The Neuropsychiatric Inventory (NPI) has been used for studies of neuropsychiatric symptoms in neurodegenerative disorders for the past 25 years. This article reviews the history of the development and application of the NPI.
Main Findings:
The NPI consists of 10 (or 12) items that are assayed with questions, subquestions, and ratings of frequency and severity. The NPI has been shown to be valid and reliable. The NPI has been translated into approximately 40 languages; it has 4 of versions designed for different clinical applications. The NPI studies show contrasting profiles of behavioral symptoms in different neurologic disorders. The NPI has been used in approximately 350 clinical trials. In economic studies, the NPI captures the cost of behavioral symptoms in dementias.
Principle Conclusions:
The NPI is a useful instrument for capturing behavioral changes in Alzheimer disease and other neurodegenerative disorders.
CummingsJLMegaMGrayKRosenberg-ThompsonSCarusiDAGornbeinJ. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308–2314.
2.
ReisbergB. Global measures: utility in defining and measuring treatment response in dementia. Int Psychogeriatr. 2007;19(3):421–456.
3.
JesteDVFinkelSI. Psychosis of Alzheimer’s disease and related dementias: diagnostic criteria for a distinct syndrome. Am J Geriat Psychiat. 2000;8(1):29–34.
4.
CummingsJL. The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology. 1997;48(5 suppl 6): S10–S16.
5.
De DeynPPWirshingWC. Scales to assess efficacy and safety of pharmacologic agents in the treatment of behavioral and psychological symptoms of dementia. J Clin Psychiatry. 2001;62 (suppl 21):19–22.
6.
StellaFForlenzaOVLaksJ, et al.The Brazilian version of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity in dementia. Int Psychogeriatr. 2013;25(9):1503–1511.
7.
KauferDICummingsJLChristineD, et al.Assessing the impact of neuropsychiatric symptoms in Alzheimer’s disease: the neuropsychiatric inventory caregiver distress scale. J Am Geriatr Soc. 1998;46(2):210–215.
8.
StreetJSClarkWSGannonKS, et al.Olanzapine treatment of psychotic and behavioral symptoms in patients with Alzheimer disease in nursing care facilities: a double-blind, randomized, placebo-controlled trial. The HGEU study group. Arch Gen Psychiatry. 2000;57(10):968–976.
9.
OkuraTPlassmanBLSteffensDCLlewellynDJPotterGGLangaKM. Neuropsychiatric symptoms and the risk of institutionalization and death: the aging, demographics, and memory study. J Am Geriatr Soc. 2011;59(3):473–481.
10.
KauferDICummingsJLKetchelP, et al.Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatry Clin Neurosci. 2000;12(2):233–239.
11.
WeinerMWVeitchDPAisenPS, et al.Alzheimer’s disease neuroimaging I. Recent publications from the Alzheimer’s Disease Neuroimaging Initiative: reviewing progress toward improved AD clinical trials. Alzheimers Dement. 2017;13(4): e1–e85.
12.
BeeklyDLRamosEMvan BelleG, et al.The National Alzheimer’s Coordinating Center (NACC) Database: an Alzheimer disease database. Alzheimer Dis Assoc Disord. 2004;18(4):270–277.
13.
BeeklyDLRamosEMLeeWW, et al.The National Alzheimer’s Coordinating Center (NACC) database: the uniform data set. Alzheimer Dis Assoc Disord. 2007;21(3):249–258.
14.
RoenISelbaekGKirkevoldOEngedalKTestadIBerghS. Resourse Use and Disease Couse in dementia–Nursing Home (REDIC-NH), a longitudinal cohort study; design and patient characteristics at admission to Norwegian nursing homes. BMC Health Serv Res. 2017;17(1):365.
15.
TunSMMurmanDLLongHLColendaCCvon EyeA. Predictive validity of neuropsychiatric subgroups on nursing home placement and survival in patients with Alzheimer disease. Am J Geriatr Psychiatry. 2007;15(4):314–327.
16.
WoodSCummingsJLHsuMA, et al.The use of the neuropsychiatric inventory in nursing home residents. Characterization and measurement. Am J Geriatr Psychiatry. 2000;8(1):75–83.
17.
WoodSCummingsJLSchnelleBStephensM. A videotape-based training method for improving the detection of depression in residents of long-term care facilities. Gerontologist. 2002;42(1):114–121.
