A COMPARISON OF THE COHEN-MANSFIELD AGITATION INVENTORY WITH THE CERAD BEHAVIORAL RATING-SCALE FOR DEMENTIA IN COMMUNITY-DWELLING PERSONS WITH ALZHEIMERS-DISEASE

In a group of 242 community-dwelling patients with Alzheimer's disease (AD), a longitudinal comparison was made of two caregiver-administere d instruments for assessment of behavioral disturbance; the Cohen-Mans field Agitation Inventory (CMAI) and the CERAD Behavioral Rating Scale for Dementia (BRSD). We examined records of the 206 patients with bas eline and 12-month follow-up data for the CMAI and the BRSD who also h ad tests of cognitive (Mini-mental State; MMSE) and global function (C linical Dementia Rating; CDR and Functional Assessment Staging; FAST). Among 114 AD subjects, the correlation between total CMAI at baseline and 1 month readministration was 0.83 (p < 0.0001). In the same subje cts, stratified into 5 groups by MMSE scores, the correlations between BRSD baseline and I-month scores ranged from 0.70-0.89 (p< 0.0001). T here was high correlation between total scores of both instruments at baseline and 12 months. In addition, all CMAI subscales except Verball y Aggressive correlated significantly with total BRSD score at both ti me points. At baseline, BRSD subscales for irritability/aggression, be havioral dysregulation and psychotic symptoms and at 12 months, irrita bility/aggression and behavioral dysregulation correlated with total C MAI scores. Neither scale changed significantly over I year, but there was wide individual variation. CMAI and BRSD scores correlated with I -year change in the FAST, but not with MMSE or CDR (which weighs cogni tion heavily), suggesting that behavioral disturbance may be more stro ngly related to ability to manage activities of daily living (executiv e function) than to other aspects of cognition. The CMAI and BRSD appe ar to be interchangeable as measures of agitation, with the CMAI possi bly more useful for patients who lack language and the BRSD more sensi tive to apathy and depression. (C) 1998 Elsevier Science Ltd. All righ ts reserved.