Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and Reliable Change Index of the Neuropsychiatric Inventory and the Cohen-Mansfield Agitation Inventory
Objective The aim of the study was to estimate inter‐observer and test–retest reliability of the Neuropsychiatric Inventory Nursing Home version (NPI‐NH) and the Cohen‐Mansfield Agitation Inventory (CMAI), and to establish their Reliable Change Index (RCI). Reliable Change methodology is a practical...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2011-02, Vol.26 (2), p.127-134 |
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| creator | Zuidema, Sytse U. Buursema, Anja L. Gerritsen, Maarten G. J. M. Oosterwal, Karen C. Smits, Mieke M. M. Koopmans, Raymond T. C. M. de Jonghe, Jos F. M. |
| description | Objective
The aim of the study was to estimate inter‐observer and test–retest reliability of the Neuropsychiatric Inventory Nursing Home version (NPI‐NH) and the Cohen‐Mansfield Agitation Inventory (CMAI), and to establish their Reliable Change Index (RCI). Reliable Change methodology is a practical method for estimating the least change acquired in outcome measures.
Methods
Nursing home physicians and certified nurses assessed 105 patients with dementia (in five nursing homes) at baseline and after 2 weeks. Spearman rank correlations were calculated and Reliable Change Difference Scores (Sdiff(80)).
Results
NPI‐NH inter‐observer correlations ranged 0.14–0.70. NPI‐NH test–retest correlations ranged 0.23–0.80. CMAI inter‐observer correlations ranged −0.10 to 0.72. CMAI test–retest correlations ranged 0.32–1.00 (CMAI total score, ρ = 0.89). Sdiff(80) for NPI‐NH items ranged 1.7–5.0. A change of 11 points on the NPI‐NH total score can be considered a true behavioral change. Sdiff(80) for CMAI total score was 8 and factor analysis based sub‐scale scores physically aggressive behavior, physically non‐aggressive behavior, and verbally agitated behavior were 3, 6, and 4, respectively.
Conclusion
Reliability estimates and RCI for the NPI‐NH were modest, seriously challenging its reliability and sensitivity to change over time. NPI‐NH may only be useful for monitoring behavioral changes in individual patients with dementia, when symptoms are moderate to severe, or when effect sizes are large. Reliability of the CMAI was good, supporting its usefulness in clinical practice. Poor inter‐observer agreement on behavioral observations poses a real challenge in nursing homes. Reliable scales are needed that include unambiguously formulated items. Copyright © 2010 John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/gps.2499 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_840349808</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1017971721</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3789-5ff4bd635fdd03c8684f9ffdb425b55bdc7a281381bbe734d2782ee2eb0f58bf3</originalsourceid><addsrcrecordid>eNp90t1u0zAYBuAIgVgZSFwBspAQnGTYcX4czqqKdRXrmPjRDi0n_tx4JHawE7ZcHbeGu5ZVmgRHluXH7yfrdRS9JPiEYJy83_T-JEnL8lE0I7gsY0Ly_HE0w4xlcZ5QfBQ98_4a43BG2NPoKMF5iQkls-j33HvwXpsNMjA62_upbrQYnK6Rn7p-sJ1H2iAzujvU2A5QLwYNZvDoRg8NktCFjRYfkINWi0q3epiQMBJ9udu3gBaNMBtAKyPhFlmFhgbQxcNxK_Mr5Fi3u7slC9uAidfCeKWhlWi-0UMYbc3BPo-eKNF6eLFfj6Pvpx-_Lc7i88_L1WJ-Hte0YGWcKZVWMqeZkhLTmuUsVaVSskqTrMqyStaFSBihjFQVFDSVScESgAQqrDJWKXocvd3l9s7-HMEPvNO-hrYVBuzoOUsxTUuGWZDv_isJJkVZkCIhgb5-QK_t6Ex4R8hjGcNpUR7yame9d6B473Qn3BSS-LZ9Htrn2_YDfbXPG6sO5D38W3cAb_ZA-Fq0yglTa39wtMjCb9m6eOdudAvTPwfy5eXX_eC9136A23sv3A-eFyGUX10s-aers8vl6XrNS_oHzEPaAA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>848580479</pqid></control><display><type>article</type><title>Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and Reliable Change Index of the Neuropsychiatric Inventory and the Cohen-Mansfield Agitation Inventory</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Zuidema, Sytse U. ; Buursema, Anja L. ; Gerritsen, Maarten G. J. M. ; Oosterwal, Karen C. ; Smits, Mieke M. M. ; Koopmans, Raymond T. C. M. ; de Jonghe, Jos F. M.</creator><creatorcontrib>Zuidema, Sytse U. ; Buursema, Anja L. ; Gerritsen, Maarten G. J. M. ; Oosterwal, Karen C. ; Smits, Mieke M. M. ; Koopmans, Raymond T. C. M. ; de Jonghe, Jos F. M.</creatorcontrib><description>Objective
The aim of the study was to estimate inter‐observer and test–retest reliability of the Neuropsychiatric Inventory Nursing Home version (NPI‐NH) and the Cohen‐Mansfield Agitation Inventory (CMAI), and to establish their Reliable Change Index (RCI). Reliable Change methodology is a practical method for estimating the least change acquired in outcome measures.
