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Clinical Manifestations.

Dylan X Guan1, Byron Creese2, Cassandra M Germain3

  • 1Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Agitation in neurocognitive disorders is challenging to measure consistently. Few validated scales fully align with the International Psychogeriatric Association (IPA) criteria, impacting research and clinical practice.

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Area of Science:

  • Geriatric Psychiatry
  • Neuroscience
  • Clinical Psychology

Background:

  • Agitation is a common, distressing behavior in neurocognitive disorders.
  • Measuring agitation is complicated by inconsistent definitions and tools.
  • The International Psychogeriatric Association (IPA) established consensus criteria for agitation.

Purpose of the Study:

  • To systematically review validated agitation scales in older adults with neurocognitive disorders.
  • To evaluate the alignment of these scales with IPA criteria.

Main Methods:

  • Systematic review of MEDLINE, EMBASE, and PsycINFO databases.
  • Included validation studies of agitation scales in neurocognitive disorder populations.
  • Evaluated scale alignment with IPA criteria by independent reviewers.

Main Results:

  • Identified 39 unique agitation scales from 226 full-text articles.
  • The Staff Observation Aggression Scale, Neuropsychiatric Inventory Nursing Home, and Modified Overt Aggression Scale showed greatest IPA alignment.
  • Many scales lacked items on excessive motor activity or physical aggression.

Conclusions:

  • While numerous agitation scales exist for older adults, few fully meet IPA criteria.
  • Common deficiencies include inadequate capture of symptom persistence and emotional distress.
  • Significant variation exists in how scales address core agitation domains.