The Neuropsychiatric Inventory: Development and Applications

Cummings, Jeffrey L.

doi:10.1177/0891988719882102

Cited by 89 publications

(90 citation statements)

References 107 publications

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“…As mentioned previously, the existing reviews [8,13,22,11,23] focused only on the reported psychometric properties of the NPI, and have not addressed whether these data are sufficient in light of general psychometric recommendations. To address this gap, we used a comprehensive framework for the evaluation of psychometric properties in development and validation studies of the NPI.…”

Section: Review Proceduresmentioning

confidence: 99%

“…The NPI is a flexible and a relatively brief informant questionnaire that screens for the most common NPS in AD and other memory disorders. It has been utilized both clinically and in research, with applications in clinical trials, neuroimaging, descriptive psychopathology, and as a validity benchmark for the development of subsequent NPS scales [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Variants of the NPI have been applied outside memory disorder contexts: for instance, in stroke [17], delirium [18] and cognitively healthy elderly [19]. It is envisioned that the NPI could be applied to central nervous system (CNS) disorder clinical trials in general, covering "anticonvulsants, Parkinson's disease therapies, hyperactivity/attention deficit disorder, pain therapies, CNS cancer therapies, and multiple sclerosis treatments" [11].…”

Section: Introductionmentioning

confidence: 99%

“…While important, these qualities are only a subset of those usually desired in scale validation [20,21]. Previous reviews of the NPI [8,11,13,22,23] have summarized these data at face value and solidified the notion that the psychometric data are sufficient and indicative of good reliability and validity. However, drawing inferences based on just the reported metrics may have led to biased conclusions at least for two reasons: the conditions for stricter psychometric analyses have not been met, or that the good properties have come at the expense of unexamined properties through overoptimization [21].…”

Section: Introductionmentioning

confidence: 99%

“…Combining these cautionary observations with the NPI's aspiration of becoming an outcome measure in CNS disorders more broadly [11], a thorough review of its psychometric basis is timely and needed. After outlining the rationale, format and scoring of the NPI, we review the psychometric data of the scale.…”

Section: Introductionmentioning

confidence: 99%

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Psychometric properties of the Neuropsychiatric Inventory: a review

Saari¹,

Koivisto²,

Hintsa³

et al. 2019

Preprint

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Neuropsychiatric symptoms (NPSs) cause a significant burden to individuals with memory disorders and their families. Insights into the clinical associations, neurobiology, and treatment of NPSs are largely dependent on informant questionnaires, such as the commonly used Neuropsychiatric Inventory (NPI). Like any scale, the utility of the NPI relies on its psychometric properties, but unlike many scales, the NPI faces unique challenges related to its skip-question and scoring formats.We examined and reviewed the psychometric properties of the NPI in a framework including psychometric properties pertinent for construct validation, and health-related outcome measurement in general. We found that aspects such as test-retest and inter-rater reliability are major strengths of the NPI in addition to its flexible and relatively quick administration. These properties are desired in clinical trials. However, it seems that the reported properties cover only some of the generally examined psychometric properties, representing perhaps necessary but not sufficient reliability and validity evidence for the NPI. There appear to be significant gaps in psychometric data, at least partially owing to small sample sizes in the studies that preclude more comprehensive analyses. Regarding construct validity, only one study examined structural validity with the NPI subquestions. Measurement error was not assessed in the reviewed studies. For future validation, we recommend using data from all subquestions, collecting larger samples, paying specific attention to construct validity and formulating hypotheses a priori. As the NPI is an outcome measure of interest in clinical trials, examining measurement error could be of practical importance.

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Section: Review Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychometric properties of the Neuropsychiatric Inventory: a review

Saari¹,

Koivisto²,

Hintsa³

et al. 2019

Preprint

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Research Criteria for the Behavioral Variant of Alzheimer Disease

et al. 2022

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A data‐driven examination of apathy and depressive symptoms in dementia with independent replication

Silva

Meléndez-Torres

Ismail

et al. 2023

Alz & Dem Diag Ass & Dis Mo

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Apathy is one of the most common neuropsychiatric symptoms (NPS) and is associated with poor clinical outcomes. Research that helps define the apathy phenotype is urgently needed, particularly for clinical and biomarker studies. We used latent class analysis (LCA) with two independent cohorts to understand how apathy and depression symptoms co‐occur statistically. We further explored the relationship between latent class membership, demographics, and the presence of other NPS. The LCA identified a four‐class solution (no symptoms, apathy, depression, and combined apathy/depression), reproducible over both cohorts, providing robust support for an apathy syndrome distinct from depression and confirming that an apathy/depression syndrome exists, supported by the model fit test with the four‐class solution scores evidencing better fitting (Bayesian information criterion adjusted and entropy R 2 ). Using a data‐driven method, we show distinct and statistically meaningful co‐occurrence of apathy and depressive symptoms. There was evidence that these classes have different clinical associations, which may help inform diagnostic categories for research studies and clinical practice. Highlights We found four classes: no symptoms, apathy, depression and apathy/depression. Apathy conferred a higher probability for agitation. Apathy diagnostic criteria should include accompanying neuropsychiatric symptoms.

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The Neuropsychiatric Inventory: Development and Applications

Cited by 89 publications

References 107 publications

Psychometric properties of the Neuropsychiatric Inventory: a review

Psychometric properties of the Neuropsychiatric Inventory: a review

Research Criteria for the Behavioral Variant of Alzheimer Disease

A data‐driven examination of apathy and depressive symptoms in dementia with independent replication

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