ABSTRACT
Aggressive behaviour is the most disturbing and distressing behaviour displayed by elderly people. The prevalence of aggressive behaviour is around 50% among psychogeriatric patients. OBJECTIVE: This study sought to analyze the psychometric properties and diagnostic accuracy of the French version of the Rating Scale for Aggressive Behaviour in the Elderly (F-RAGE). METHODS: The F-RAGE was administered to 79 patients hospitalized in a geriatric psychiatry department. A psychiatrist, who was blind to the subjects' RAGE scores, performed the diagnosis for aggressivity based on global clinical impression. The F-RAGE and MMSE were applied by a trained researcher blind to subjects' clinical diagnoses while the Cohen-Mans Agitation Inventory and Neuropsychiatric Inventory were administered by medical and nursing staff. Internal consistency, reliability, cut-off points, sensitivity and specificity for F-RAGE were estimated. RESULTS: F-RAGE showed satisfactory validity and reliability measurements. Regarding reliability, Cronbach's ? coefficient was satisfactory with a value of 0.758. For diagnostic accuracy, a cut-off point of 8 points (sensitivity=74.19%; specificity=97.98%) and area under curve of 0.960 were estimated to distinguish between aggressive patients and control subjects. DISCUSSION: F-RAGE showed acceptable psychometric properties, supported by evidence of validity and reliability for its use in the diagnosis of aggressive behaviour in elderly.
O comportamento agressivo é o comportamento mais perturbador e angustiante que possa ser apresentado pelos idosos. A prevalência de comportamento agressivo é cerca de 50% entre os pacientes psicogeriátricos. OBJETIVO: Analisar as propriedades psicométricas e acurácia diagnóstica da versão francesa da Escala de Avaliação do Comportamento Agressivo em Idosos (F-RAGE). MÉTODOS: A F-RAGE foi administrada a 79 pacientes internados no departamento de psiquiatria geriátrica. Um psiquiatra que era cego às pontuações F-RAGE dos sujeitos realizou o diagnóstico de DSM-IV com base na impressão clínica global. O F-RAGE e MMSE foram realizados por um pesquisador treinado cego ao diagnóstico clínico dos sujeitos e o Inventário de agitação de Cohen-Mans e o Inventário Neuropsiquiátrico pela equipe médica e de enfermagem. Consistência interna, pontos de corte, sensibilidade e especificidade para F-RAGE foram estimados. RESULTADOS: F-RAGE mostrou validade satisfatória e medidas de confiabilidade. Em relação à confiabilidade, coeficiente ? de Cronbach foi satisfatória com um valor de 0,758. Para maior precisão de diagnóstico, um ponto de corte de 8 pontos (sensibilidade=74,2%, especificidade=98,0%) e área sob a curva de 0,960 foram estimados para distinguir entre os pacientes agressivos e controles.DISCUSSÃO: F-RAGE mostrou propriedades psicométricas aceitáveis, apoiados por evidências de validade e confiabilidade para sua utilização no diagnóstico do comportamento agressivo em idosos.
Subject(s)
Humans , Rage , Aggression , Mental Status and Dementia Tests , Geriatric PsychiatryABSTRACT
A preliminary study has been conducted to screen psychogeriatric disorder among elderly. This survey was designed to determine the prevalence of cognitive impairment, stroke and depression in a population sample of 60-89 years old. A total of 40 subjects and informants were selected from the Klang Valley, Kuala Lumpur and Selangor. The screening tools that were used in this survey were Psychogeriatric Assessment Scale (PAS). The Psychogeriatric Assessment Scale (PAS) consists of two sections: the subject’s self report and the informant report. The subject’s self report was used to assess cognitive impairment, stroke and depression. Meanwhile the informant report was used to assess cognitive decline, stroke and behavioral changes in the subject. Results indicated that there was a high percentage cognitive impairment (male 67% case, female 64.3% case) and stroke (male 75% case, female 64.4% case) among elderly. There was also a significant correlation between the subject’s self report and the informant’s report according to PAS each subscale. PAS psychological assessment tool able to screen psychogeriatric problem among elderly and the accuracy of screening ability can be tested with informant report data. Psychogeriatic screening is important to detect early presentation of cognitive impairment and depression among elderly.
ABSTRACT
OBJECTIVES: This study was designed to develop the Korean version of the Psychogeriatric Assessment Scale(PAS-K), a multidimensional screening tool for the dementia and depression. METHODS: Through three times preliminary trials, the authors translated PAS into Korean. The PAS-K, Geriatric Depression Scale, Hamilton Depression Rating Scale, Hachinski Ischemic Scale and Mini-Mental State Examination-Korean version were administered to 291 subjects over the age of 60 and the same number of their informants(67 subjects were institutionalized, 168 subjects were in community, 58 subjects were psychiatric hospital patients). And the Diagnostic Interview Schedule (DIS-III-R) was independently administered to exactly diagnose dementia and depression. The reliability and validity test, optimal cut-off point estimation for six each scale and ROC curve analyses were done to investigate the diagnostic validity of PAS-K. RESULTS: Internal consistency and interrater reliability of the PAS-K were high. Concurrent validity of each scales of PAS-K was good in being measured with other standardized scales. The optimal cut-off points of each scale of the PAS-K were estimated as follows: 1) Stroke Scale of subject interview: 1, 2) Cognitive Impairment Scale of subject interview: 10, 3) Depression Scale of subject interview: 5, 4) Stroke Scale of informant interview: 1, 5) Cognitive Decline Scale of informant interview: 3, and 6) Behavioral Change Scale of informant: 2. CONCLUSIONS: The PAS-K was valid and reliable screening tools for detecting dementia and depression. Therefore the PAS-K could be widely and extensively used in psychogeriatric epidemiological research or clinical setting of primary screening for dementia and depression.