Methods
Nursing home physicians and certified nurses assessed 105 patients with dementia (in five nursing homes) at baseline and after 2 weeks. Spearman rank correlations were calculated and Reliable Change Difference Scores (Sdiff(80)).
Results
NPI‐NH inter‐observer correlations ranged 0.14–0.70. NPI‐NH test–retest correlations ranged 0.23–0.80. CMAI inter‐observer correlations ranged −0.10 to 0.72. CMAI test–retest correlations ranged 0.32–1.00 (CMAI total score, ρ = 0.89). Sdiff(80) for NPI‐NH items ranged 1.7–5.0. A change of 11 points on the NPI‐NH total score can be considered a true behavioral change. Sdiff(80) for CMAI total score was 8 and factor analysis based sub‐scale scores physically aggressive behavior, physically non‐aggressive behavior, and verbally agitated behavior were 3, 6, and 4, respectively.
Conclusion
Reliability estimates and RCI for the NPI‐NH were modest, seriously challenging its reliability and sensitivity to change over time. NPI‐NH may only be useful for monitoring behavioral changes in individual patients with dementia, when symptoms are moderate to severe, or when effect sizes are large. Reliability of the CMAI was good, supporting its usefulness in clinical practice. Poor inter‐observer agreement on behavioral observations poses a real challenge in nursing homes. Reliable scales are needed that include unambiguously formulated items. Copyright © 2010 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>ISSN: 1099-1166</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.2499</identifier><identifier>PMID: 20690131</identifier><identifier>CODEN: IJGPES</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Aged, 80 and over ; assessment ; Behavior ; Biological and medical sciences ; Correlation analysis ; Dementia ; Dementia - diagnosis ; Dementia - psychology ; Estimating techniques ; Female ; Fundamental and applied biological sciences. Psychology ; General aspects ; Geriatric psychiatry ; Geriatrics ; Humans ; Male ; Medical sciences ; neuropsychiatric symptoms ; Neuropsychological Tests ; Neuropsychology ; nursing home ; Nursing Homes ; Observer Variation ; Psychiatric Status Rating Scales ; Psychoanalysis ; Psychology. Psychoanalysis. Psychiatry ; Psychomotor Agitation - diagnosis ; Psychomotor Agitation - psychology ; Psychopathology. Psychiatry ; Reliability ; Reproducibility of Results ; Severity of Illness Index ; Studies</subject><ispartof>International journal of geriatric psychiatry, 2011-02, Vol.26 (2), p.127-134</ispartof><rights>Copyright © 2010 John Wiley & Sons, Ltd.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright John Wiley and Sons, Limited Feb 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3789-5ff4bd635fdd03c8684f9ffdb425b55bdc7a281381bbe734d2782ee2eb0f58bf3</citedby><cites>FETCH-LOGICAL-c3789-5ff4bd635fdd03c8684f9ffdb425b55bdc7a281381bbe734d2782ee2eb0f58bf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.2499$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.2499$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45552,45553</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23752301$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20690131$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zuidema, Sytse U.</creatorcontrib><creatorcontrib>Buursema, Anja L.</creatorcontrib><creatorcontrib>Gerritsen, Maarten G. J. M.</creatorcontrib><creatorcontrib>Oosterwal, Karen C.</creatorcontrib><creatorcontrib>Smits, Mieke M. M.</creatorcontrib><creatorcontrib>Koopmans, Raymond T. C. M.</creatorcontrib><creatorcontrib>de Jonghe, Jos F. M.</creatorcontrib><title>Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and Reliable Change Index of the Neuropsychiatric Inventory and the Cohen-Mansfield Agitation Inventory</title><title>International journal of geriatric psychiatry</title><addtitle>Int. J. Geriat. Psychiatry</addtitle><description>Objective
The aim of the study was to estimate inter‐observer and test–retest reliability of the Neuropsychiatric Inventory Nursing Home version (NPI‐NH) and the Cohen‐Mansfield Agitation Inventory (CMAI), and to establish their Reliable Change Index (RCI). Reliable Change methodology is a practical method for estimating the least change acquired in outcome measures.
