Difficulty and Change of Sub-items of the Dementia Behavior Disturbance Scale in Patients with Alzheimer-type Dementia

Abstract

Objectives: It is difficult to predict behavioral disturbances in patients with Alzheimer's dementia because the order of appearance of behaviors is not clear. This study aimed to clarify the difficulty of the Dementia Behavior Disturbance Scale (DBDS) sub-items in patients with Alzheimer's disease and to compare changes in behavioral disorders after 6 months. Methods: The participants were inpatients with Alzheimer-type dementia hospitalized in participating hospitals for more than a year. They were assessed with the DBDS, the Mini-Mental State Examination (MMSE), and the Functional Independence Measure (FIM) twice: at the initial assessment and after 6 months. Rasch analysis for the sub-items of the DBDS determined the difficulty of behavioral disturbances. Results: The participants were 44 inpatients. There was no significant difference in the DBDS, MMSE, and FIM between the initial assessment and that after 6 months. Even though many participants increased or decreased for each assessment scale, there was no major change in the order of item difficulty of DBDS between the initial assessment and after 6 months. Conclusions:The systematic indication of the difficulty of behavioral disturbances in the DBDS is a new finding. It is possible to rank the difficulty of sub-items of the DBDS and infer behavioral disturbances that are likely to appear in the future. This is useful for clinical decision-making in dementia rehabilitation and care because it indicates the predictability of signs of dementia and behavioral disturbances that suggest the need for dementia intervention.