The evaluation of behavioral disturbances in Alzheimer's disease: the utility of three rating scales.
Behavioral disturbances, eg, wandering, irritability, depression, and delusions, are observed in Alzheimer's disease (AD). Determining the importance of such symptoms requires that they be evaluated objectively. The Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD), Cornell Scale for Depression in Dementia (Cornell), and Brief Psychiatric Rating Scale (BPRS) were administered to 61 AD and 20 elderly control subjects. Only one AD subject showed no behavioral symptoms. All scales were reliably rated for presence or absence of symptoms. However, assessment of reliability of severity ratings was limited, because symptom frequency and severity were low. Although the Cornell and Behave-AD appeared more appropriate for AD subjects than did the BPRS, neither scale provided a complete description of behavioral symptoms, and each showed problems that interfere with its use. We recommend the development of a comprehensive scale with a well-anchored system of scaling and detailed rater instructions.
Mack
J L
JL
Department of Neurology, Case Western Reserve University, Cleveland, OH.
Patterson
M B
MB
D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology*; D008875:Middle Aged; D015588:Observer Variation; D011581:Psychological Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index