title: The Brazilian version of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity in dementia.
abstract: BACKGROUND
  Patients with dementia may be unable to describe their symptoms, and caregivers frequently suffer emotional burden that can interfere with judgment of the patient's behavior. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C) was therefore developed as a comprehensive and versatile instrument to assess and accurately measure neuropsychiatric symptoms (NPS) in dementia, thereby using information from caregiver and patient interviews, and any other relevant available data. The present study is a follow-up to the original, cross-national NPI-C validation, evaluating the reliability and concurrent validity of the NPI-C in quantifying psychopathological symptoms in dementia in a large Brazilian cohort.
  
  
  METHODS
  Two blinded raters evaluated 312 participants (156 patient-knowledgeable informant dyads) using the NPI-C for a total of 624 observations in five Brazilian centers. Inter-rater reliability was determined through intraclass correlation coefficients for the NPI-C domains and the traditional NPI. Convergent validity included correlations of specific domains of the NPI-C with the Brief Psychiatric Rating Scale (BPRS), the Cohen-Mansfield Agitation Index (CMAI), the Cornell Scale for Depression in Dementia (CSDD), and the Apathy Inventory (AI).
  
  
  RESULTS
  Inter-rater reliability was strong for all NPI-C domains. There were high correlations between NPI-C/delusions and BPRS, NPI-C/apathy-indifference with the AI, NPI-C/depression-dysphoria with the CSDD, NPI-C/agitation with the CMAI, and NPI-C/aggression with the CMAI. There was moderate correlation between the NPI-C/aberrant vocalizations and CMAI and the NPI-C/hallucinations with the BPRS.
  
  
  CONCLUSIONS
  The NPI-C is a comprehensive tool that provides accurate measurement of NPS in dementia with high concurrent validity and inter-rater reliability in the Brazilian setting. In addition to universal assessment, the NPI-C can be completed by individual domains.
authors.affiliation: Biosciences Institute, Universidade Estadual Paulista, Rio Claro, SP, Brazil. fstelldo@gmail.com
authors.forename: Florindo
authors.initials: F
authors.lastname: Stella
authors.forename: Orestes Vicente
authors.initials: OV
authors.lastname: Forlenza
authors.forename: Jerson
authors.initials: J
authors.lastname: Laks
authors.forename: Larissa Pires
authors.initials: LP
authors.lastname: de Andrade
authors.forename: Michelle A Ljubetic
authors.initials: MA
authors.lastname: Avendaño
authors.forename: Elisandra Villela Gasparetto
authors.initials: EV
authors.lastname: Sé
authors.forename: João de Castilho
authors.initials: Jde C
authors.lastname: Cação
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.forename: Kate
authors.initials: K
authors.lastname: de Medeiros
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D057565:Apathy / Q000145:classification; D001938:Brazil; D003430:Cross-Sectional Studies; D003702:Delusions / Q000175:diagnosis / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D009483:Neuropsychological Tests / Q000592:standards / Q000706:statistics & numerical data*; D015588:Observer Variation; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000523:psychology; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires