Behavioral disorders and caregivers' reaction in Taiwanese patients with Alzheimer's disease

Int Psychogeriatr. 2001 Mar;13(1):121-8. doi: 10.1017/s1041610201007517.


Objectives: To evaluate the applicability of the Chinese version of the Neuropsychiatric Inventory Scale (NPI), and to explore the neuropsychiatric manifestations of Taiwanese patients with Alzheimer's disease (AD) and caregiver distress.

Method: The Mini-Mental State Examination (MMSE) was administered to 95 patients with AD, and their caregivers were interviewed with the NPI. To assess the test-retest reliability of the Chinese version of the NPI, 86 caregivers underwent a second NPI 3 weeks later.

Results: The Cronbach's alpha coefficient of the Chinese version of the NPI was .76. The test-retest reliabilities of frequency, severity, and caregiver burden scores were significantly correlated; overall correlations were .85 for frequency (p < .001), .82 for severity (p < .001), and .79 (p < .001) for distress. Factor analysis was carried out, and three groups, "mood and psychosis," "psychomotor regulation," and "social engagement," were found. Aberrant motor behavior was the most frequently recorded behavior; euphoria was the least. There was no significant correlation between the patient's MMSE and the caregiver distress score, except for aberrant motor activity (r = -.23, p = .03). The symptoms most frequently reported to be severely distressing to caregivers were aberrant motor activity, anxiety, agitation, and delusions.

Conclusions: These results indicate that the NPI is a reliable tool to assess behavioral disturbance and caregiver distress in Taiwanese AD patients. These findings also confirm the high prevalence of psychopathology among AD patients and the marked distress produced by many of these behaviors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Aged
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / psychology*
  • Caregivers / psychology*
  • Dementia / diagnosis
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Mental Disorders / psychology*
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Psychopathology
  • Reproducibility of Results
  • Severity of Illness Index
  • Stress, Psychological / diagnosis*
  • Taiwan