Biweekly fluctuations of neuropsychiatric symptoms according to the Neuropsychiatric Inventory: Erratic symptoms or scores?

Willem S. Eikelboom*, Amy den Teuling, Daphne E. Pol, Michiel Coesmans, Sanne Franzen, Lize C. Jiskoot, Judy van Hemmen, Ellen H. Singleton, Rik Ossenkoppele, Frank Jan de Jong, Esther van den Berg, Janne M. Papma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objectives: This study investigates the stability of neuropsychiatric symptoms (NPS) assessed biweekly using the Neuropsychiatric Inventory (NPI) in a memory clinic population during a 6 week period. Methods: Twenty-three spousal caregivers (mean [SD] age = 69.7 [8.8], 82.6% female) of 23 patients (43.5% had dementia) completed all assessments. The NPI was assessed four times during 6 weeks. We examined whether NPI domains were present during all four assessments, studied within-person variation for each NPI domain, and calculated Spearman's correlations between subsequent time-points. Furthermore, we associated repeated NPI assessments with repeated measures of caregiver burden to examine the clinical impact of changes in NPI scores over time. Results: The course of NPS was highly irregular according to the NPI, with only 35.8% of the NPI domains that were present at baseline persisted during all 6 weeks. We observed large within-person variation in the presence of individual NPI domains (61.3%, range 37.5%–83.9%) and inconsistent correlations between NPI assessments (e.g., range r s = 0.20–0.57 for agitation, range r s = 0.29–0.59 for anxiety). Higher NPI total scores were related to higher caregiver burden (r s = 0.60, p < 0.001), but changes in NPI total scores were unrelated to changes in caregiver burden (r s = 0.16, p = 0.20). Conclusions: We observed strong fluctuations in NPI scores within very short time windows raising the question whether this represents erratic symptoms and/or scores. Further studies are needed to investigate the origins of these fluctuations.

Original languageEnglish
JournalInternational Journal of Geriatric Psychiatry
Issue number7
Early online date8 Jun 2022
Publication statusPublished - 1 Jul 2022

Bibliographical note

Funding Information:
Dr. Janne Papma and Dr. Rik Ossenkoppele were supported by an Alzheimer Nederland and Memorabel ZonMw Grant 733050823 (Deltaplan Dementie).

Publisher Copyright:
© 2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.


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