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Departments of Neurology (Drs. Cummings and Mega, and D.A. Carusi) and Psychiatry and Biobehavioral Science (Drs. Cummings and Gray, and S. Rosenberg-Thompson), UCLA School of Medicine, Behavioral Neuroscience Section, Psychiatry Service; West Los Angeles Veterans Affairs Medical Center (Drs. Cummings and Gray); and the Biomathematical Consulting Unit, Department of Biomathematics (Dr. Gornbein), UCLA School of Medicine, Los Angeles, CA.
We developed a new instrument, the Neuropsychiatric Inventory (NPI), to assess 10 behavioral disturbances occurring in dementia patients: delusions, hallucinations, dysphoria, anxiety, agitation/aggression, euphoria, disinhibition, irritability/lability, apathy, and aberrant motor activity. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. Studies reported here demonstrate the content and concurrent validity as well as between-rater, test-retest, and internal consistency reliability; the instrument is both valid and reliable. The NPI has the advantages of evaluating a wider range of psychopathology than existing instruments, soliciting information that may distinguish among different etiologies of dementia, differentiating between severity and frequency of behavioral changes, and minimizing administration time.
Address correspondence and reprint requests to Dr. Jeffrey L. Cummings, Neurobehavior Unit, Psychiatry Service (116AF), West Los Angeles VAMC, 11301 Wilshire Boulevard, Los Angeles, CA 90073.
Supported by the Department of Veterans Affairs, a National Institute on Aging Alzheimer's Disease Core Center grant (AG10123), and the Irving and Helga Cooper Award.
Received February 1, 1994. Accepted in final form June 7, 1994.
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D.-C. Chan, J. D. Kasper, B. S. Black, and P. V. Rabins Clinical Diagnosis of Dementia, Not Presence of Behavioral and Psychological Symptoms, Is Associated With Psychotropic Use in Community-Dwelling Elders Classified as Having Dementia J Geriatr Psychiatry Neurol, March 1, 2007; 20(1): 50 - 57. [Abstract] [PDF]
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J Ellul, N Archer, C M L Foy, M Poppe, H Boothby, H Nicholas, R G Brown, and S Lovestone The effects of commonly prescribed drugs in patients with Alzheimer's disease on the rate of deterioration J. Neurol. Neurosurg. Psychiatry, March 1, 2007; 78(3): 233 - 239. [Abstract] [Full Text] [PDF]
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M. K Beyer, C. C Janvin, J. P Larsen, and D. Aarsland A magnetic resonance imaging study of patients with Parkinson's disease with mild cognitive impairment and dementia using voxel-based morphometry J. Neurol. Neurosurg. Psychiatry, March 1, 2007; 78(3): 254 - 259. [Abstract] [Full Text] [PDF]
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J. Murphy, R. Henry, and C. Lomen-Hoerth Establishing Subtypes of the Continuum of Frontal Lobe Impairment in Amyotrophic Lateral Sclerosis Arch Neurol, March 1, 2007; 64(3): 330 - 334. [Abstract] [Full Text] [PDF]
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N. R. Graff-Radford, J. E. Crook, J. Lucas, B. F. Boeve, D. S. Knopman, R. J. Ivnik, G. E. Smith, L. H. Younkin, R. C. Petersen, and S. G. Younkin Association of Low Plasma Abeta42/Abeta40 Ratios With Increased Imminent Risk for Mild Cognitive Impairment and Alzheimer Disease Arch Neurol, March 1, 2007; 64(3): 354 - 362. [Abstract] [Full Text] [PDF]
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G. E. Smith, A. M. Lunde, J. C. Hathaway, and K. S. Vickers Telehealth Home Monitoring of Solitary Persons With Mild Dementia American Journal of Alzheimer's Disease and Other Dementias, February 1, 2007; 22(1): 20 - 26. [Abstract] [PDF]
