Reliability and structural validity of the Chinese version of the Neuropsychiatric Inventory, Nursing Home version

With the increasing number of dementia patients in China, there is a pressing need for a reliable and valid Chinese instrument that can measure neuropsychiatric symptoms in institutionalized dementia patients. This study examined the reliability and structural validity of the Chinese version of the Neuropsychiatric Inventory, Nursing Home version (NPI-NH), in a sample of institutionalized dementia patients in China.

A total of 112 residents with dementia (Clinical Dementia Rating = 1: 10.7%; Clinical Dementia Rating = 2: 39.3%; Clinical Dementia Rating = 3: 50.0%) and 30 informants participated in this cross-sectional study. Reliability was tested using Cronbach's α and intra-class correlation coefficient. Principal component analysis was used to evaluate the factor structure of the inventory.

Of the patients, 92.9% had at least one neuropsychiatric symptom. Apathy (57%) was the most common symptom. The Chinese version of the Neuropsychiatric Inventory, Nursing Home version, showed acceptable internal consistency (Cronbach's α for the total scale, frequency, severity, and disturbance subscales were 0.64, 0.70, 0.73, and 0.80, respectively) and test-retest reliability (intra-class correlation coefficient for the total scale, frequency, severity, and disturbance subscales were 0.93, 0.92, 0.89, and 0.91, respectively). Five factors-psychomotor behaviour, affective symptoms, psychosis, sleep disorders, and eating disorders-were identified for the total scale. The cluster symptoms aggression and irritability, depression and anxiety, and delusions and hallucinations were three of the optimally stable groups of symptoms.

This study demonstrated that the Chinese version of the Neuropsychiatric Inventory, Nursing Home version, is a valid and reliable instrument for evaluating neuropsychiatric symptoms in institutionalized dementia patients.