18.
de MedeirosKRobertPGauthierS, et al.The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia. Int Psychogeriatr. 2010;22(6):984–994.
19.
TractenbergRESingerCMCummingsJLThalLJ. The sleep disorders inventory: an instrument for studies of sleep disturbance in persons with Alzheimer’s disease. J Sleep Res. 2003;12(4):331–337.
20.
WildDGroveAMartinM, et al.Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005;8(2):94–104.
21.
ChenSLinKWangHYamakawaMMakimotoKLiaoX. Reliability and structural validity of the Chinese version of the Neuropsychiatric Inventory, Nursing Home version. Psychogeriatrics. 2018;18(2):113–122.
22.
FuhJLLiuCKMegaMSWangSJCummingsJL. Behavioral disorders and caregivers’ reaction in Taiwanese patients with Alzheimer’s disease. Int Psychogeriatr. 2001;13(1):121–128.
23.
LeungVPLamLCChiuHFCummingsJLChenQL. Validation study of the Chinese version of the Neuropsychiatric Inventory (CNPI). Int J Geriatr Psychiatry. 2001;16(8):789–793.
24.
WangTXiaoSLiX, et al.Reliability and validity of the Chinese version of the Neuropsychiatric Inventory in mainland China. Int J Geriatr Psychiatry. 2012;27(5):539–544.
25.
MusaGHenriquezFMunoz-NeiraCDelgadoCLilloPSlachevskyA. Utility of the Neuropsychiatric Inventory Questionnaire (NPI-Q) in the assessment of a sample of patients with Alzheimer’s disease in Chile. Dement Neuropsychol. 2017;11(2):129–136.
26.
ChoiSHNaDLKwonHMYoonSJJeongJHHaCK. The Korean version of the Neuropsychiatric Inventory: a scoring tool for neuropsychiatric disturbance in dementia patients. J Korean Med Sci. 2000;15(6):609–615.
27.
KimHJChoiKHKimSHCummingsJLYangDW. Validation study of the Korean version of the brief clinical form of the Neuropsychiatric Inventory. Dement Geriatr Cogn Dis Extra. 2016;6(2):214–221.
28.
Sahin CankurtaranEDanismanMTutarHUlusoy KaymakS. The reliability and validity of the Turkish version of the Neuropsychiatric Inventory-clinician. Turk J Med Sci. 2015;45(5):1087–1093.
29.
CamozzatoALGodinhoCKochhannRMassochiniGChavesML. Validity of the Brazilian version of the Neuropsychiatric Inventory Questionnaire (NPI-Q). Arq Neuropsiquiatr. 2015;73(1):41–45.
30.
FerreiraARMartinsSRibeiroOFernandesL. Validity and reliability of the European Portuguese version of Neuropsychiatric Inventory in an institutionalized sample. J Clin Med Res. 2015;7(1):21–28.
31.
MalakoutiSKPanaghiLForoughanMSalehiMZandiT. Farsi version of the Neuropsychiatric Inventory: validity and reliability study among Iranian elderly with dementia. Int Psychogeriatr. 2012;24(2):223–230.
32.
DavidsdottirSRSnaedalJKarlsdottirGAtladottirIHannesdottirK. Validation of the Icelandic version of the Neuropsychiatric Inventory with caregiver distress (NPI-D). Nord J Psychiatry. 2012;66(1):26–32.
33.
HironoNMoriEIkejiriY, et al.Japanese version of the Neuropsychiatric Inventory--a scoring system for neuropsychiatric disturbance in dementia patients [in Japanese]. No To Shinkei. 1997;49(3):266–271.
34.
MatsumotoNIkedaMFukuharaR, et al.Validity and reliability of the Japanese version of the Neuropsychiatric Inventory Caregiver Distress Scale (NPI D) and the Neuropsychiatric Inventory Brief Questionnaire Form (NPI-Q) [in Japanese]. No To Shinkei. 2006;58(9):785–790.
35.
ShigenobuKHironoNTabushiK, Ikeda M. Validity and reliability of the Japanese version of the Neuropsychiatric Inventory-nursing home version (NPI-NH) [in Japanese]. Brain Nerve. 2008;60(12):1463–1469.
36.
SelbaekGKirkevoldOSommerOHEngedalK. The reliability and validity of the Norwegian version of the Neuropsychiatric Inventory, nursing home version (NPI-NH). Int Psychogeriatr. 2008;20(2):375–382.