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L. Rozzini, B. V. Chilovi, E. Bertoletti, M. Conti, I. Delrio, M. Trabucchi, and A. Padovani Cognitive and Psychopathologic Response to Rivastigmine in Dementia With Lewy Bodies Compared to Alzheimer's Disease: A Case Control Study American Journal of Alzheimer's Disease and Other Dementias, February 1, 2007; 22(1): 42 - 47. [Abstract] [PDF]
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 A. T. Blaszczyk and M. Mathys Treatment of Cognitive Decline and Psychiatric Disturbances Associated With Alzheimer's Dementia Journal of Pharmacy Practice, February 1, 2007; 20(1): 13 - 28. [Abstract] [PDF]
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P. Aalten, J. Jolles, M. E. de Vugt, and F. R.J. Verhey The Influence of Neuropsychological Functioning on Neuropsychiatric Problems in Dementia J Neuropsychiatry Clin Neurosci, February 1, 2007; 19(1): 50 - 56. [Abstract] [Full Text] [PDF]
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D. E. Clarke, R. v. Reekum, M. Simard, D. L. Streiner, M. Freedman, and D. Conn Apathy in Dementia: An Examination of the Psychometric Properties of the Apathy Evaluation Scale J Neuropsychiatry Clin Neurosci, February 1, 2007; 19(1): 57 - 64. [Abstract] [Full Text] [PDF]
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M. L. Onor, M. Saina, and E. Aguglia Efficacy and Tolerability of Quetiapine in the Treatment of Behavioral and Psychological Symptoms of Dementia American Journal of Alzheimer's Disease and Other Dementias, January 1, 2007; 21(6): 448 - 453. [Abstract] [PDF]
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G Livingston, A E Walker, C L E Katona, and C Cooper Antipsychotics and cognitive decline in Alzheimer's disease: the LASER-Alzheimer's disease longitudinal study J. Neurol. Neurosurg. Psychiatry, January 1, 2007; 78(1): 25 - 29. [Abstract] [Full Text] [PDF]
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D Aarsland, K Bronnick, U Ehrt, P P De Deyn, S Tekin, M Emre, and J L Cummings Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress J. Neurol. Neurosurg. Psychiatry, January 1, 2007; 78(1): 36 - 42. [Abstract] [Full Text] [PDF]
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I Leroi and A Burns Behavioural and psychological symptoms of dementia associated with Parkinson's disease J. Neurol. Neurosurg. Psychiatry, January 1, 2007; 78(1): 2 - 3. [Full Text] [PDF]
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L. E. Gibbons, L. Teri, R. G. Logsdon, and S. M. McCurry Assessment of anxiety in dementia: an investigation into the association of different methods of measurement. J Geriatr Psychiatry Neurol, December 1, 2006; 19(4): 202 - 208. [Abstract] [PDF]
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Y. Nagahama, T. Okina, N. Suzuki, and M. Matsuda The cambridge behavioral inventory: validation and application in a memory clinic. J Geriatr Psychiatry Neurol, December 1, 2006; 19(4): 220 - 225. [Abstract] [PDF]
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J. G. Gonyea, M. K. O'Connor, and P. A. Boyle Project CARE: A Randomized Controlled Trial of a Behavioral Intervention Group for Alzheimer's Disease Caregivers Gerontologist, December 1, 2006; 46(6): 827 - 832. [Abstract] [Full Text] [PDF]
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S A Molloy, E N Rowan, J T O'Brien, I G McKeith, K Wesnes, and D J Burn Effect of levodopa on cognitive function in Parkinson's disease with and without dementia and dementia with Lewy bodies J. Neurol. Neurosurg. Psychiatry, December 1, 2006; 77(12): 1323 - 1328. [Abstract] [Full Text] [PDF]
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R. R. Davies, C. M. Kipps, J. Mitchell, J. J. Kril, G. M. Halliday, and J. R. Hodges Progression in Frontotemporal Dementia: Identifying a Benign Behavioral Variant by Magnetic Resonance Imaging Arch Neurol, November 1, 2006; 63(11): 1627 - 1631. [Abstract] [Full Text] [PDF]
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