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Published on: February 25, 2011
Care partner evaluation of the behaviors in the Cohen-Mansfield Agitation Inventory
Dorothee Oberdhan1, Andrew Palsgrove1, Christy Houle2
1Otsuka Pharmaceutical Development and Commercialization, Inc., Global Value and Real-World Evidence, Rockville, MD, United States.
Introduction:
Agitation is a common symptom in patients with Alzheimer's dementia. But agitation can be a heterogeneous symptom, encompassing a diverse array of behaviors exhibited by patients. The Cohen-Mansfield Agitation Inventory (CMAI) is a 29-item scale that is used to systematically assess the frequency and severity of agitation in older adults as rated by a primary caregiver. The CMAI was originally designed for use by professional care givers in institutional care settings. Alzheimer's dementia, however, is associated with a significant burden on family members, who provide the majority of care, and other informal care partners.
Methods:
Our qualitative study aimed to assess the accuracy and applicability of the CMAI according to the needs and perceptions of non-professional care partners. Specifically, we wanted to determine if the behaviors included in the instrument reflect: (a) the care partner's experience with agitation in Alzheimer's dementia patients, (b) how the behaviors and their frequency are related to the perception of agitation severity, and (c) what changes in agitation behaviors are meaningful to care partners. We interviewed 30 care partners for patients with Alzheimer's dementia in the United States.
Results:
The care partners confirmed all behaviors listed in the CMAI as relevant. The behaviors reflect a spectrum of severity, with aggressive behaviors considered more severe than non-aggressive behaviors and physical behaviors generally considered more severe than verbal behaviors. Any reduction or increase in the frequency of a behavior was meaningful to care partners. Generally, a change from physical to verbal behaviors and aggressive to non-aggressive was considered a meaningful improvement while a change from verbal to physical and non-aggressive to aggressive was considered a meaningful worsening.
Discussion:
The CMAI appropriately captures relevant behaviors of agitation in Alzheimer's dementia and provides insight into the relative improvement or worsening of agitation symptoms.
Insights
The Cohen-Mansfield Agitation Inventory (CMAI) accurately assesses agitation in Alzheimer's dementia patients. Care partners find the scale relevant, with changes in behavior frequency and type indicating meaningful improvements or worsening.
Area of Science:
- Gerontology
- Neurology
- Psychiatry
Background:
- Agitation is a common and heterogeneous symptom in Alzheimer's dementia.
- The Cohen-Mansfield Agitation Inventory (CMAI) is a standard tool for assessing agitation.
- Informal care partners bear a significant burden in managing Alzheimer's dementia.
Purpose of the Study:
- To evaluate the accuracy and applicability of the CMAI for non-professional care partners.
- To determine if CMAI behaviors align with care partners' experiences of agitation.
- To understand how agitation severity and meaningful changes are perceived by care partners.
Main Methods:
- A qualitative study involving 30 care partners of Alzheimer's dementia patients in the United States.
- Interviews were conducted to gather perceptions on agitation behaviors and the CMAI.
- Analysis focused on the relevance, severity, and meaningfulness of behaviors listed in the CMAI.
Main Results:
- Care partners confirmed the relevance of all behaviors listed in the CMAI.
- Agitation behaviors were perceived on a spectrum of severity, with physical and aggressive behaviors rated as more severe.
- Any change in behavior frequency or type (e.g., physical to verbal) was considered meaningful by care partners.
Conclusions:
- The CMAI effectively captures relevant agitation behaviors in Alzheimer's dementia.
- The inventory provides valuable insights into the perceived severity and meaningful changes in agitation symptoms.
- The CMAI is applicable and accurate for use by informal care partners.
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