The merits and problems of Neuropsychiatric Inventory as an assessment tool in people with dementia and other neurological disorders

Lai, Claudia Kam Yuk

doi:10.2147/cia.s63504

Cited by 111 publications

(84 citation statements)

References 52 publications

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“…Chapman and colleagues (2004) examined the effects of cognitive communication stimulation for people with dementia. This study, however, measured carers' distress by using the Neuropsychiatric Inventory (Cummings et al, 1994), which is not a validated measure for carer distress (Lai, 2014). The study by Spector et al (2001) described the development and implementation of group CS therapy for people with dementia.…”

Section: Discussionmentioning

confidence: 99%

The effects on carer well‐being of carer involvement in cognition‐based interventions for people with dementia: a systematic review and meta‐analysis

Leung

Orgeta

Orrell

2017

Int J Geriat Psychiatry

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Objectives: To investigate the effects on carer well-being of carer involvement in cognition-based interventions (CBIs) for people with dementia. Methods:A review and meta-analysis were performed. We searched electronic databases for randomised controlled trials (RCTs). Two reviewers worked independently to select trials, extract data and assess the risk of bias.Results: A total of 4737 studies were identified. Eight randomised controlled trials (RCTs) met the inclusion criteria. Only seven studies with 803 dyads of people with dementia and carers were included in the meta-analysis. Evidence indicated that carer involvement in CBIs for people with dementia had a beneficial effect on carers' QoL with effect size Hedges' g=0.22; 95% CI of 0.02 to 0.42, z=2.19 and p=0.03. Carers' depression levels were reduced in the intervention group with effect size Hedges' g=0.17; 95% CI of 0.02 to 0.32, z=2.19 and p=0.03. No significant differences were observed in levels of anxiety symptoms, caregiving relationship and carer burden in the intervention group compared to the control group. Conclusions:Since CBIs are designed to deliver benefit for people with dementia, the collateral benefits for carers have potential implications for the importance of CBIs in service delivery and may contribute to cost effectiveness. However, there remains a Page 2 of 33 lack of quality of research in this area. Particularly, in some outcomes, there was a lack of consistency of results, so the findings should be interpreted with caution.Future studies of the impact of CBIs on carers with larger samples and high-quality RCTs are warranted.

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Section: Discussionmentioning

confidence: 99%

The effects on carer well‐being of carer involvement in cognition‐based interventions for people with dementia: a systematic review and meta‐analysis

Leung

Orgeta

Orrell

2017

Int J Geriat Psychiatry

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“…390 This holds for npiq where the test set mean is poorly estimated (∆ cv < 0). This can be explained by the fact that this score does not yield a very sensitive characterization of dementia, nor does it differentiate between clinical groups (Lai, 2014). Also, the clinical dementia rate (CDR) has only 5 possible values, 395 which makes regression approaches less accurate.…”

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confidence: 99%

Joint prediction of multiple scores captures better individual traits from brain images

et al. 2017

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To probe individual variations in brain organization, population imaging relates features of brain images to rich descriptions of the subjects such as genetic information or behavioral and clinical assessments. Capturing common trends across these measurements is important: they jointly characterize the disease status of patient groups. In particular, mapping imaging features to behavioral scores with predictive models opens the way toward more precise diagnosis. Here we propose to jointly predict all the dimensions (behavioral scores) that make up the individual profiles, using so-called multi-output models. This approach often boosts prediction accuracy by capturing latent shared information across scores. We demonstrate the efficiency of multi-output models on two independent resting-state fMRI datasets targeting different brain disorders (Alzheimer's Disease and schizophrenia). Furthermore, the model with joint prediction generalizes much better to a new cohort: a model learned on one study is more accurately transferred to an independent one. Finally, we show how multi-output models can easily be extended to multi-modal settings, combining heterogeneous data sources for a better overall accuracy.

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“…As mentioned previously, the existing reviews [8,13,22,11,23] focused only on the reported psychometric properties of the NPI, and have not addressed whether these data are sufficient in light of general psychometric recommendations. To address this gap, we used a comprehensive framework for the evaluation of psychometric properties in development and validation studies of the NPI.…”

Section: Review Proceduresmentioning

confidence: 99%

“…The NPI is a flexible and a relatively brief informant questionnaire that screens for the most common NPS in AD and other memory disorders. It has been utilized both clinically and in research, with applications in clinical trials, neuroimaging, descriptive psychopathology, and as a validity benchmark for the development of subsequent NPS scales [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…While important, these qualities are only a subset of those usually desired in scale validation [20,21]. Previous reviews of the NPI [8,11,13,22,23] have summarized these data at face value and solidified the notion that the psychometric data are sufficient and indicative of good reliability and validity. However, drawing inferences based on just the reported metrics may have led to biased conclusions at least for two reasons: the conditions for stricter psychometric analyses have not been met, or that the good properties have come at the expense of unexamined properties through overoptimization [21].…”

Section: Introductionmentioning

confidence: 99%

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Psychometric properties of the Neuropsychiatric Inventory: a review

Saari¹,

Koivisto²,

Hintsa³

et al. 2019

Preprint

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Neuropsychiatric symptoms (NPSs) cause a significant burden to individuals with memory disorders and their families. Insights into the clinical associations, neurobiology, and treatment of NPSs are largely dependent on informant questionnaires, such as the commonly used Neuropsychiatric Inventory (NPI). Like any scale, the utility of the NPI relies on its psychometric properties, but unlike many scales, the NPI faces unique challenges related to its skip-question and scoring formats.We examined and reviewed the psychometric properties of the NPI in a framework including psychometric properties pertinent for construct validation, and health-related outcome measurement in general. We found that aspects such as test-retest and inter-rater reliability are major strengths of the NPI in addition to its flexible and relatively quick administration. These properties are desired in clinical trials. However, it seems that the reported properties cover only some of the generally examined psychometric properties, representing perhaps necessary but not sufficient reliability and validity evidence for the NPI. There appear to be significant gaps in psychometric data, at least partially owing to small sample sizes in the studies that preclude more comprehensive analyses. Regarding construct validity, only one study examined structural validity with the NPI subquestions. Measurement error was not assessed in the reviewed studies. For future validation, we recommend using data from all subquestions, collecting larger samples, paying specific attention to construct validity and formulating hypotheses a priori. As the NPI is an outcome measure of interest in clinical trials, examining measurement error could be of practical importance.

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The merits and problems of Neuropsychiatric Inventory as an assessment tool in people with dementia and other neurological disorders

Cited by 111 publications

References 52 publications

The effects on carer well‐being of carer involvement in cognition‐based interventions for people with dementia: a systematic review and meta‐analysis

The effects on carer well‐being of carer involvement in cognition‐based interventions for people with dementia: a systematic review and meta‐analysis

Joint prediction of multiple scores captures better individual traits from brain images

Psychometric properties of the Neuropsychiatric Inventory: a review

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