Methods
Nursing home physicians and certified nurses assessed 105 patients with dementia (in five nursing homes) at baseline and after 2 weeks. Spearman rank correlations were calculated and Reliable Change Difference Scores (Sdiff(80)).
Results
NPI‐NH inter‐observer correlations ranged 0.14–0.70. NPI‐NH test–retest correlations ranged 0.23–0.80. CMAI inter‐observer correlations ranged −0.10 to 0.72. CMAI test–retest correlations ranged 0.32–1.00 (CMAI total score, ρ = 0.89). Sdiff(80) for NPI‐NH items ranged 1.7–5.0. A change of 11 points on the NPI‐NH total score can be considered a true behavioral change. Sdiff(80) for CMAI total score was 8 and factor analysis based sub‐scale scores physically aggressive behavior, physically non‐aggressive behavior, and verbally agitated behavior were 3, 6, and 4, respectively.
Conclusion
Reliability estimates and RCI for the NPI‐NH were modest, seriously challenging its reliability and sensitivity to change over time. NPI‐NH may only be useful for monitoring behavioral changes in individual patients with dementia, when symptoms are moderate to severe, or when effect sizes are large. Reliability of the CMAI was good, supporting its usefulness in clinical practice. Poor inter‐observer agreement on behavioral observations poses a real challenge in nursing homes. Reliable scales are needed that include unambiguously formulated items. Copyright © 2010 John Wiley & Sons, Ltd.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>assessment</subject><subject>Behavior</subject><subject>Biological and medical sciences</subject><subject>Correlation analysis</subject><subject>Dementia</subject><subject>Dementia - diagnosis</subject><subject>Dementia - psychology</subject><subject>Estimating techniques</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>General aspects</subject><subject>Geriatric psychiatry</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>neuropsychiatric symptoms</subject><subject>Neuropsychological Tests</subject><subject>Neuropsychology</subject><subject>nursing home</subject><subject>Nursing Homes</subject><subject>Observer Variation</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychoanalysis</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychomotor Agitation - diagnosis</subject><subject>Psychomotor Agitation - psychology</subject><subject>Psychopathology. Psychiatry</subject><subject>Reliability</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>Studies</subject><issn>0885-6230</issn><issn>1099-1166</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90t1u0zAYBuAIgVgZSFwBspAQnGTYcX4czqqKdRXrmPjRDi0n_tx4JHawE7ZcHbeGu5ZVmgRHluXH7yfrdRS9JPiEYJy83_T-JEnL8lE0I7gsY0Ly_HE0w4xlcZ5QfBQ98_4a43BG2NPoKMF5iQkls-j33HvwXpsNMjA62_upbrQYnK6Rn7p-sJ1H2iAzujvU2A5QLwYNZvDoRg8NktCFjRYfkINWi0q3epiQMBJ9udu3gBaNMBtAKyPhFlmFhgbQxcNxK_Mr5Fi3u7slC9uAidfCeKWhlWi-0UMYbc3BPo-eKNF6eLFfj6Pvpx-_Lc7i88_L1WJ-Hte0YGWcKZVWMqeZkhLTmuUsVaVSskqTrMqyStaFSBihjFQVFDSVScESgAQqrDJWKXocvd3l9s7-HMEPvNO-hrYVBuzoOUsxTUuGWZDv_isJJkVZkCIhgb5-QK_t6Ex4R8hjGcNpUR7yame9d6B473Qn3BSS-LZ9Htrn2_YDfbXPG6sO5D38W3cAb_ZA-Fq0yglTa39wtMjCb9m6eOdudAvTPwfy5eXX_eC9136A23sv3A-eFyGUX10s-aers8vl6XrNS_oHzEPaAA</recordid><startdate>201102</startdate><enddate>201102</enddate><creator>Zuidema, Sytse U.</creator><creator>Buursema, Anja L.</creator><creator>Gerritsen, Maarten G. J. M.</creator><creator>Oosterwal, Karen C.</creator><creator>Smits, Mieke M. M.</creator><creator>Koopmans, Raymond T. C. M.</creator><creator>de Jonghe, Jos F. M.</creator><general>John Wiley & Sons, Ltd</general><general>Psychology Press</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201102</creationdate><title>Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and Reliable Change Index of the Neuropsychiatric Inventory and the Cohen-Mansfield Agitation Inventory</title><author>Zuidema, Sytse U. ; Buursema, Anja L. ; Gerritsen, Maarten G. J. M. ; Oosterwal, Karen C. ; Smits, Mieke M. M. ; Koopmans, Raymond T. C. M. ; de Jonghe, Jos F. