Measuring change in psychiatric symptoms using the Neuropsychiatric Inventory: Nursing Home version

Iverson, Grant L.; Hopp, Grace A.; DeWolfe, Kimberley; Solomons, Kevin

doi:10.1002/gps.617

Cited by 35 publications

(40 citation statements)

References 20 publications

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“…For each symptom endorsed, the interviewer follows up with a series of questions to rate the frequency and severity of the disturbance (Cummings). For descriptive purposes, symptom severity was estimated by multiplying scores for frequency and severity within each NPI domain (e.g., Iverson et al, 2002;.…”

Section: Assessment Of Neuropsychiatric Symptomsmentioning

confidence: 99%

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Treiber

Corcoran

Steinberg

et al. 2008

IPG

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Objective-To examine, in an exploratory analysis, the association between vascular conditions and the occurrence of neuropsychiatric symptoms (NPS) in a population-based sample of incident Alzheimer's disease (AD).Methods-The sample consisted of 254 participants, identified through two waves of assessment. NPS were assessed using the Neuropsychiatric Inventory. Prior to the onset of AD, data regarding a history of stroke, hypertension, hyperlipidemia, heart attack or CABG, and diabetes were recorded. Logistic regression procedures were used to examine the relationship of each vascular condition to individual neuropsychiatric symptoms. Covariates considered were age, gender, education, APOE genotype, dementia severity, and overall health status.Results-One or more NPS were observed in 51.0% of participants. Depression was most common (25.8%), followed by apathy (18.6%), and irritability (17.7%). Least common were elation (0.8%), hallucinations (5.6%), and disinhibition (6.0%). Stroke prior to the onset of AD was associated with increased risk of delusions (OR=4.76, p=0.02), depression (OR=3.87, p=0.03), and apathy (OR=4.48, p=0.02). Hypertension was associated with increased risk of delusions (OR=2.34, p=0.02), anxiety (OR=4.10, p=0.002), and agitation/aggression (OR=2.82, p=0.01). No associations were observed between NPS and diabetes, hyperlipidemia, heart attack or CABG, or overall health. Conclusions-Resultssuggest that a history of stroke and hypertension increase the risk of specific NPS in patients with AD. These conditions may disrupt neural circuitry in brain areas involved in CORRESPONDING AUTHOR:

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Section: Assessment Of Neuropsychiatric Symptomsmentioning

confidence: 99%

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Treiber

Corcoran

Steinberg

et al. 2008

IPG

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“…Street et al, 2000;Clark et al, 2001;Tariot et al, 2001). In one of the few studies examining the psychometric properties of the NPI-NH, Iverson et al (2002) reported 72-hour test-retest reliability coefficients ranging from r ¼ 0.55 to r ¼ 0.88 for each of the 12 individual symptoms in a geriatric neuropsychiatric sample. This research further indicated that psychometric properties of the npi-nha change in scores of less than 22 points should be interpreted with caution, as this difference may not reflect a meaningful change between two NPI-NH scores.…”

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confidence: 98%

Psychometric properties and factor structure of the Neuropsychiatric Inventory Nursing Home version in an elderly neuropsychiatric population

Lange

Hopp

Kang

2004

Int J Geriat Psychiatry

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“…In addition, the total score increased as dementia-related disability worsened, individuals with mild dementia had a mean total score on the NPI of 5.80 (SD = 12.5), those with moderate dementia had a mean score of 8.8 (SD = 11.10), and those with severe dementia had a mean score of 10.6 (SD = 17.0) (Lyketsos et al 2002). The mean total NPI score increased dramatically, ie, 36.4 (SD = 24.5), among patients with moderate to severe dementia admitted to the hospital for the management of their disturbed behaviors (Iverson et al 2002). The prevalence data provide an idea of the total NPI score range but they do not explain the fl uctuating nature of BPSD.…”

Section: The Natural History Of the Bpsdmentioning

confidence: 94%

Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer’s disease: A meta-analysis

Campbell

Ayub

Boustani

et al. 2008

CIA

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Objective: To determine the effi cacy of cholinesterase inhibitors (ChEIs) in improving the behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD). Data sources: We searched MEDLINE, Cochrane Registry, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from 1966 to 2007. We limited our search to English Language, full text, published articles and human studies. Data extraction: We included randomized, double-blind, placebo-controlled trials evaluating the effi cacy of donepezil, rivastigmine, or galantamine in managing BPSD displayed by AD patients. Using the United States Preventive Services Task Force (USPSTF) guidelines, we critically appraised all studies and included only those with an attrition rate of less than 40%, concealed measurement of the outcomes, and intention to treat analysis of the collected data. All data were imputed into pre-defi ned evidence based tables and were pooled using the Review Manager 4.2.1 software for data synthesis. Results: We found 12 studies that met our inclusion criteria but only nine of them provided suffi cient data for the meta-analysis. Among patients with mild to severe AD and in comparison to placebo, ChEIs as a class had a benefi cial effects on reducing BPSD with a standard mean difference (SMD) of −0.10 (95% confi dence interval [CI]; −0.18, −0.01) and a weighted mean difference (WMD) of −1.38 neuropsychiatry inventory point (95% CI; −2.30, −0.46). In studies with mild AD patients, the WMD was −1.92 (95% CI; −3.18, −0.66); and in studies with severe AD patients, the WMD was −0.06 (95% CI; −2.12, +0.57). Conclusion: Cholinesterase inhibitors lead to a statistical signifi cant reduction in BPSD among patients with AD, yet the clinical relevance of this effect remains unclear.

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Measuring change in psychiatric symptoms using the Neuropsychiatric Inventory: Nursing Home version

Abstract: Overall, the results of this study indicate that the clinician evaluating elderly psychiatric inpatients should interpret a change in the total score of less than 22 points with caution, because it may be due to measurement error.

Cited by 35 publications

References 20 publications

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Psychometric properties and factor structure of the Neuropsychiatric Inventory Nursing Home version in an elderly neuropsychiatric population

Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer’s disease: A meta-analysis

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Measuring change in psychiatric symptoms using the Neuropsychiatric Inventory: Nursing Home version

Abstract: Overall, the results of this study indicate that the clinician evaluating elderly psychiatric inpatients should interpret a change in the total score of less than 22 points with caution, because it may be due to measurement error.

Cited by 35 publications

References 20 publications

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Psychometric properties and factor structure of the Neuropsychiatric Inventory Nursing Home version in an elderly neuropsychiatric population

Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer&rsquo;s disease: A meta-analysis

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Product

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Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer’s disease: A meta-analysis