37.
BidzanLBidzanM. Reliability of the neuropsychiatric inventory-nursing homes Polish version [in Polish]. Psychiatr Pol. 2005;39(6):1219–1229.
38.
PolitisAMMayerLSPassaMMaillisALyketsosCG. Validity and reliability of the newly translated Hellenic Neuropsychiatric Inventory (H-NPI) applied to Greek outpatients with Alzheimer’s disease: a study of disturbing behaviors among referrals to a memory clinic. Int J Geriatr Psychiatry. 2004;19(3):203–208.
39.
BaiyewuOSmith-GambleVAkinbiyiA, et al.Behavioral and caregiver reaction of dementia as measured by the neuropsychiatric inventory in Nigerian community residents. Int Psychogeriatr. 2003;15(4):399–409.
40.
KornerALauritzenLLolkAAbelskovKChristensenPNilssonFM. The Neuropsychiatric Inventory—NPI. Validation of the Danish version. Nord J Psychiatry. 2008;62(6):481–485.
41.
ZuidemaSUde JongheJFVerheyFRKoopmansRT. Neuropsychiatric symptoms in nursing home patients: factor structure invariance of the Dutch nursing home version of the Neuropsychiatric Inventory in different stages of dementia. Dement Geriatr Cogn Disord. 2007;24(3):169–176.
42.
FarinaEBaglioFCaffarraP, et al.Frequency and clinical features of Lewy body dementia in Italian memory clinics. Acta Biomed. 2009;80(1):57–64.
43.
BoadaMCejudoJCTarragaLLopezOLKauferD.Neuropsychiatric Inventory questionnaire (NPI-Q): Spanish validation of an abridged form of the Neuropsychiatric Inventory (NPI) [in Japanese]. Neurologia. 2002;17(6):317–323.
44.
Vilalta-FranchJLozano-GallegoMHernandez-FerrandizMLlinas-ReglaJLopez-PousaSLopezOL. The Neuropsychiatric Inventory. Psychometric properties of its adaptation into Spanish [in Spanish]. Rev Neurol. 1999;29(1):15–19.
45.
ChowTWLiuCKFuhJL, et al.Neuropsychiatric symptoms of Alzheimer’s disease differ in Chinese and American patients. Int J Geriatr Psychiatry. 2002;17(1):22–28.
46.
PangFCChowTWCummingsJL, et al.Effect of neuropsychiatric symptoms of Alzheimer’s disease on Chinese and American caregivers. Int J Geriatr Psychiatry. 2002;17(1):29–34.
47.
GrillJDRamanRErnstromK, et al.Comparing recruitment, retention, and safety reporting among geographic regions in multinational Alzheimer’s disease clinical trials. Alzheimers Res Ther. 2015;7(1):39.
48.
ZahodneLBOrnsteinKCosentinoSDevanandDPSternY. Longitudinal relationships between Alzheimer disease progression and psychosis, depressed mood, and agitation/aggression. Am J Geriatr Psychiatry. 2015;23(2):130–140.
49.
LaiCK. The merits and problems of Neuropsychiatric Inventory as an assessment tool in people with dementia and other neurological disorders. Clin Interv Aging. 2014;9:1051–1061.
50.
MegaMSCummingsJLFiorelloTGornbeinJ. The spectrum of behavioral changes in Alzheimer’s disease. Neurology. 1996;46(1):130–135.
51.
ZuidemaSUDerksenEVerheyFRKoopmansRT. Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. Int J Geriatr Psychiatry. 2007;22(7):632–638.
52.
SelbaekGEngedalK. Stability of the factor structure of the Neuropsychiatric Inventory in a 31-month follow-up study of a large sample of nursing-home patients with dementia. Int Psychogeriatr. 2012;24(1):62–73.
53.
TengELuPHCummingsJL. Neuropsychiatric symptoms are associated with progression from mild cognitive impairment to Alzheimer’s disease. Dement Geriatr Cogn Disord. 2007;24(4):253–259.
54.
RingmanJMLiangLJZhouY, et al.Early behavioural changes in familial Alzheimer’s disease in the dominantly inherited Alzheimer network. Brain. 2015;138(pt 4):1036–1045.
55.
LyketsosCGSteinbergMTschanzJTNortonMCSteffensDCBreitnerJC. Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry. 2000;157(5):708–714.