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3789-5ff4bd635fdd03c8684f9ffdb425b55bdc7a281381bbe734d2782ee2eb0f58bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>assessment</topic><topic>Behavior</topic><topic>Biological and medical sciences</topic><topic>Correlation analysis</topic><topic>Dementia</topic><topic>Dementia - diagnosis</topic><topic>Dementia - psychology</topic><topic>Estimating techniques</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>General aspects</topic><topic>Geriatric psychiatry</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>neuropsychiatric symptoms</topic><topic>Neuropsychological Tests</topic><topic>Neuropsychology</topic><topic>nursing home</topic><topic>Nursing Homes</topic><topic>Observer Variation</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychoanalysis</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychomotor Agitation - diagnosis</topic><topic>Psychomotor Agitation - psychology</topic><topic>Psychopathology. Psychiatry</topic><topic>Reliability</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zuidema, Sytse U.</creatorcontrib><creatorcontrib>Buursema, Anja L.</creatorcontrib><creatorcontrib>Gerritsen, Maarten G. J. M.</creatorcontrib><creatorcontrib>Oosterwal, Karen C.</creatorcontrib><creatorcontrib>Smits, Mieke M. M.</creatorcontrib><creatorcontrib>Koopmans, Raymond T. C. M.</creatorcontrib><creatorcontrib>de Jonghe, Jos F. M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zuidema, Sytse U.</au><au>Buursema, Anja L.</au><au>Gerritsen, Maarten G. J. M.</au><au>Oosterwal, Karen C.</au><au>Smits, Mieke M. M.</au><au>Koopmans, Raymond T. C. M.</au><au>de Jonghe, Jos F. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and Reliable Change Index of the Neuropsychiatric Inventory and the Cohen-Mansfield Agitation Inventory</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int. J. Geriat. Psychiatry</addtitle><date>2011-02</date><risdate>2011</risdate><volume>26</volume><issue>2</issue><spage>127</spage><epage>134</epage><pages>127-134</pages><issn>0885-6230</issn><issn>1099-1166</issn><eissn>1099-1166</eissn><coden>IJGPES</coden><abstract>Objective
The aim of the study was to estimate inter‐observer and test–retest reliability of the Neuropsychiatric Inventory Nursing Home version (NPI‐NH) and the Cohen‐Mansfield Agitation Inventory (CMAI), and to establish their Reliable Change Index (RCI). Reliable Change methodology is a practical method for estimating the least change acquired in outcome measures.
Methods
Nursing home physicians and certified nurses assessed 105 patients with dementia (in five nursing homes) at baseline and after 2 weeks. Spearman rank correlations were calculated and Reliable Change Difference Scores (Sdiff(80)).
Results
NPI‐NH inter‐observer correlations ranged 0.14–0.70. NPI‐NH test–retest correlations ranged 0.23–0.80. CMAI inter‐observer correlations ranged −0.10 to 0.72. CMAI test–retest correlations ranged 0.32–1.00 (CMAI total score, ρ = 0.89). Sdiff(80) for NPI‐NH items ranged 1.7–5.0. A change of 11 points on the NPI‐NH total score can be considered a true behavioral change. Sdiff(80) for CMAI total score was 8 and factor analysis based sub‐scale scores physically aggressive behavior, physically non‐aggressive behavior, and verbally agitated behavior were 3, 6, and 4, respectively.
Conclusion
Reliability estimates and RCI for the NPI‐NH were modest, seriously challenging its reliability and sensitivity to change over time. NPI‐NH may only be useful for monitoring behavioral changes in individual patients with dementia, when symptoms are moderate to severe, or when effect sizes are large. Reliability of the CMAI was good, supporting its usefulness in clinical practice. Poor inter‐observer agreement on behavioral observations poses a real challenge in nursing homes. Reliable scales are needed that include unambiguously formulated items. Copyright © 2010 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>20690131</pmid><doi>10.1002/gps.2499</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Aged, 80 and over assessment Behavior Biological and medical sciences Correlation analysis Dementia Dementia - diagnosis Dementia - psychology Estimating techniques Female Fundamental and applied biological sciences. Psychology General aspects Geriatric psychiatry Geriatrics Humans Male Medical sciences neuropsychiatric symptoms Neuropsychological Tests Neuropsychology nursing home Nursing Homes Observer Variation Psychiatric Status Rating Scales Psychoanalysis Psychology. Psychoanalysis. Psychiatry Psychomotor Agitation - diagnosis Psychomotor Agitation - psychology Psychopathology. Psychiatry Reliability Reproducibility of Results Severity of Illness Index Studies |
| title | Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and Reliable Change Index of the Neuropsychiatric Inventory and the Cohen-Mansfield Agitation Inventory |
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