective of the present report is to describe this new Behavioral Pathology in Alzheimer’s Disease Frequency-Weighted Severity Scale (BEHAVE-AD-FW) and to establish its inter-rater reliability. In this investigation the BEHAVE-AD-FW scale was administered to caregivers of 28 patients with either mildly impaired cognitive function or a dementia diagnosis. Two clinicians separately and independently rated the responses. Analyses determined that the intraclass correlation coefficients (ICCs) for the frequency component varied between 0.86 and 0.97 for each of the seven BEHAVE-AD categories (ps < 0.001). ICCs for the frequency-weighted scores (item severity score x item frequency score) ranged from 0.69 to 0.98 for the seven symptom categories (ps < 0.001). For the BEHAVE-AD-FW total scores, the ICC was 0.91 (P < 0.001). These results indicate that the frequency-weighted component is a reliable addition to the BEHAVE-AD scale.

A FREQUENCY ADDENDUM TO THE BEHAVIORAL PATHOLOGY IN ALZHEIMER's DISEASE RATING SCALE (BEHAVE-AD)

1999 ◽  
Vol 7 ◽  
pp. 51
Author(s):  
I. Monteiro ◽  
I. Boksay ◽  
S.R. Auer ◽  
C. Torossian ◽  
E. Sinaiko ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Disease Rating ◽  
Behavioral Pathology

Assessment of Behavioral and Affective Symptoms in Alzheimer's Disease

1990 ◽  
Vol 3 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Marian B. Patterson ◽  
Audrey H. Schnell ◽  
Richard J. Martin ◽  
Mario F. Mendez ◽  
Kathleen A. Smyth ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Signs And Symptoms ◽  
Behavioral Symptoms ◽  
Symptoms Of Depression ◽  
Patient Interviews ◽  
Affective Symptoms ◽  
Disease Rating ◽  
State Examination

Noncognitive behavioral symptoms occurring during the prior week were studied in 34 Alzheimer's disease (AD) patients and 21 spousal control subjects via caregiver and patient interviews using the Behavioral Pathology in Alzheimer's Disease Rating Scale and the Cornell Scale for Depression in Dementia. Delusional or paranoid features were reported in 13 subjects (38%) and hallucinations in six (18%); patients with these psychoticlike symptoms had lower scores on the Folstein's Mini-Mental State Examination. Other behavioral symptoms reported in AD patients included anxiety (50%) and activity disturbances (44%). Six AD subjects (18%) and two controls (10%) showed mild to moderate symptoms of depression ; AD subjects were more likely than controls to show behavioral signs and symptoms of depression, but the two groups did not differ in terms of mood-related, cyclical, or physical signs and symptoms. (J Geriatr Psychiatry Neurol 1990;3:21-30).

Behavioral and psychological symptoms of dementia in an Indian population: comparison between Alzheimer's disease and vascular dementia

2006 ◽  
Vol 18 (1) ◽  
pp. 87-93 ◽  
Author(s):  
C. Pinto ◽  
R. Seethalakshmi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Behavioral Symptoms ◽  
Caregiver Distress ◽  
Population Comparison ◽  
Behavioral And Psychological Symptoms ◽  
Behavioral Pathology

Background: Differential patterns of brain lesions in patients with Alzheimer's disease (AD) or vascular dementia (VaD) can result in differing clinical courses and presentations.Method: Thirty patients with AD were compared with 29 patients with VaD for differences in behavioral symptoms using the Behavioral Pathology in Alzheimer's Disease (BEHAV-AD) rating scale.Results: Patients with AD had significantly more delusions, hallucinations, anxieties and phobias and caregiver distress than patients with VaD.Conclusions: Behavioral symptoms in both AD and VaD exhibit specific longitudinal patterns. An understanding of the pattern can aid the treating physician in giving appropriate advice to caregivers regarding the course of the illness and also help them in planning appropriate interventions.

Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) Rating Scale

1997 ◽  
Vol 8 (S3) ◽  
pp. 301-308 ◽  
Author(s):  
Barry Reisberg ◽  
Stefanie R. Auer ◽  
Isabel M. Monteiro
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Psychiatric Disorders ◽  
Behavioral Problems ◽  
Rating Scale ◽  
Behavioral Symptoms ◽  
Functional Impairments ◽  
Behavioral Disturbances ◽  
Cognitive Disturbances ◽  
Behavioral Pathology

Before the development of the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) rating scale in 1987 by Reisberg and colleagues and its predecessor scale, the Symptoms of Psychosis in Alzheimer's Disease (SPAD) rating scale, in 1985 by Reisberg and Ferris, other scales were available for measuring behavioral disturbances and psychiatric disorders in patients with Alzheimer's disease. However, these scales generally mixed together cognitive disturbances with behavioral symptoms and sometimes included functional impairments as well. These predecessor scales also were not specifically designed to assess the types of behavioral problems seen in Alzheimer's disease. If a scale did address behavioral disturbances of dementia, it tended to be seriously underspecified in terms of the nature of behavioral disturbances.

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