56.
Lima-SilvaTBBahiaVSCarvalhoVA, et al.Neuropsychiatric symptoms, caregiver burden and distress in behavioral-variant frontotemporal dementia and Alzheimer’s disease. Dement Geriatr Cogn Disord. 2015;40(5-6):268–275.
57.
LiuSJinYShiZ, et al.The effects of behavioral and psychological symptoms on caregiver burden in frontotemporal dementia, Lewy body dementia, and Alzheimer’s disease: clinical experience in China. Aging Ment Health. 2017;21(6):651–657.
58.
SheaYFHaJChuLW. Comparisons of clinical symptoms in biomarker-confirmed Alzheimer’s disease, dementia with Lewy bodies, and frontotemporal dementia patients in a local memory clinic. Psychogeriatrics. 2015;15(4):235–241.
59.
FingerEZhangJDickersonBBureauYMasellisM; Alzheimer’s Disease Neuroimaging Initiative. Disinhibition in Alzheimer’s disease is associated with reduced right frontal pole cortical thickness. J Alzheimers Dis. 2017;60(3):1161–1170.
60.
LegerGCBanksSJ. Neuropsychiatric symptom profile differs based on pathology in patients with clinically diagnosed behavioral variant frontotemporal dementia. Dement Geriatr Cogn Disord. 2014;37(1-2):104–112.
61.
LitvanIMegaMSCummingsJLFairbanksL. Neuropsychiatric aspects of progressive supranuclear palsy. Neurology. 1996;47(5):1184–1189.
62.
YatabeYHashimotoMKanedaK, et al.Neuropsychiatric symptoms of progressive supranuclear palsy in a dementia clinic. Psychogeriatrics. 2011;11(1):54–59.
63.
Jecmenica-LukicMPekmezovicTPetrovicINTomicASvetelMKosticVS. Use of the neuropsychiatric inventory to characterize the course of neuropsychiatric symptoms in progressive supranuclear palsy. J Neuropsychiatry Clin Neurosci. 2018;30(1):38–44.
64.
LitvanICummingsJLMegaM. Neuropsychiatric features of corticobasal degeneration. J Neurol Neurosurg Psychiatry. 1998;65(5):717–721.
65.
KazuiHYoshiyamaKKanemotoH, et al.Differences of behavioral and psychological symptoms of dementia in disease severity in four major dementias. PLoS One. 2016;11(8): e0161092.
66.
AarslandDBronnickKEhrtU, et al.Neuropsychiatric symptoms in patients with Parkinson’s disease and dementia: frequency, profile and associated care giver stress. J Neurol Neurosurg Psychiatry. 2007;78(1):36–42.
67.
AarslandDMarshLSchragA. Neuropsychiatric symptoms in Parkinson’s disease. Mov Disord. 2009;24(15):2175–2186.
68.
AarslandDLarsenJPLimNG, et al.Range of neuropsychiatric disturbances in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1999;67(4):492–496.
CiurliPFormisanoRBivonaUCantagalloAAngelelliP. Neuropsychiatric disorders in persons with severe traumatic brain injury: prevalence, phenomenology, and relationship with demographic, clinical, and functional features. J Head Trauma Rehabil. 2011;26(2):116–126.
71.
JungNYKimHJKimYJ, et al.Neuropsychiatric characteristics of PiB-negative subcortical vascular dementia versus behavioral variant frontotemporal dementia. Arch Gerontol Geriatr. 2016;67:86–91.
72.
SantosMAOBezerraLSCorreiaCDCBrusckyIS. Neuropsychiatric symptoms in vascular dementia: epidemiologic and clinical aspects. Dement Neuropsychol. 2018;12(1):40–44.
73.
JinYLZhangHGaoYZ, et al.Neuropsychiatric symptoms in patients with vascular dementia in mainland China. Transl Neurosci. 2015;6(1):157–161.
74.
ChinJSeoSWKimSH, et al.Neurobehavioral dysfunction in patients with subcortical vascular mild cognitive impairment and subcortical vascular dementia. Clin Neuropsychol. 2012;26(2):224–238.
75.
HsiehCJChangCCLinCC. Neuropsychiatric profiles of patients with Alzheimer’s disease and vascular dementia in Taiwan. Int J Geriatr Psychiatry. 2009;24(6):570–577.
76.
