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Addition of a frequency-weighted score to the Behavioral Pathology in Alzheimer’s Disease Rating Scale: the BEHAVE-AD-FW: methodology and reliability

Published online by Cambridge University Press:  16 April 2020

I.M. Monteiro ,
I. Boksay ,
S.R. Auer ,
C. Torossian ,
S.H. Ferris  and
B. Reisberg
I.M. Monteiro*
Affiliation:
Aging and Dementia Research Center, New York University School of Medicine, 550 First Avenue, New York, NY10016, USA
I. Boksay
Affiliation:
Aging and Dementia Research Center, New York University School of Medicine, 550 First Avenue, New York, NY10016, USA
S.R. Auer
Affiliation:
Aging and Dementia Research Center, New York University School of Medicine, 550 First Avenue, New York, NY10016, USA
C. Torossian
Affiliation:
Aging and Dementia Research Center, New York University School of Medicine, 550 First Avenue, New York, NY10016, USA
S.H. Ferris
Affiliation:
Aging and Dementia Research Center, New York University School of Medicine, 550 First Avenue, New York, NY10016, USA
B. Reisberg
Affiliation:
Aging and Dementia Research Center, New York University School of Medicine, 550 First Avenue, New York, NY10016, USA
*
*Correspondence and reprints. E-mail address: isabel.monteiro@med.nyu.edu (I.M. Monteiro).
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Summary

The Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD) is a well-established instrument, designed to assess potentially remediable behavioral symptoms in Alzheimer’s disease (AD) patients as well as to evaluate treatment outcome. It consists of 25 symptoms grouped into seven categories. Each symptom is scored on the basis of severity on a four-point scale. A knowledgeable caregiver is queried and items are scored on the basis of symptoms noted in the preceding two weeks. Reliability, construct validity and criterion validity data for the BEHAVE-AD have previously been published. Because of the significance of psychopathology in dementia, it is necessary to optimally describe and define the nature, magnitude and prevalence of behavioral symptomalogy. Accordingly, a frequency component was added to each of the 25 items of the BEHAVE-AD scale. The objective of the present report is to describe this new Behavioral Pathology in Alzheimer’s Disease Frequency-Weighted Severity Scale (BEHAVE-AD-FW) and to establish its inter-rater reliability. In this investigation the BEHAVE-AD-FW scale was administered to caregivers of 28 patients with either mildly impaired cognitive function or a dementia diagnosis. Two clinicians separately and independently rated the responses. Analyses determined that the intraclass correlation coefficients (ICCs) for the frequency component varied between 0.86 and 0.97 for each of the seven BEHAVE-AD categories (ps < 0.001). ICCs for the frequency-weighted scores (item severity score x item frequency score) ranged from 0.69 to 0.98 for the seven symptom categories (ps < 0.001). For the BEHAVE-AD-FW total scores, the ICC was 0.91 (P < 0.001). These results indicate that the frequency-weighted component is a reliable addition to the BEHAVE-AD scale.

Keywords

Alzheimer’s diseaseassessmentbehavioral scalesbehavioral symptomsdementiarating scales
Type
Original article
Information
European Psychiatry , Volume 16 , Issue S1 , 2001 , pp. 5s - 24S
Copyright
Copyright © 2001 Éditions scientifiques et médicales Elsevier SAS. All rights reserved

