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Reliability of the Brazilian Portuguese version of the Neuropsychiatric Inventory (NPI) for patients with Alzheimer's disease and their caregivers

Published online by Cambridge University Press:  04 October 2007

Ana Luiza Camozzato ,
Renata Kochhann ,
Camila Simeoni ,
Cássio A Konrath ,
Adelar Pedro Franz ,
André Carvalho  and
Márcia L. Chaves
Ana Luiza Camozzato
Affiliation:
Alzheimer's Disease and Neurogeriatric Clinic, Neurology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
Renata Kochhann
Affiliation:
Undergraduate students (CNPq or FAPERGS research assistants), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
Camila Simeoni
Affiliation:
Undergraduate students (CNPq or FAPERGS research assistants), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
Cássio A Konrath
Affiliation:
Undergraduate students (CNPq or FAPERGS research assistants), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
Adelar Pedro Franz
Affiliation:
Undergraduate students (CNPq or FAPERGS research assistants), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
André Carvalho
Affiliation:
Medical Sciences Post-Graduation Course, UFRGS School of Medicine, Porto Alegre, Brazil
Márcia L. Chaves*
Affiliation:
Alzheimer's Disease and Neurogeriatric Clinic, Neurology Service, HCPA, and Internal Medicine Department, UFRGS School of Medicine, Porto Alegre, Brazil
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Abstract

Background: Behavioral symptoms and caregivers' responses may differ among various ethnic and cultural groups. Therefore it is important to have a reliable instrument to assess behavioral disturbances of dementia in various cultures. The Neuropsychiatric Inventory (NPI) has been widely used in many countries. To date there has been no reliability study of this instrument in Brazil.

Methods: The psychometric properties of the Brazilian Portuguese version of the NPI were studied in a sample of 36 Alzheimer's disease (AD) outpatients from southern Brazil. Test-retest, inter-rater reliability and internal consistency were estimated. The profile of neuropsychiatric symptoms and caregiver distress were also evaluated. The NPI was translated into Portuguese and then back translated to English.

Results: The Brazilian Portuguese version of the NPI showed good inter-rater and test-retest reliability with the coefficients of all scales > 0.85. Internal consistency was also good (Cronbach's α 0.70 for total severity and distress). Apathy provided higher NPI scores of total severity and distress.

Conclusions: This NPI version was found to be a reliable instrument for the evaluation of neuropsychiatric symptoms and caregiver distress due to dementia in AD. The profile of behavioral disturbances was similar to that observed in other countries. Severity of dementia may have biased some caregivers' answers.

Keywords

dementiaAlzheimer's diseaseneuropsychiatric symptomsBrazil
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 2 , April 2008 , pp. 383 - 393
Copyright
Copyright © International Psychogeriatric Association 2007

