Validity and Reliability of the Neuropsychiatric Inventory Questionnaire Version in Patients With Stroke or Transient Ischemic Attack Having Cognitive Impairment

Abstract

This study examined the validity and reliability of the Neuropsychiatric Inventory Questionnaire version (NPI-Q), a proxy-reported format of the interview-based NPI, in assessing neuropsychiatric symptoms in 173 patients with stroke or transient ischemic attack (TIA) having cognitive impairment. The NPI-Q was validated against the NPI as a gold standard. Informants took approximately 7 minutes to complete the NPI-Q. Bland-Altman analysis revealed a bias of 0.7 points, with 95% limits of agreement between −8.6 and 10.0 between the total symptom scores of the NPI and NPI-Q. The NPI-Q correlated significantly with the NPI in individual and total symptom scores and caregiver distress scores. In predicting presence of symptoms on the NPI, the NPI-Q yielded, on average, sensitivity of 74.1% and specificity of 79.5%. On the NPI-Q, informants tended to overreport symptoms in patients with less severe symptoms but underreport with increasing symptom severity. Internal consistency of the NPI-Q was acceptable (Cronbach's α = 0.756). One-week test–retest reliability of the NPI-Q was excellent (intraclass correlation coefficient = .990). The NPI-Q is a valid and reliable instrument for screening neuropsychiatric symptoms in patients with stroke and TIA.

Keywords

neuropsychiatric inventory questionnaire behavioral and psychological symptoms of dementia vascular cognitive impairment vascular dementia stroke clinical assessment

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References

Tan

Wong

Allen

. The impact of neuropsychiatric symptoms of dementia on distress in family and professional caregivers in Singapore. Int Psychogeriatr. 2005;17(2):253–263.

Samus

Rosenblatt

Onyike

. Correlates of caregiver-rated quality of life in assisted living: the Maryland Assisted Living study. J Gerontol B Psychol Sci Soc Sci. 2006;61(5):P311–P314.

Royall

Lauterbach

Cummings

. Executive control function: a review of its promise and challenges for clinical research. A report from the committee on research of the American neuropsychiatric association. J Neuropsychiatry Clin Neurosci. 2002;14(4):377–405.

Palmer

Di Iulio

Varsi

. Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer's disease: the role of depression and apathy. J Alzheimers Dis. 2010;20(1):175–183.

Angelelli

Paolucci

Bivona

. Development of neuropsychiatric symptoms in poststroke patients: a cross-sectional study. Acta Psychiatr Scand. 2004;110(1):55–63.

Cummings

. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997;48(5 suppl 6):S10–S16.

Black

Doody

. Donepezil preserves cognition and global function in patients with severe Alzheimer disease. Neurology. 2007;69(5):459–469.

Kaufer

Cummings

Ketchel

. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci. 2000;12(2):233–239.

Yang

Wong

Wang

. Risk factors for incident dementia after stroke and transient ischemic attack [published online March 3, 2014]. Alzheimers Dement. 2014.

10.

Hughes

Berg

Danziger

Coben

Martin

. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566–572.

11.

Chiu

HFK

Kee

Chung

Kwong

. Reliability and validity of the cantonese version of mini-mental state examination - a preliminary study. J Hong Kong College Psychiatry. 1994;4(S2):25–28.

12.

Leung

Lam

Chiu

Cummings

Chen

. Validation study of the Chinese version of the neuropsychiatric inventory (CNPI). Int J Geriatr Psychiatry. 2001;16(8):789–793.

13.

Bland

Altman

. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–310.

14.

Bland

Altman

. Cronbach's alpha. BMJ. 1997;314(7080):572.

15.

Cheng

S-T

Kwok

Lam

. Neuropsychiatric symptom clusters of Alzheimer's disease in Hong Kong Chinese: prevalence and confirmatory factor analysis of the Neuropsychiatric Inventory. Int Psychogeriatr. 2012;24(9):1465–1473.

16.

Mayer

Bay

Politis

. Comparison of three rating scales as outcome measures for treatment trials of depression in Alzheimer disease: findings from DIADS. Int J Geriatr Psychiatry. 2006;21(10):930–936.