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Sensitivity to change of composite and frequency scores of the neuropsychiatric inventory in mild cognitive impairment

Published online by Cambridge University Press:  03 July 2014

Jeffrey L. Cummings ,
Michael Tribanek  and
Robert Hoerr
Jeffrey L. Cummings
Affiliation:
Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA
Michael Tribanek
Affiliation:
Hamburg, Germany
Robert Hoerr*
Affiliation:
Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
*
Correspondence should be addressed to: Robert Hoerr, MD, Head Geriatrics/CNS, Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Str. 4, 76227 Karlsruhe, Germany. Phone: +49-7214005492; Fax: +49-72140058492. Email: robert.hoerr@schwabe.de.
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Abstract

Background:

The most appropriate means of capturing data from the Neuropsychiatric Inventory (NPI) must be understood to optimize use of this instrument in clinical trials. The utility of the composite score (frequency times severity) was recently demonstrated in mild and moderate dementia. Determination of frequency compared to composite scores in mild cognitive impairment (MCI) warrants investigation.

Methods:

We used the NPI data from a randomized, placebo-controlled, multi-center, 24-week, clinical trial involving 160 patients who were diagnosed with amnestic MCI and had clinically significant neuropsychiatric symptoms (NPS). We calculated standardized changes for both frequency and composite scores.

Results:

There were improvements in NPI composite scores in both active drug- and placebo-treated patients, with significant superiority of active drug. Standardized changes in severity and composite scores tended to be larger than those in the frequency scores, whereas discrimination between treatment groups was similar for all three scores.

Conclusions:

Our findings support the hypothesis that in MCI, as in dementia, the NPI frequency score is not more sensitive to treatment-related change than the composite score. As the severity score adds information, the use of the composite score has better performance characteristics.

Keywords

assessmentbehaviorNPIpsychometric propertiesmild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 11 , November 2014 , pp. 1871 - 1874
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

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.Google Scholar
Cummings, J. L. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48, S10–S16.Google Scholar
Cummings, J. L., Ihl, R., Herrschaft, H., Hoerr, R. and Tribanek, M. (2013). Sensitivity to change of composite and frequency scores of the Neuropsychiatric Inventory in mild to moderate dementia. International Psychogeratrics, 25, 431–438. doi:10.1017/S1041610212001974.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.Google Scholar
Cummings, J. L. et al. (2013). Alzheimer's disease drug development: translational neuroscience strategies. CNS Spectrums, 18, 128–138.Google Scholar
Gauthier, S. et al. (2010). Management of behavioral problems in Alzheimer's disease. International Psychogeriatrics, 22, 346–372.Google Scholar
Gavrilova, S. I., Preuss, U. W., Wong, J. W. M., Hoerr, R., Kaschel, R., Bachinskaya, N. and the GIMCIPlus Study Group. (2014). Efficacy and safety of Ginkgo biloba extract EGb 761® in mild cognitive impairment with neuropsychiatric symptoms: a randomized, placebo-controlled, double-blind, multi-center trial. International Journal of Geriatric Psychiatry. Epublished ahead of print, doi:10.1002/gps.4103.Google Scholar
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.Google 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. Journal of the American Medical Association, 288, 1475–1483.Google Scholar
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.Google Scholar
Mangialasche, F., Kivipelto, M., Solomon, A. and Fratiglioni, L. (2012). Dementia prevention: current epidemiological evidence and future perspective. Alzheimer's Research & Therapy, 4, 6.Google Scholar
Palmer, K., Berger, A. K., Monastero, R., Winblad, B., Bäckman, L. and Fratiglioni, L. (2007). Predictors of progression from mild cognitive impairment to Alzheimer disease. Neurology, 68, 1596–1602.Google Scholar
Rosenberg, P. B., Mielke, M. M., Appleby, B. S., Oh, E. S., Geda, Y. E. and Lyketsos, C. G. (2013). The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer disease. American Journal of Geriatric Psychiatry, 21, 685–695.CrossRefGoogle ScholarPubMed
Teng, E., Lu, P. H. and Cummings, J. L. (2007). Neuropsychiatric symptoms are associated with progression from mild cognitive impairment to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 24, 253–259.CrossRefGoogle ScholarPubMed
Vellas, B. et al. (2012). Alzheimer's disease therapeutic trials: EU/US Task Force report on recruitment, retention, and methodology. The Journal of Nutrition, Health & Aging, 16, 339–345.CrossRefGoogle ScholarPubMed
Winblad, B. et al. (2004). Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar