BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Neuropsychiatric Inventory (NPI) Year: 1994 Domain: Psychological Assessment Tool Category: Mental Health Variations/Translations: Three modified versions of the NPI have been developed: the NPI-NH (for nursing home setting), the NPI-Q (self administered), and the CGA-NPI (self administered). Setting: Clinical Method of Delivery: Assessment by clinician in a fully structured interview. Description: The NPI includes 10 behavioral domains with 7-8 sub-questions and measures severity (3-point scale) and frequency (4-point scale). Categories include delusions, hallucinations, dysphoria, anxiety, agitation/aggression, euphoria, disinhibition, irritability, apathy, and aberrant motor activity Scoring/Interpretation: A gate questions is included for each subsection. If this question is answered affirmative, the interviewer then asks the 7 to 9 follow-up questions about the presence or absence of specific symptoms within that domain. The total subscale score is the mathematical product of the frequency and severity. The total NPI score is the sum of the subscale scores. Higher scores indicate more behavioural disturbance. A global score can be generated by summing the total scores (frequency multiplied by severity) of the individual subscales. Time to Administer: 30 minutes Availability: As appendix in many studies; online for a fee Software: N/A Website: N/A Quantitative/Qualitative: Quantitative Validity (Quantitative): Concurrent validity was determined by comparing the scores on the relevant subscales of the NPI with the appropriate scales of 2 instruments, Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) and the Hamilton Depression Rating Scale (HDRS) (coefficients not reported). To establish content validity a delphi panel was developed and asked to rate the scale items. Inter-rater reliability was found to be very high (correlation not reported). 45 patients with Alzheimer’s disease were rated on the NPI and BEHAV-AD and its subscales as the gold standard, the following correlations were found: total BEHAV-AD with NPI total frequency score, 0.66; total BEHAV-AD score with NPI severity, 0.71; and total BEHAV-AD score with NPI frequency times severity, 0.62. Reliability (Quantitative): Test-retest reliability was found to be 0.79 for frequency (P = 0.0001) and 0.86 for sensitivity (P = 0.0001). In a study of the internal consistency of NPI, a Cronbach alpha of 0.88 was observed for the total NPI score. For individual subscales, alpha ranged from 0.87 to 0.88. References: Cummings, J.L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A., & Gornbein, J. (1994) The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308-14. Rush, J.A., First, M.B., & Blacker, D. (2008). Handbook of psychiatric measures. Task Force for the American Psychiatric Association (Second Edition) Washington, D.C.: American Psychiatric Publications. Comments: N/A