KrishnamoorthyESTrimbleMR. Prevalence, patterns, service needs, and assessment of neuropsychiatric disorders among people with epilepsy in residential care: validation of the Neuropsychiatric Inventory as a caregiver-rated measure of neuropsychiatric functioning in epilepsy. Epilepsy Behav. 2008;13(1):223–228.
77.
KulisevskyJLitvanIBerthierMLPascual-SedanoBPaulsenJSCummingsJL. Neuropsychiatric assessment of Gilles de la Tourette patients: comparative study with other hyperkinetic and hypokinetic movement disorders. Mov Disord. 2001;16(6):1098–1104.
78.
HolttaELaakkonenMLLaurilaJV, et al.The overlap of delirium with neuropsychiatric symptoms among patients with dementia. Am J Geriatr Psychiatry. 2011;19(12):1034–1041.
79.
LevyMLCummingsJLFairbanksLA, et al.Apathy is not depression. J Neuropsychiatry Clin Neurosci. 1998;10(3):314–319.
80.
KumforFZhenAHodgesJRPiguetOIrishM. Apathy in Alzheimer’s disease and frontotemporal dementia: distinct clinical profiles and neural correlates. Cortex. 2018;103:350–359.
81.
RosenbergPBLanctotKLDryeLT, et al.Safety and efficacy of methylphenidate for apathy in Alzheimer’s disease: a randomized, placebo-controlled trial. J Clin Psychiatry. 2013;74(8):810–816.
82.
ApostolovaLGAkopyanGGPartialiN, et al.Structural correlates of apathy in Alzheimer’s disease. Dement Geriatr Cogn Disord. 2007;24(2):91–97.
83.
CraigAHCummingsJLFairbanksL, et al.Cerebral blood flow correlates of apathy in Alzheimer disease. Arch Neurol. 1996;53(11):1116–1120.
84.
JeongHKangIImJJ, et al.Brain perfusion correlates of apathy in Alzheimer’s disease. Dement Neurocogn Disord. 2018;17(2):50–56.
85.
BallariniTIaccarinoLMagnaniG, et al.Neuropsychiatric subsyndromes and brain metabolic network dysfunctions in early onset Alzheimer’s disease. Hum Brain Mapp. 2016;37(12):4234–4247.
86.
TekinSMegaMSMastermanDM, et al.Orbitofrontal and anterior cingulate cortex neurofibrillary tangle burden is associated with agitation in Alzheimer disease. Ann Neurol. 2001;49(3):355–361.
87.
RosenHJAllisonSCSchauerGFGorno-TempiniMLWeinerMWMillerBL. Neuroanatomical correlates of behavioural disorders in dementia. Brain. 2005;128(Pt 11):2612–2625.
88.
WeissbergerGHMelroseRJNarvaezTAHarwoodDMandelkernMASultzerDL.(18)F-fluorodeoxyglucose positron emission tomography cortical metabolic activity associated with distinct agitation behaviors in Alzheimer disease. Am J Geriatr Psychiatry. 2017;25(6):569–579.
89.
IaccarinoLSalaACaminitiSPSantangeloRIannacconeSMagnaniGPeraniD. The brain metabolic signature of visual hallucinations in dementia with Lewy bodies. Cortex. 2018;108:13–24.
90.
BensamounDGuignardRFurstAJ, et al.Associations between neuropsychiatric symptoms and cerebral amyloid deposition in cognitively impaired elderly people. J Alzheimers Dis. 2016;49(2):387–398.
91.
MoriTShimadaHShinotohH, et al.Apathy correlates with prefrontal amyloid beta deposition in Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2014;85(4):449–455.
92.
BabulalGMGhoshalNHeadD, et al.Mood changes in cognitively normal older adults are linked to Alzheimer disease biomarker levels. Am J Geriatr Psychiatry. 2016;24(11):1095–1104.
93.
GonzalesMMInselPSNelsonC, et al.Chronic depressive symptomatology and CSF amyloid beta and tau levels in mild cognitive impairment. Int J Geriatr Psychiatry. 2018;33(10):1305–1311.
94.
BlonieckiVAarslandDCummingsJBlennowKFreund-LeviY. Agitation in dementia: relation to core cerebrospinal fluid biomarker levels. Dement Geriatr Cogn Dis Extra. 2014;4(2):335–343.
95.
