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The Brazilian version of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity in dementia

Published online by Cambridge University Press:  14 June 2013

Florindo Stella ,
Orestes Vicente Forlenza ,
Jerson Laks ,
Larissa Pires de Andrade ,
Michelle A. Ljubetic Avendaño ,
Elisandra Villela Gasparetto Sé ,
João de Castilho Cação ,
Constantine G. Lyketsos  and
Kate de Medeiros
Florindo Stella*
Affiliation:
Biosciences Institute, Universidade Estadual Paulista (UNESP), Rio Claro, SP, Brazil Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, SP, Brazil
Orestes Vicente Forlenza
Affiliation:
Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, SP, Brazil
Jerson Laks
Affiliation:
Centre for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, RJ, Brazil
Larissa Pires de Andrade
Affiliation:
Biosciences Institute, Universidade Estadual Paulista (UNESP), Rio Claro, SP, Brazil
Michelle A. Ljubetic Avendaño
Affiliation:
Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, SP, Brazil
Elisandra Villela Gasparetto Sé
Affiliation:
Clinic of Geriatric Psychiatry, Faculty of Medicine, State University of Campinas, Campinas, SP, Brazil
João de Castilho Cação
Affiliation:
FAMERP – Faculty of Medicine, Geriatric Unity, São José do Rio Preto, Brazil
Constantine G. Lyketsos
Affiliation:
Department of Psychiatry, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, Maryland, USA
Kate de Medeiros
Affiliation:
Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
*
Correspondence should be addressed to: Florindo Stella, Biosciences Institute, Universidade Estadual Paulista (UNESP), Rio Claro 13506-900, SP, Brazil. Phone: 55-19-3526-4245; Fax: 55-19-3526-4246. Email: fstelldo@gmail.com.
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Abstract

Background:

Patients with dementia may be unable to describe their symptoms, and caregivers frequently suffer emotional burden that can interfere with judgment of the patient's behavior. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C) was therefore developed as a comprehensive and versatile instrument to assess and accurately measure neuropsychiatric symptoms (NPS) in dementia, thereby using information from caregiver and patient interviews, and any other relevant available data. The present study is a follow-up to the original, cross-national NPI-C validation, evaluating the reliability and concurrent validity of the NPI-C in quantifying psychopathological symptoms in dementia in a large Brazilian cohort.

Methods:

Two blinded raters evaluated 312 participants (156 patient-knowledgeable informant dyads) using the NPI-C for a total of 624 observations in five Brazilian centers. Inter-rater reliability was determined through intraclass correlation coefficients for the NPI-C domains and the traditional NPI. Convergent validity included correlations of specific domains of the NPI-C with the Brief Psychiatric Rating Scale (BPRS), the Cohen-Mansfield Agitation Index (CMAI), the Cornell Scale for Depression in Dementia (CSDD), and the Apathy Inventory (AI).

Results:

Inter-rater reliability was strong for all NPI-C domains. There were high correlations between NPI-C/delusions and BPRS, NPI-C/apathy-indifference with the AI, NPI-C/depression-dysphoria with the CSDD, NPI-C/agitation with the CMAI, and NPI-C/aggression with the CMAI. There was moderate correlation between the NPI-C/aberrant vocalizations and CMAI and the NPI-C/hallucinations with the BPRS.

Conclusion:

The NPI-C is a comprehensive tool that provides accurate measurement of NPS in dementia with high concurrent validity and inter-rater reliability in the Brazilian setting. In addition to universal assessment, the NPI-C can be completed by individual domains.

Keywords

neuropsychiatric symptomsdementiaAlzheimer’s diseasescaleneuropsychiatric assessmentBrazil
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 9 , September 2013 , pp. 1503 - 1511
Copyright
Copyright © International Psychogeriatric Association 2013 

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