ABSTRACT
BACKGROUND: The Neuropsychiatric Inventory (NPI) is an interview-based instrument designed to elicit information from an informal caregiver to evaluate behavioral disturbances in persons with dementia. Minor modifications of this instrument have produced the Neuropsychiatric Inventory-Nursing Home version (NPI-NH), a version specifically designed for interviewing professional care facility staff. The purpose of this investigation is to further understand the psychometric properties of the NPI-NH by examining its reliability, validity, and factor structure in an elderly neuropsychiatric population. METHOD: Participants were 204 elderly inpatients from a large provincial neuropsychiatric hospital in British Columbia, Canada. Data were collected as part of a patient needs assessment project. RESULTS: The internal consistency reliability of the NPI-NH was alpha=0.67. An exploratory principal axis analysis with varimax rotation revealed five factors that accounted for 63.2% of the variance. These factors reflect aspects of psychiatric disturbance associated with: (a) Agitation; (b) Mood; (c) Psychosis; (d) Sleep/Motor Activity; and (e) Elevated Behavior. Convergent and discriminant validity of the five factors by correlating them with other behavioral measures was considered satisfactory. CONCLUSIONS: These results provide support for the clinical use of the NPI-NH as a screen for neuropsychiatric symptoms in an elderly neuropsychiatric population. However, additional research is encouraged to further evaluate the clinical utility of the NPI-NH in nursing home and inpatient geriatric settings.
Subject(s)
Dementia/psychology , Mental Disorders/diagnosis , Neuropsychological Tests , Adult , Aged , Aged, 80 and over , Factor Analysis, Statistical , Female , Geriatric Assessment/methods , Homes for the Aged , Humans , Male , Mental Disorders/etiology , Middle Aged , Nursing Homes , Psychiatric Status Rating Scales , Psychometrics , Reproducibility of ResultsABSTRACT
Evidence pertaining to self-reported use of memory compensation techniques was collected using the Memory Compensation Questionnaire (MCQ). Five forms of everyday memory compensation were evaluated: (a) external memory aids, (b) internal mnemonic strategies, (c) investing and managing processing time, (d) applying more effort, and (e) reliance on human memory aids. The sample was derived from the Kungsholmen Project in Stockholm, Sweden, and consisted of (n = 85) healthy older adults (M age = 81.80 years; M MMSE = 28.34) and (n = 21) diagnosed Alzheimer's Disease (AD) patients (Mage = 81.80 years; M MMSE = 23.55). Participants were tested on two occasions, 6 months apart. Results showed that the MCQ was a largely reliable instrument in these two groups. Moreover, we observed substantial sample similarity in frequency of using the five forms of everyday memory compensation techniques. The healthy sample reported using the external techniques more than the AD sample. Over the 6-month interval, however, AD patients differentially increased their use of others to assist them in everyday memory performance. Results are interpreted in terms of insight into changes in memory skills and inthe implementation of effective memory support systems.
Subject(s)
Aged, 80 and over/psychology , Alzheimer Disease/physiopathology , Autobiographies as Topic , Geriatric Assessment , Memory , Adaptation, Psychological , Aged , Alzheimer Disease/psychology , Case-Control Studies , Defense Mechanisms , Female , Humans , Male , Mental Status Schedule , Neuropsychological Tests , Psychometrics , Surveys and Questionnaires , SwedenABSTRACT
BACKGROUND: The Neuropsychiatric Inventory-Nursing Home version (NPI-NH) is a modified version of the Neuropsychiatric Inventory (NPI). Accurate interpretation of change in the symptom ratings on the NPI-NH, as with any measure, is a concern for both clinicians and researchers. The purpose of this article is to present data for the interpretation of reliable change in the NPI-NH scores for acute geriatric neuropsychiatry patients. METHOD: Fifty-two geriatric psychiatry inpatients were administered the NPI-NH twice, at a 72-hour interval. Standard errors of difference scores were used to calculate confidence intervals for each of the NPI-NH subscales and the total score. RESULTS: Based on the calculations described above, estimates of reliable change on the individual subscales ranged from plus or minus 1.29 points on the Euphoria/Elation subscale to 5.13 points on the Anxiety subscale. Statistically meaningful change on the Agitation and the Apathy subscales was established at 4.0 and 4.3 points, respectively. A change in the total score of plus or minus 22 points is required to exceed the possible range of measurement error, at a 0.80 confidence interval (CI). CONCLUSIONS: Overall, the results of this study indicate that the clinician evaluating elderly psychiatric inpatients should interpret a change in the total score of less than 22 points with caution, because it may be due to measurement error.