KauferDICummingsJLChristineD. Effect of tacrine on behavioral symptoms in Alzheimer’s disease: an open-label study. J Geriatr Psychiatry Neurol. 1996;9(1):1–6.
96.
MegaMSDinovIDLeeL, et al.Orbital and dorsolateral frontal perfusion defect associated with behavioral response to cholinesterase inhibitor therapy in Alzheimer’s disease. J Neuropsychiatry Clin Neurosci. 2000;12(2):209–218.
97.
CummingsJLSchneiderLTariotPNKershawPRYuanW. Reduction of behavioral disturbances and caregiver distress by galantamine in patients with Alzheimer’s disease. Am J Psychiatry. 2004;161(3):532–538.
98.
GauthierSLoftHCummingsJ. Improvement in behavioural symptoms in patients with moderate to severe Alzheimer’s disease by memantine: a pooled data analysis. Int J Geriatr Psychiatry. 2008;23(5):537–545.
99.
CummingsJLSchneiderETariotPNGrahamSM; Memantine MEM-MD-02 Study Group. Behavioral effects of memantine in Alzheimer disease patients receiving donepezil treatment. Neurology. 2006;67(1):57–63.
100.
EganMFKostJTariotPN, et al.Randomized trial of verubecestat for mild-to-moderate Alzheimer’s disease. N Engl J Med. 2018;378(18):1691–1703.
101.
De DeynPJesteDVSwaninkR, et al.Aripiprazole for the treatment of psychosis in patients with Alzheimer’s disease: a randomized, placebo-controlled study. J Clin Psychopharmacol. 2005;25(5):463–467.
102.
CummingsJLyketsosCTariotP, et al.Dextromethorphan/quinidine (AVP-923) efficacy and safety for treatment of agitation in persons with Alzheimer’s disease: results from a phase 2 study (NCT01584440) (S16.007). Neurology. 2015;84(14 suppl):S16.007.
103.
CummingsJIsaacsonSMillsR, et al.Pimavanserin for patients with Parkinson’s disease psychosis: a randomised, placebo-controlled phase 3 trial. Lancet. 2014;383(9916):533–540.
104.
PorsteinssonAPDryeLTPollockBG, et al.Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA. 2014;311(7):682–691.
105.
CummingsJLLyketsosCGPeskindER, et al.Effect of dextromethorphan-quinidine on agitation in patients with Alzheimer disease dementia: a randomized clinical trial. JAMA. 2015;314(12):1242–1254.
106.
SchererRWDryeLMintzerJ, et al.The Apathy in Dementia Methylphenidate Trial 2 (ADMET 2): study protocol for a randomized controlled trial. Trials. 2018;19(1):46.
107.
LichtwarckBSelbaekGKirkevoldO, et al.Targeted interdisciplinary model for evaluation and treatment of neuropsychiatric symptoms: a cluster randomized controlled trial. Am J Geriatr Psychiatry. 2018;26(1):25–38.
108.
ReubenDBTanZSRomeroTWengerNSKeelerEJenningsLA. Patient and caregiver benefit from a comprehensive dementia care program: 1-year results from the UCLA Alzheimer’s and Dementia Care Program. J Am Geriatr Soc. 2019.
109.
TangSHChioOIChangLH, et al.Caregiver active participation in psychoeducational intervention improved caregiving skills and competency. Geriatr Gerontol Int. 2018;18(5):750–757.
110.
RattingerGBSandersCLVernonE, et al.Neuropsychiatric symptoms in patients with dementia and the longitudinal costs of informal care in the cache county population. Alzheimers Dement (N Y). 2019;5:81–88.
111.
MurmanDLChenQPowellMCKuoSBBradleyCJColendaCC. The incremental direct costs associated with behavioral symptoms in AD. Neurology. 2002;59(11):1721–1729.
112.
MorrisSPatelNBaioGKellyLLewis-HolmesEOmarRZKatonaCCooperCLivingstonG. Monetary costs of agitation in older adults with Alzheimer’s disease in the UK: prospective cohort study. BMJ Open. 2015;5(3): e007382.
113.
D’AmicoFRehillAKnappM, et al.Cost-effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM-E randomised controlled trial. Int J Geriatr Psychiatry. 2016;31(6):656–665.
114.
CummingsJMintzerJBrodatyH, et al.Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition. Int Psychogeriatr. 2015;27(1):7–17.
