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Alzheimer & Demetia: How to better identify the mood disorders of patients with Alzheimer's disease?

 Last Update: 2021-06-29
 Source: Internet
 Author: User

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In the RCT for anxiety and affective disorders of Alzheimer's disease (Alzheimer's disease, AD ) patients , two methods are used to assess treatment response: 1 ) Overall score based on the judgment of experienced clinicians; and (2) reflection Severity and / or frequency score of the scale items of the anxiety syndrome components .
Examples of the latter method include the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory (NPI), which are the most widely used measures in the trial .

Examples of the latter method include examples of the latter method include the Cohen-Mansfield Irritability Scale (CMAI) and the Neuropsychiatric Inventory (NPI), which are the most widely used measures in the trial .
The Cohen-Mansfield Irritability Scale (CMAI) and the Neuropsychiatric Disorder Scale (NPI) are the most widely used measures in the trial .

However, the disadvantage of this method is that the score derived entirely from the opinions of the caregiver can lead to various deviations
.

The NPI- Clinician ( NPI-C ) version was developed to address this limitation; however, so far, there is no gold standard score for these trials

However, the disadvantage of this method is that the score derived entirely from the opinions of the caregiver can lead to various deviations

In 2015 , the International Psychiatric Association of Geriatrics ( IPA ) published temporary standards for anxiety in cognitive disorders to promote research in this field
.

In 2018 , the European Union - North American Alzheimer's Disease Clinical Trial ( EU-US CTAD ) Anxiety Problem Working Group encouraged evidence-based, using existing data sets and items in the existing scale to develop an anxiety standard for IPA Single rating scale

In 2015 , the International Psychiatric Association of Geriatrics ( IPA ) published temporary standards for anxiety in cognitive disorders to promote research in this field

In response to the EU - U.

In a modified Delphi process, the Cohen-Mansfield Anxiety Inventory ( CMAI ) and Neuropsychiatric Inventory - Clinician ( NPI-C ) items were mapped to the IPA anxiety domain, resulting in new tools, CMAI-IPA and NPI -C-IPA
.

Validation in the Agitation and Aggression AD cohort ( A3C ) evaluated the smallest clinically important differences ( MCIDs ), change sensitivity, and predictive validity

1 month, 31 patients (13.

mADCS-CGIC1-2 and ≥3 and Cohen-Mansfield Agitation Scale (CMAI), Neuropsychiatric Scale Clinician Score (NPI-C)-Agitation + Depression (A+A), CMAI-International Geriatric Association (IPA) And NPI-C-IPA in 1 month and 3 months

At 3 months, 44 patients (20.
5%) had a great or very great improvement with mADCS-CGIC
.

The average score of CMAI is 52.

At 3 months, 44 patients (20.

Based on five indexes, sensitivity to changes in CMAI, NPI-C-anxiety + attack (A+A), CMAI-IPA, NPI-C-IPA between M0 and M3 and between M0 and M1

The MCID of CMAI is -17 ( OR=14.
9 , 95% CI=6.
8-32.
6 ); CMAI-IPA is -5 ( OR=9.
3 , 95%CI=4.
0-21.
2 ); NPI-C-A+A is -3 ( OR=11.
9 , 95%CI=4.
1-34.
8 ); NPI-C-IPA at 3 months is -5 ( OR=7.
8 , 95%CI=3.
4-17.
9 ) .

The MCID of CMAI is -17 ( OR=14.

9 , 95% CI=6.
8-32.
6 ); CMAI-IPA is -5 ( OR=9.
3 , 95%CI=4.
0-21.
2 ); NPI-C-A+A is -3 ( OR=11.
9 , 95%CI=4.
1-34.
8 ); NPI-C-IPA at 3 months is -5 ( OR=7.
8 , 95%CI=3.
4-17.
9 ) .

The area under the curve shows that no scale can better predict the clinician’s overall score
.
All indicators are highly sensitive to changes
.

The area under the curve shows that no scale can better predict the clinician’s overall score
.
All indicators are highly sensitive to changes
.
The area under the curve shows that no scale can better predict the clinician’s overall score
.
All indicators are highly sensitive to changes
.

Analysis of internal consistency and reliability shows that NPI-C-IPA is more accurate than CMAI-IPA, and can be used for the inclusion of AD anxiety clinical trials and the response to intervention
.
Analysis of internal consistency and reliability shows that NPI-C-IPA is more accurate than CMAI-IPA, and can be used for the inclusion of AD anxiety clinical trials and the response to intervention
.

references:

Agitation in Alzheimer's disease: Novel outcome measures reflecting the International Psychogeriatric Association (IPA) agitation criteria.
https://doi.
org/10.
1002/alz.
12335

Agitation in Alzheimer's disease: Novel outcome measures reflecting the International Psychogeriatric Association (IPA) agitation criteria.
https://doi.
org/10.
1002/alz.
12335 Agitation in Alzheimer's disease: Novel outcome measures reflecting the International Psychogeriatric Association (IPA) agitation criteria .
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