title: Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition.
abstract: BACKGROUND
  Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. There is no consensus definition of agitation and no widespread agreement on what elements should be included in the syndrome. The International Psychogeriatric Association formed an Agitation Definition Work Group (ADWG) to develop a provisional consensus definition of agitation in patients with cognitive disorders that can be applied in epidemiologic, non-interventional clinical, pharmacologic, non-pharmacologic interventional, and neurobiological studies. A consensus definition will facilitate communication and cross-study comparison and may have regulatory applications in drug development programs.
  
  
  METHODS
  The ADWG developed a transparent process using a combination of electronic, face-to-face, and survey-based strategies to develop a consensus based on agreement of a majority of participants. Nine-hundred twenty-eight respondents participated in the different phases of the process.
  
  
  RESULTS
  Agitation was defined broadly as: (1) occurring in patients with a cognitive impairment or dementia syndrome; (2) exhibiting behavior consistent with emotional distress; (3) manifesting excessive motor activity, verbal aggression, or physical aggression; and (4) evidencing behaviors that cause excess disability and are not solely attributable to another disorder (psychiatric, medical, or substance-related). A majority of the respondents rated all surveyed elements of the definition as "strongly agree" or "somewhat agree" (68-88% across elements). A majority of the respondents agreed that the definition is appropriate for clinical and research applications.
  
  
  CONCLUSIONS
  A provisional consensus definition of agitation has been developed. This definition can be used to advance interventional and non-interventional research of agitation in patients with cognitive impairment.
authors.affiliation: Cleveland Clinic Lou Ruvo Center for Brain Health,Las Vegas,Nevada,USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cummings
authors.affiliation: Roper St. Francis Hospital,The Clinical Biotechnology Research Institute,South Carolina,USA.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Mintzer
authors.affiliation: Centre for Health Brain Ageing,The University of New South Wales,Sydney,New South Wales,Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Mount Sinai School of Medicine,New York,New York,USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Sano
authors.affiliation: Brighton and Sussex Medical School,Trafford Centre for Medical Research,University of Sussex,Brighton,East Sussex,UK.
authors.forename: Sube
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: New York State Psychiatric Institute,Riverside Drive,New York,New York,USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Devanand
authors.affiliation: McGill Center for Studies in Aging,Douglas Mental Health University Institute Montreal,Montreal,Quebec,Canada.
authors.forename: Serge
authors.initials: S
authors.lastname: Gauthier
authors.affiliation: Institute of Psychiatry,King's College of London,London,UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Howard
authors.affiliation: Sunnybrook Research Institute,University of Toronto,Toronto,Ontario,Canada.
authors.forename: Krista
authors.initials: K
authors.lastname: Lanctôt
authors.affiliation: The Johns Hopkins Memory and Alzheimer's Treatment Center,The Johns Hopkins Bayview Medical Center,Baltimore,Maryland,USA.
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.affiliation: VA Puget Sound Health Care System,Columbian Way,Seattle,Washington,USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Peskind
authors.affiliation: Monroe Community Hospital,Rochester,New York,USA.
authors.forename: Anton P
authors.initials: AP
authors.lastname: Porsteinsson
authors.affiliation: Department of Neuroscience,Hospital Julio Mendez,University of Buenos Aires,Buenos Aires,Argentina.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Reich
authors.affiliation: CHDI Foundation,Princeton,New Jersey,USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sampaio
authors.affiliation: Department of Psychiatry,University of Connecticut Health Center,Farmington,Connecticut,USA.
authors.forename: David
authors.initials: D
authors.lastname: Steffens
authors.affiliation: Alzheimer's Disease International,London,UK.
authors.forename: Marc
authors.initials: M
authors.lastname: Wortmann
authors.affiliation: Cleveland Clinic Lou Ruvo Center for Brain Health,Las Vegas,Nevada,USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Zhong
mesh_terms: D000368:Aged; D001526:Behavioral Symptoms / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D003072:Cognition Disorders / Q000150:complications*; D003704:Dementia / Q000150:complications*; D019468:Disease Management; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D009626:Terminology as Topic