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Assessment of Cognitive, Psychiatric, and Behavioral Disturbances in Patients with Dementia: The Neurobehavioral Rating Scale
Author(s) -
Sultzer David L.,
Levin Harvey S.,
Mahler Michael E.,
High Walter M.,
Cummings Jeffrey L.
Publication year - 1992
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1992.tb02101.x
Subject(s) - dementia , psychiatry , medicine , brief psychiatric rating scale , mood , rating scale , apathy , clinical psychology , cognition , disinhibition , anxiety , hostility , psychosis , disease , psychology , developmental psychology , pathology
Objective To assess the validity of the Neurobehavioral Rating Scale (NRS) in patients with Alzheimer's disease (AD) or multi‐infarct dementia (MID) and to characterize the cognitive, psychiatric, and behavioral disturbances that occur in these patients. Design Cross‐sectional evaluation. Setting West Los Angeles VAMC Geropsychiatry Inpatient Unit, Neurobehavior Inpatient Unit, and Dementia Clinic; UCLA Alzheimer's Disease Clinic. Patients Convenience sample of 61 patients with AD and 22 patients with MID. Main Outcome Measure The NRS, a 27‐item observer‐rated instrument that measures cognitive, psychiatric, and behavioral disturbances. Results The NRS demonstrated content and convergent validity in this patient group. Principal components analysis of the NRS ratings identified a six‐factor solution, and each factor contained clinically related symptoms. The factors were Cognition/Insight, Agitation/Disinhibition, Behavioral Retardation, Anxiety/Depression, Verbal Output Disturbance, and Psychosis. Among the patients with AD, agitation, disinhibition, hostility, poor insight, poor motivation, suspiciousness, and delusions were more severe in patients with more advanced dementia. Depressive symptoms occurred with equal severity in patients with mild and advanced dementia, but depressed mood was more severe in patients with earlier age of onset of AD. Conclusion The NRS is a useful instrument for structured assessment of a broad range of cognitive, psychiatric, and behavioral disturbances in patients with dementia.