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References

Alzheimer, A. About a peculiar disease of the cerebral cortex (Über eine eigenartige erkrankung der hirnrinde. Allgemeine Z Psychiatrie Psychisch-Gerichtliche Med 1907; 64: 146–8), translated by L. Jarvik and H. Greenson. Alzheimer Dis Assoc Disord 1987; 1: 7–8.Google Scholar
Auer, SR, Monteiro, IM, Reisberg, B.The empirical behavioral pathology in Alzheimer’s disease (E-BEHAVE-AD) rating scale. Int Psychogeriatr 1996; 8: 247–66.CrossRefGoogle ScholarPubMed
Blessed, G, Tomlinson, BE, Roth, M.The association between quantitative measures of dementia and senile change in the cerebral gray matter of elderly subjects. Br J Psychiatry 1968; 114: 797–811.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J, Marx, MS, Rosenthal, AS.A description of agitation in a nursing home. J Gerontol 1989; 44: M77–M84.CrossRefGoogle ScholarPubMed
Cummings, JL.Theories behind existing scales for rating behavior in dementia. Int Psychogeriatr 1996; 8 Suppl 3: 293–300.CrossRefGoogle ScholarPubMed
Cummings, JL, Mega, M, Gray, K, Rosenberg-Thompson, S, Carusi, DA, Gornbein, J.The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.CrossRefGoogle ScholarPubMed
Devanand, DP, Miller, L, Richards, M, Marder, K, Bell, K.The Columbia University scale for psychopathology in Alzheimer’s disease. Arch Neurol 1992; 49: 371–6.CrossRefGoogle ScholarPubMed
Esquirol, J.E.D.Des maladies mentales. Paris: Balliere; 1838.Google Scholar
Finkel, SI.Behavioral and psychological signs and symptoms of dementia: implications for research and treatment. Int Psychogeriatr 1996; 8 Suppl 3: 552Google ScholarPubMed
Finkel, SI, Burns, A.Behavioral and psychological symptoms of dementia (BPSD): a clinical and research update. Int Psychogeriatr 2000; 12 Suppl 1: 424CrossRefGoogle Scholar
Finkel, SI, Costa e Silva, JC, Cohen, GD, Miller, S, Sartorius, N.Behavioral and psychological symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Am J Geriatr Psychiatry 1998; 6: 97–100.Google Scholar
Katz, IR, Jeste, DV, Mintzer, JE, Clyde, C, Napolitano, J, Brecher, M.Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial. J Clin Psychiatry 1999; 60: 107–15.CrossRefGoogle ScholarPubMed
Knopman, DS, Kitto, J, Deinard, S, Heiring, J.Longitudinal study of death and institutionalization in patients with primary degenerative dementia. J Am Geriatr Soc 1998; 36: 108–12.CrossRefGoogle Scholar
Levy, MA, Burgio, LD, Sweet, R, Bonino, P, Janosky, J, Perel, J.A trial of buspirone for the control of disruptive behaviors in community-dwelling patients with dementia. Int J Geriatr Psychiatry 1994; 9: 841–8.CrossRefGoogle Scholar
Lyketsos, CG, Steinberg, M, Tschanz, JAT, Norton, MC, Steffens, DC, Breitner, JCS.Mental and behavioral disturbances in dementia: findings from the Cache county study on memory in aging. Am J Psychiatry 2000; 157: 708–14.CrossRefGoogle Scholar
McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM.Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health & Human Services Task Force on Alzheimer’s disease. Neurology 1984; 34: 939–44.CrossRefGoogle ScholarPubMed
Monteiro, IM, Boksay, I, Auer, SR, Torossian, C, Sinaiko, E, Reisberg, B.The reliability of routine clinical instruments for the assessment of Alzheimer’s disease administered by telephone. J Geriatr Psychiatry Neurol 1998; 11: 18–24.CrossRefGoogle Scholar
Patel, V, Hope, RA.A rating scale for aggressive behavior in the elderly: the RAGE. Psychol M 1992; 22: 211–21.CrossRefGoogle ScholarPubMed
Patterson, MB, Schnell, AH, Martin, RJ, Mendez, MF, Smyth, KA, Whitehouse, PJ.Assessment of behavioral and affective symptoms in Alzheimer’s disease. J Geriatr Psychiatry Neurol 1990; 3: 21–30.CrossRefGoogle ScholarPubMed
Reisberg, B, Borenstein, J, Franssen, EH, Shulman, E, Steinberg, G, Ferris, SH.Remediable behavioral symptomatology in Alzheimer’s disease. Hosp Commun Psychiatry 1986; 37: 1199–1201.Google ScholarPubMed
Reisberg, B, Borenstein, J, Salob, SP, Ferris, SH, Franssen, EH, Georgotas, A.Behavioral symptoms in Alzheimer’s disease: phenomenology and treatment. J Clin Psychiatry 1987; 48 Suppl: 9–15.Google ScholarPubMed
Reisberg, B, Ferris, SH, de Leon, MJ, Crook, T.The global deterioration scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139: 1136–9.Google ScholarPubMed
Reisberg, B, Ferris, SH, Torossian, CL, Kluger, A, Monteiro, I.Pharmacologic treatment of Alzheimer’s disease: a methodologic critique based upon current knowledge of symptomatology and relevance for drug trials. Int Psychogeriatr 1992; 4 Suppl 1: 9–42.CrossRefGoogle ScholarPubMed
Reisberg, B, Franssen, EH, Sclan, SG, Kluger, A, Ferris, SH.Stage specific incidence of potentially remediable behavioral symptoms in aging and Alzheimer’s disease: a study of 120 patients using the BEHAVE-AD. Bull Clin Neurosci 1989; 54: 95–112.Google Scholar
Rosen, J, Burgio, LD, Kollar, M, Cain, M, Allison, M, Fogleman, M. et al. The Pittsburgh agitation scale: a user-friendly instrument for rating agitation in dementia patients. Am J Geriatr Psychiatry 1994; 2: 52–9.CrossRefGoogle ScholarPubMed
Sclan, SG, Saillon, A, Franssen, EH, Hugonot-Diener, L, Reisberg, B.The Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD): reliability and analysis of symptom category scores. Int J Geriatr Psychiatry 1996; 11: 819–30.3.0.CO;2-S>CrossRefGoogle Scholar
Shader, RI, Harmatz, JS, Salzman, C.A new scale for clinical assessment in geriatric populations: Sandoz Clinical Assessment-Geriatric (SCAG). J Am Geriatr Soc 1974; 22: 107–13.CrossRefGoogle Scholar
Shrout, EP, Fleiss, JL.Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979; 86: 420–8.CrossRefGoogle ScholarPubMed
Sinha, D, Zemlan, FP, Nelson, S, Bienenfeld, D, Thienhaus, O, Ramaswamy, G. et al. A new scale for assessing behavioral agitation in dementia. Psychiatry Res 1992; 41: 73–88.CrossRefGoogle ScholarPubMed
Steele, C, Rovner, B, Chase, GA, Folstein, M.Psychiatric symptoms and nursing home placement with patients with Alzheimer’s disease. Am J Psychiatry 1990; 147: 1049–51.Google ScholarPubMed
Tariot, PN, Mack, JL, Patterson, MB, Edland, SD, Weiner, MF, Fillenbaum, G. et al. The behavior rating scale for dementia of the consortium to establish a registry for Alzheimer's disease. Am J Psychiatry 1995; 152: 1349–57.Google ScholarPubMed
Teri, L, Rabins, P, Whitehouse, P, Berg, L, Reisberg, B, Sunderland, T. et al. Management of behavior disturbance in Alzheimer’s disease: current knowledge and future directions. Alzheimer Dis Assoc Disord 1992; 6: 77–88.CrossRefGoogle ScholarPubMed
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