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References

American Psychiatric Association 1994. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Baiyewu, O. et al. 2003. Behavioral and caregiver reaction of dementia as measured by the neuropsychiatric inventory in Nigerian community residents. International Psychogeriatrics, 15, 399–409.CrossRefGoogle ScholarPubMed
Binetti, G. et al. 1998. Behavioral disorders in Alzheimer disease: a transcultural perspective. Archives of Neurology, 55, 539–544.Google Scholar
Chaves, M. L. and Izquierdo, I. 1992. Validity of the Clinical Dementia Rating scale for the detection and staging of dementia in Brazilian patients. Acta Neurologica Scandinavica, 85, 378–382.Google Scholar
Chaves, M. L. et al. 2007. Validity of the Clinical Dementia Rating scale for the detection and staging of dementia in Brazilian patients. Alzheimer Disease and Associated Disorders, 21 (4) (in press).Google Scholar
Choi, S. H., Na, D. L., Kwon, H. M., Yoon, S. J., Jeong, J. H. and Ha, C. K. 2000. The Korean version of the Neuropsychiatric Inventory: a scoring tool for neuropsychiatric disturbance in dementia patients. Journal of Korean Medical Science, 15, 609–615.CrossRefGoogle ScholarPubMed
Cummings, J. L. 1997. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48 (Suppl. 6), S10–S16.Google Scholar
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
Folstein, M. R., Folstein, S. E. and McHugh, P. R. 1975. “Mini-mental State:” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Fuh, J. L., Liu, C. K., Mega, M. S., Wang, S. J. and Cummings, J. L. 2001. Behavioral disorders and caregivers' reaction in Taiwanese patients with Alzheimer's disease. International Psychogeriatrics, 13, 121–128.CrossRefGoogle ScholarPubMed
Hamilton, M. A. 1960. A rating scale for depression, Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62.Google Scholar
Hirono, N. et al. 1997. Japanese version of the Neuropsychiatric Inventory: a scoring system for neuropsychiatric disturbance in dementia patients. No To Shinkei (Brain Nerve), 49, 266–271.Google ScholarPubMed
Hughes, C. P., Berg, L., Danziger, W. L., Cobar, L. A. and Martin, R. L. 1982. A new clinical scale for staging dementia. British Journal of Psychiatry, 140, 566–572.Google Scholar
Kat, M. G., de Jonghe, J. F., Aalten, P., Kalisvaart, C. J., Droes, R. M. and Verhey, F. R. 2002. Neuropsychiatric symptoms of dementia: psychometric aspects of the Dutch Neuropsychiatric Inventory (NPI). Tijdschrift voor Gerontologie en Geriatrie, 33, 150–155.Google Scholar
Kaufer, D. I. et al. 1998. Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale. Journal of the American Geriatrics Society, 46, 210–215.Google Scholar
Koss, E. et al. 1997. Assessing patterns of agitation in Alzheimer's disease patients with the Cohen-Mansfield Agitation Inventory: the Alzheimer's Disease Cooperative Study. Alzheimer Disease and Associated Disorders, 11 (Suppl. 2), S45–S50.CrossRefGoogle ScholarPubMed
Leung, V. P. Y., Lam, L. C. W., Chiu, H. F. K., Cummings, J. L. and Chen, K. L. 2001. Validation study of the Chinese version of the neuropsychiatric inventory (CNPI). International Psychogeriatrics, 16, 789–793.Google ScholarPubMed
Lyketsos, C. G. et al. 2001. Neuropsychiatric disturbance in Alzheimer's disease clusters into three groups: the Cache County Study. International Journal of Geriatric Psychiatry, 16, 1043–1053.CrossRefGoogle ScholarPubMed
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.Google Scholar
Maia, A. L. G. et al. 2006. Aplicação da versão brasileira da escala de avaliação clínica da demência (Clinical Dementia Rating - CDR) em amostras de pacientes com demência. Arquivos de Neuro-Psiquiatria, 64 (2B), 485–489.CrossRefGoogle Scholar
McKeith, I. and Cummings, J. 2005. Behavioural changes and psychological symptoms in dementia disorders. Lancet Neurology, 4, 735–742.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. 1984. Clinical diagnosis of Alzheimer's disease: report from 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.Google Scholar
Mega, M. S., Cummings, J. L., Fiorello, T. and Gornbein, J. 1996 The spectrum of behavioral changes in Alzheimer's disease. Neurology, 46, 130–135.CrossRefGoogle ScholarPubMed
Overall, J. E. and Gorham, D. R. 1988. Introduction: the Brief Psychiatric Rating Scale (BPRS): recent developments in ascertainment and scaling. Psychopharmacology Bulletin, 24, 97–98.Google Scholar
Politis, A. M., Mayer, L. S., Passa, M., Maillis, A. and Lyketsos, C. G. 2004. Validity and reliability of the newly translated Hellenic Neuropsychiatric Inventory (H-NPI) applied to Greek outpatients with Alzheimer's disease: a study of disturbing behaviors among referrals to memory clinic. International Journal of Geriatric Psychiatry, 19, 203–208.Google Scholar
Reisberg, B., Borenstein, J., Salob, S. P., Ferris, S. H., Franssen, E. and Georgotas, A. 1987. Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. Journal of Clinical Psychiatry, 48 (Suppl.), 9–15.Google ScholarPubMed
Starkstein, S. E., Petracca, G., Chemerinski, E. and Kremer, J. 2001. Syndromic validity of apathy in Alzheimer's disease. American Journal of Psychiatry, 158, 872–877.Google Scholar
Tatsch, M. F. et al. 2006. Neuropsychiatric symptoms in Alzheimer disease and cognitively impaired, nondemented elderly from a community-based sample in Brazil: prevalence and relationship with dementia severity. American Journal of Psychiatry, 14, 438–445.Google Scholar
Vilalta-Franch, J., Lozano-Gallego, M., Hernandez-Ferrandiz, M., Llinas-Regla, J., Lopez-Pousa, S. and Lopez, O. L. 1999. The Neuropsychiatric Inventory: psychometric properties of its adaptation into Spanish. Revista de Neurologia, 29, 15–19.Google Scholar