Dimensions of Agitation Based on the Cohen-Mansfield Agitation Inventory in Patients with Dementia

Abstract

The aim of this study was to investigate the dimensions of agitation in dementia patients using the Turkish version of the Cohen-Mansfield Agitation Inventory (CMAI-T). Materials and Method: The study included 100 patients diagnosed as dementia, according to the DSM-IV-TR. The CMAI-T was administered to the patients' caregivers via face-to-face interviews. The Standardized Mini Mental State Examination (SMMSE) was used to assess cognitive functions. The severity of depression and the functional state of the patients were assessed using the Cornell Scale for Depression in Dementia (CSDD) and the Functional Activities Questionnaire (FAQ). Principal component analysis and varimax rotation were used to determine the factor structure of the CMAI-T. Results: Factor analysis of the CMAI-T indicated a 3-factor structure: physically aggressive agitation, verbal agitation, and physically non-aggressive agitation. In 92% of the patients there was ≥1 agitation behavior during the previous 2 weeks. The CMAI-T total and factor scores were negatively correlated with the SMMSE scores, and positively correlated with the CSDD and the FAQ scores. Conclusions: The CMAI-T yielded 3 factors (physically aggressive agitation, verbal agitation, and physically non-aggressive agitation), which indicated the scale had construct validity. Agitation behaviors were associated with cognitive dysfunction, symptoms of depression and general level of functioning. Additional research is necessary to identify the predictors of these dimensions in different dementia samples, and to determine the efficacy of therapeutic interventions.

Specific agitation behaviours in dementia differentially contribute to aspects of caregiver burden

“…Exploratory factor analysis results initially supported a seven-factor structure that explained 62% of the variance with eigen values >1. However, based on scree plot results, requiring minimum factor loadings of 0.4, and requiring that the number of items in each factor be greater than or equal to three as suggested by prior work, 31,36,37 the number of extracted factors was limited to three. Results supported three robust factors accounting for 52.45% of the total variance and aligned with prior work, finding factors of 'Physically Aggressive', 'Physically Non-Aggressive', and 'Verbally Agitated' behaviours.…”

Psychometric evaluation of the Cohen‐Mansfield Agitation Inventory in an acute general hospital setting

“…We have developed the original version of the CMAI by expanding its transferability from a nursing home population to a sample admitted to acute general hospitals. Our study builds on work describing the usefulness of the tool in those attending out‐patient clinics (Altunöz et al, ). Those people with dementia who present with acute illnesses, are sicker and require admission may experience different levels of distress, pain and agitation.…”

“…Later studies produced a four-factor structure separating the nonaggressive agitated behaviours to reflect physical and verbal behaviour (Cohen-Mansfield, 1991;Rabinowitz et al, 2005). The CMAI has been validated previously using data collected within nursing homes (Cohen-Mansfield, 1986), outpatient clinics in general hospitals (Altunöz et al, 2015) and day centres (Cohen-Mansfield et al, 1995). However, as older ageing adults with cognitive impairment are commonly admitted to acute general hospitals and interest in research in this area is increasing, it is important to determine if these factor structures are applicable for people assessed during inpatient acute hospital stays.…”

Effect of acupressure on agitation in the elderly with dementia who receive institutional care: A pilot study

“…It was reported that the prevalence of agitation was between 21% and 63% among those living in nurseries 6‐9 . However, in patients with dementia, its prevalence ranges between 12% and 99% 10‐14 …”

“…[6][7][8][9] However, in patients with dementia, its prevalence ranges between 12% and 99%. [10][11][12][13][14] Furthermore, it was stated that agitation was a significant determinant factor in the institutionalization of dementia patients in nurseries. 15 The higher the prevalence of agitation, the heavier the burden of the caregiver becomes for the elderly receiving institutional care, and more employees are needed.…”