General Scale Assessing Aggression, Agitation, Hyperactivity, and Irritability

The NPI, [4] the most commonly used assessment tool in research on BPSD, screens for ten behavioral domains, including irritability/lability and agitation/ aggression. Moreover, aberrant motor activity (Does the patient pace around the house without apparent purpose?), which may also be considered agitated behavior or hyperactivity, is assessed. Severity and frequency are assessed over the preceding month. Two additional versions have been developed, the NPI-Questionnaire (NPI-Q) [24], a shorter version of the original carried out as a questionnaire which only assesses severity, and the NPI-Clinician (NPI-C) rating scale [25], which expands on the original NPI. Importantly, the NPI-C assesses agitation and aggression separately, whereas the NPI and NPI-Q assesses these symptoms under one item. The NPI-Q is widely used and may be better suited for clinical use and has reasonable reliability across populations [29]. The BEHAVE-AD rating scale [3], which assesses several items, including aggression and activity disturbances, is interview based and rates behavior in the 2 weeks prior to assessment. Note that some scales assess behavior that may be considered as agitation (e.g., irrational or restless), aggressiveness (dangerous), irritability (annoying), or a mixture of these (e.g., verbal output disturbance and interpersonal difficulties), but these scales are not reviewed in this chapter. For a thorough review which includes these scales, see [30].

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