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Sensitivity to change of composite and frequency scores of the Neuropsychiatric Inventory in mild to moderate dementia

Published online by Cambridge University Press:  30 November 2012

Jeffrey L. Cummings ,
Ralf Ihl ,
Horst Herrschaft ,
Robert Hoerr  and
Michael Tribanek
Jeffrey L. Cummings
Affiliation:
Lou Ruvo Center for Brain Health, The Andrea L. and Joseph F. Hahn MD Chair of Neurotherapeutics, Cleveland Clinic, Las Vegas, NV, USA
Ralf Ihl
Affiliation:
Alexian Hospital Krefeld and Department of Psychiatry, University of Duesseldorf, Duesseldorf, Germany
Horst Herrschaft
Affiliation:
Medical Faculty, University of Cologne, Cologne, Germany
Robert Hoerr*
Affiliation:
Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
Michael Tribanek
Affiliation:
Statistician, Hamburg, Germany
*
Correspondence should be addressed to: Robert Hoerr, MD, PhD, Clinical Research Department, Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Str. 4, 76227 Karlsruhe, Germany. Phone: +49 721 4005-492; Fax: +49 721 4005-8492. Email: robert.hoerr@schwabe.de.
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Abstract

Background: The Neuropsychiatric Inventory (NPI) is widely used to assess psychopathology in dementia. The scoring involves ratings of frequency and severity, as well as the calculation of a composite score. It was suggested recently that, due to lower variance, the frequency score might be more sensitive to detect treatment-related change and to discriminate active treatment from placebo than the composite score, particularly in milder forms of the disease.

Methods: Based on data from three randomized controlled trials in patients with mild to moderate dementia, standardized changes were calculated for both frequency and composite scores for two strata of disease severity. The two strata were formed by dichotomizing the sample along the median score of the short cognitive performance test (SKT) battery.

Results: Across all studies and for both severity strata, standardized changes in frequency scores were not consistently larger than those in composite scores and both scores discriminated active treatment from placebo at similar probabilities for type-1 error.

Conclusion: Our findings do not support the notion that there is a difference between frequency score and composite score with respect to their sensitivity to treatment-related change.

Keywords

assessmentbehaviorNPIpsychometric properties
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 3 , March 2013 , pp. 431 - 438
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Alzheimer, A. (1907). Über eine eigenartige Erkrankung der Hirnrinde. Allgemeine Zeitschrift für Psychiatrie und Psychisch-Gerichtliche Medizin (Berlin), 64, 146–148.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR®). Washington, DC: American Psychiatric Association.Google Scholar
Chan, D. C., Kasper, J. D., Black, B. S. and Rabins, P. V. (2003). Prevalence and correlates of behavioral and psychiatric symptoms in community-dwelling elders with dementia or mild cognitive impairment: the Memory and Medical Care Study. International Journal of Geriatric Psychiatry, 18, 174–182.CrossRefGoogle ScholarPubMed
Cummings, J. L. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48, S10–S16.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
de Medeiros, K. et al. (2010). The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia. International Psychogeriatrics, 22, 984–994. doi:10.1017/S1041610210000876.CrossRefGoogle ScholarPubMed
Dubois, B.et al. (2007). Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurology, 6, 734–746.CrossRefGoogle ScholarPubMed
Dubois, B.et al. (2010). Revising the definition of Alzheimer's disease: a new lexicon. Lancet Neurology, 9, 1118–1127.CrossRefGoogle ScholarPubMed
Gauthier, S.et al. (2010). Management of behavioral problems in Alzheimer's disease. International Psychogeriatrics, 22, 346–372.CrossRefGoogle ScholarPubMed
Geda, Y. E.et al. (2008). Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging. Archives of General Psychiatry, 65, 1193–1198.CrossRefGoogle ScholarPubMed
Herrschaft, H., Nacu, A., Likhachev, S., Sholomov, I., Hoerr, R., Schlaefke, S., on behalf of the GOT-IT! Study Group (2012). Ginkgo biloba extract EGb 761® in dementia with neuropsychiatric features: a randomized, placebo-controlled trial to confirm the efficacy and safety of a daily dose of 240 mg. Journal of Psychiatric Research, 46, 716–723.CrossRefGoogle Scholar
Ihl, R., Grass-Kapanke, B., Jänner, M. and Weyer, G. (1999). Neuropsychometric tests in cross sectional and longitudinal studies – a regression analysis of ADAS-Cog, SKT and MMSE. Pharmacopsychiatry, 32, 248–254.CrossRefGoogle ScholarPubMed
Ihl, R.et al. (2011). Efficacy and safety of a once-daily formulation of Ginkgo biloba extract EGb 761® in dementia with neuropsychiatric features: a randomized controlled trial. International Journal of Geriatric Psychiatry, 26, 1186–1194. doi:10.1002/gps.2662.CrossRefGoogle ScholarPubMed
Lyketsos, C. G. (2007). Neuropsychiatric symptoms (behavioral and psychological symptoms of dementia) and the development of dementia treatments. International Psychogeriatrics, 19, 409–420. doi:10.1017/S104161020700484X.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Steinberg, M., Tschanz, J. T., Norton, M. C., Steffens, D. C. and Breitner, J. C. S. (2000). Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. American Journal of Psychiatry, 157, 708–714.CrossRefGoogle Scholar
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment. Results from the Cardiovascular Health Study. JAMA, 288, 1475–1483.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Napryeyenko, O., Borzenko, I., for the GINDEM-NP Study Group (2007). Ginkgo biloba special extract in dementia with neuropsychiatric features. A randomized, placebo-controlled, double-blind clinical trial. Arzneimittelforschung, 57, 4–11.Google Scholar
Román, G. C.et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43, 250–260.CrossRefGoogle ScholarPubMed
Steinberg, M.et al. (2008). Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study. International Journal of Geriatric Psychiatry, 23, 170–177.CrossRefGoogle ScholarPubMed
Stelzmann, R. A., Schnitzlein, H. N. and Murtagh, F. R. (1995). An English translation of Alzheimer's 1907 paper, “Über eine eigenartige Erkrankung der Hirnrinde. Clinical Anatomy, 8, 429–431.CrossRefGoogle Scholar