Scales to assess efficacy and safety of pharmacologic agents in the treatment of behavioral and psychological symptoms of dementia

Advances in the assessment of the behavioral and psychological symptoms of dementia (BPSD) have been employed in large-scale clinical trials of new an tipsychotic medications such as risperidone. These scales can be used to as sess drug efficacy and to compare different treatment regimens. We review 3 valid and reliable scales, the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), the Cohen-Mansfield Agitation Inventory (CMAI), and the Neuropsychiatric Inventory (NPI). Extrapyramidal side effects (EPS) associated with the treatment of BPSD have also been assessed using a numb er of rating instruments. The design of the most comprehensive of these, th e Extrapyramidal Symptom Rating Scale (ESRS), is exhaustive, and it success fully quantifies EPS and distinguishes toxic from nontoxic medications. Thi s publication serves as an aid to researchers and clinicians in their inter pretation of qualitative and quantitative data from trials evaluating antip sychotic agents in the treatment of BPSD.