Biweekly fluctuations of neuropsychiatric symptoms according to the Neuropsychiatric Inventory: Erratic symptoms or scores?. (15th June 2022)

• Record Type: Journal Article
• Authors: Eikelboom, Willem S.; den Teuling, Amy; Pol, Daphne E.; Coesmans, Michiel; Franzen, Sanne; Jiskoot, Lize C.; van Hemmen, Judy; Singleton, Ellen H.; Ossenkoppele, Rik; de Jong, Frank Jan; van den Berg, Esther; Papma, Janne M.
• Is Part Of: International journal of geriatric psychiatry. Volume 37:Number 7(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-06-15
• Subjects: Alzheimer's disease -- behavioral and psychological symptoms of dementia (BPSD) -- behavioral symptoms -- dementia -- Neuropsychiatric Inventory -- neuropsychiatric symptoms; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5770
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract: Objectives: This study investigates the stability of neuropsychiatric symptoms (NPS) assessed biweekly using the Neuropsychiatric Inventory (NPI) in a memory clinic population during a 6 week period. Methods: Twenty‐three spousal caregivers (mean [SD] age = 69.7 [8.8], 82.6% female) of 23 patients (43.5% had dementia) completed all assessments. The NPI was assessed four times during 6 weeks. We examined whether NPI domains were present during all four assessments, studied within‐person variation for each NPI domain, and calculated Spearman's correlations between subsequent time‐points. Furthermore, we associated repeated NPI assessments with repeated measures of caregiver burden to examine the clinical impact of changes in NPI scores over time. Results: The course of NPS was highly irregular according to the NPI, with only 35.8% of the NPI domains that were present at baseline persisted during all 6 weeks. We observed large within‐person variation in the presence of individual NPI domains (61.3%, range 37.5%–83.9%) and inconsistent correlations between NPI assessments (e.g., range r s = 0.20–0.57 for agitation, range r s = 0.29–0.59 for anxiety). Higher NPI total scores were related to higher caregiver burden ( r s = 0.60, p < 0.001), but changes in NPI total scores were unrelated to changes in caregiver burden ( r s = 0.16, p = 0.20). Conclusions: We observed strong fluctuations in NPI scores within very short time windows raising the question whether this represents erratic symptoms and/or scores. Further studies are needed to investigate the origins of these fluctuations. Key points: The presence and severity of all neuropsychiatric symptoms (NPS) measured with the Neuropsychiatric Inventory (NPI) were highly variable within a memory clinic population when repeatedly assessed during 6 weeks. Although we found subtle differences between longitudinal NPI domain scores, not a single domain score was stable over time. Findings either reflects the fluctuating nature of NPS in neurocognitive disorders and/or the limited ability of the NPI to reliably measure NPS in a memory clinic population.