Utility of the Neuropsychiatric Inventory Questionnaire (NPI-Q) in the assessment of a sample of patients with Alzheimer's disease in Chile

Musa, Gada; Henríquez, Fernando; Muñoz-Neira, Carlos; Delgado, Carolina; Lillo, Patricia; Slachevsky, Andrea

doi:10.1590/1980-57642016dn11-020005

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 11 (2) • Apr-Jun 2017 • https://doi.org/10.1590/1980-57642016dn11-020005 copy

Utility of the Neuropsychiatric Inventory Questionnaire (NPI-Q) in the assessment of a sample of patients with Alzheimer's disease in Chile

UTILIDADE DO QUESTIONÁRIO DE INVENTÁRIO NEUROPSIQUIÁTRICO (NPI-Q) NA AVALIAÇÃO DE UMA AMOSTRA DE PACIENTES COM DOENÇA DE ALZHEIMER NO CHILE

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The Neuropsychiatric Inventory Questionnaire (NPI-Q) is an informant-based instrument that measures the presence and severity of 12 Neuropsychiatric Symptoms (NPS) in patients with dementia, as well as informant distress.

Objective:

To measure the psychometric properties of the NPI-Q and the prevalence of NPS in patients with Alzheimer's disease (AD) in Chile.

Methods:

53 patients with AD were assessed. Subjects were divided into two different groups: mild AD (n=26) and moderate AD (n=27). Convergent validity was estimated by correlating the outcomes of the NPI-Q with Neuropsychiatric Inventory (NPI) scores and with a global cognitive efficiency test (Addenbrooke's Cognitive Examination - Revised - ACE-R). Reliability of the NPI-Q was analysed by calculating its internal consistency. Prevalence of NPS was estimated with both the NPI and NPI-Q.

Results:

Positive and significant correlations were observed between the NPI-Q, the NPI, and the ACE-R (r=0.730; p<0.01 and 0.315; p<0.05 respectively). The instrument displayed an adequate level of reliability (Cronbach's alpha=0.783). The most prevalent NPS were apathy/indifference (62.3%) and dysphoria/depression (58.5%).

Conclusion:

The NPI-Q exhibited acceptable validity and reliability indicators for patients with AD in Chile, indicating that it is a suitable instrument for the routine assessment of NPS in clinical practice.

Key words:
dementia; assessment; neuropsychiatric inventory; Alzheimer's disease; prevalence; neuropsychiatric symptoms

Variable	All (n=53)	CDR=1 (n=26)	CDR=2 (n=27)	Caregivers
Age	73.8±6.87	74.4±6.5	73.3±6.3	63.66±12.66
Education (years)	11.5±4.82	12.2±4.6	10.9±4.9	12.32±5.05
Total ACE-R score^* * Groups differ significantly (p> 0.05)	61.02±16.18	70.2±12.5	52.2±14.4
Total NPI score^* * Groups differ significantly (p> 0.05)	17.58±20.61	11.6±12.8	23.3±24.9
NPI - Distress score	8.21±8.63	5.9±7.2	10.4±9.4
Total NPI-Q score^* * Groups differ significantly (p> 0.05)	8.64±6.54	6.3±4.8	10.5±7.2
NPI-Q - Distress score^* * Groups differ significantly (p> 0.05)	11.09±9.87	7.4±7.9	14.1±10.4

Variables	All (n=53)	CDR=1 (n=26)	CDR=2 (n=27)
NPI-Q -Total/NPI - Total^b b Spearman's correlation coefficient (r).	0.730^ p< 0.01;	0.725^ p< 0.01;	0.691^ p< 0.01;
NPI-Q - Distress/NPI - Distress^b b Spearman's correlation coefficient (r).	0.715^ p< 0.01;	0.671^ p< 0.01;	0.671^ p< 0.01;
NPI-Q - Total/NPI-Q - Distress^b b Spearman's correlation coefficient (r).	0.900^ p< 0.01;	0.818^ p< 0.01;	0.912^ p< 0.01;
NPI - Total/NPI - Distress^b b Spearman's correlation coefficient (r).	0.882^ p< 0.01;	0.834^ p< 0.01;	0.929^ p< 0.01;
NPI-Q - Total/ACE-R^a a Pearson's correlation coefficient (r).	-0.315^* * p< 0.05;	^n.s. n.s. Non-significant.	^n.s. n.s. Non-significant.
NPI - Total/ACE-R^a a Pearson's correlation coefficient (r).	^n.s. n.s. Non-significant.	^n.s. n.s. Non-significant.	^n.s. n.s. Non-significant.

Domain	NPI-Q Symptom/NPI	NPI-Q - Total/NPI - Total	NPI-Q - Distress/NPI - Distress
Delusions^a a Pearson's correlation coefficient (r).	0.628^ p< 0.01;	0.678	^n.s. n.s Non-significant.
Hallucinations^a a Pearson's correlation coefficient (r).	0.542^ p< 0.01;	0.962^* * p< 0.05;	^n.s. n.s Non-significant.
Agitation/Aggression^a a Pearson's correlation coefficient (r).	0.413^ p< 0.01;	^n.s. n.s Non-significant.	^n.s. n.s Non-significant.
Dysphoria/Depression^b b Spearman's correlation coefficient (r).	0.653^ p< 0.01;	0.383^* * p< 0.05;	0.438^ p< 0.01;
Anxiety^b b Spearman's correlation coefficient (r).	0.673^ p< 0.01;	0.499^* * p< 0.05;	0.594^ p< 0.01;
Euphoria/Elation^b b Spearman's correlation coefficient (r).	0.292^* * p< 0.05;	--	1
Apathy/Indifference^b b Spearman's correlation coefficient (r).	0.450^ p< 0.01;	0.433^* * p< 0.05;	0.627^ p< 0.01;
Disinhibition^b b Spearman's correlation coefficient (r).	0.632^ p< 0.01;	^n.s. n.s Non-significant.	^n.s. n.s Non-significant.
Irritability/Lability^b b Spearman's correlation coefficient (r).	0.708^ p< 0.01;	0.419^* * p< 0.05;	0.496^ p< 0.01;
Aberrant Motor Behavior^b b Spearman's correlation coefficient (r).	0.522^ p< 0.01;	^n.s. n.s Non-significant.	^n.s. n.s Non-significant.
Nighttime Behavioral Disturbances^b b Spearman's correlation coefficient (r).	0.676^ p< 0.01;	0.861^ p< 0.01;	^n.s. n.s Non-significant.
Appetite/Eating Disturbances^b b Spearman's correlation coefficient (r).	0.580^ p< 0.01;	0.655^* * p< 0.05;	^n.s. n.s Non-significant.

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Andrea Slachevsky. Av. Salvador 486 – Facultad de Medicina Oriente – Universidad de Chile. E-mail: aslachevsky@me.com