Addition of a frequency-weighted score to the Behavioral Pathology in Alzheimer's disease Rating Scale: the BEHAVE-AD-FW: methodology and reliability

The Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) is a well-established instrument, designed to assess potentially remediable b ehavioral symptoms in Alzheimer's disease (AD) patients as well as to evalu ate treatment outcome. It consists of 25 symptoms grouped into seven catego ries. Each symptom is scored on the basis of severity on a four-point scale . A knowledgeable caregiver is queried and items are scored on the basis of symptoms noted in the preceding two weeks. Reliability, construct validity and criterion validity data for the BEHAVE-AD have previously been publish ed. Because of the significance of psychopathology in dementia, it is neces sary to optimally describe and define the nature, magnitude and prevalence of behavioral symptomalogy. Accordingly, a frequency component was added to each of the 25 items of the BEHAVE-AD scale. The objective of the present report is to describe this new Behavioral Pathology in Alzheimer's Disease Frequency-Weighted Severity Scale (BEHAVE-AD-FW) and to establish its inter -rater reliability. In this investigation the BEHAVE-AD-FW scale was admini stered to caregivers of 28 patients with either mildly impaired cognitive f unction or a dementia diagnosis. Two clinicians separately and independentl y rated the responses. Analyses determined that the intraclass correlation coefficients (ICCs) for the frequency component varied between 0.86 and 0.9 7 for each of the seven BEHAVE-AD categories (p(s) < 0.001). ICCs for the f requency-weighted scores (item severity score x item frequency score) range d from 0.69 to 0.98 for the seven symptom categories (p(s) < 0.001). For th e BEHAVE-AD-FW total scores, the ICC was 0.91 (P < 0.001). These results in dicate that the frequency-weighted component is a reliable addition to the BEHAVE-AD scale. (C) 2000 Editions scientifiques et medicales Elsevier SAS.