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P.5.a.015 Psychometric properties of the Turkish version of the Cohen-Mansfield agitation inventory
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P.5.a. Dementia and neurological disorders − Dementia (clinical)
proportions of patients who experienced each degree of worsening at endpoint (Week 12) and overall (i.e., throughout the trial). Results: On the FLCI, no significant difference was observed between memantine and placebo in the proportion of patients who experienced any decline (endpoint and overall); however, a significantly higher percentage of patients in the placebo group experienced greater-than-mild worsening at endpoint (P = 0.032) and overall (P = 0.013) and greater-than-moderate worsening at endpoint (P = 0.039) but not overall (P = 0.081). On the ASHA-FACS, significantly more caregivers of patients taking placebo relative to memantine reported any worsening overall (P = 0.013) but not at endpoint (P = 0.079); significantly greater-than-mild worsening at endpoint (P = 0.012) and overall (P = 0.018), and significantly greater-than-moderate worsening at endpoint (P = 0.011), though not overall (P = 0.133). Conclusion: These results suggest that memantine treatment of patients with moderate AD may be associated with a prevention of worsening in functional communication. Disclosure statement: Supported by Forest Laboratories, Inc. P.5.a.015 Psychometric properties of the Turkish version of the Cohen-Mansfield agitation inventory E.T. Ozel-Kizil1 ° , G. Bastug1 , S. Erdogan2 , D. Sakarya1 . 1 Ankara University, Department of Psychiatry Geriatric Psychiatry Unit, Ankara, Turkey; 2 Ankara University, Department of Neurology, Ankara, Turkey Purpose: The Cohen-Mansfield Agitation Inventory (CMAI) is a widely used scale for the assessment of the severity of agitation in dementia patients (1). In this study, we aimed to examine psychometric properties of the Turkish version of the scale and also to investigate the association of agitation behaviour with other measures of dementia like functioning, depression and other neuropsychiatric symptoms. The relationship between caregiver burden and agitation was also studied. Methods: DSM-IV dementia patients (n = 34), who were admitted to an outpatient geriatric psychiatry unit between JanuaryMarch 2010 with their caregivers, were included. Turkish versions of Mini Mental State Examination (MMSE), Cornell Scale for Depression in Dementia (CSDD), Neuropsychiatric Inventory (NPI), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-T), Functional Activities Questionnaire (FAQ), Zarit Caregiver Burden Scale (ZCBS) were applied to either patients or their caregivers (2,3). The CMAI is a scale consisting of 29 items rated from 1-never to 7-a few/several times in an hour. Total score is calculated by adding the item scores. The original forms (long and short forms) of CMAI was translated into Turkish by two authors after getting permission from the author of the original scale (1). For concurrent validity of CMAI, Pearson correlation test was used to evaluate the relationship between CMAI and NPI. For internal consistency, Cronbach alpha value was calculated. Also, the associations between CMAI scores and other scale scores were analyzed by Pearson correlation test. Results: Mean age of the patients was 76.4±5.6, total years of education was 4.6± 3.3. More than half of the patients were male (n = 20, 58.8%). Most of their caregivers were their children (82.4%). Mean CMAI score of the patients was 59.7 ±28.1. Table-1 shows mean scores and standart deviations of the scales and correlations with CMAI scores. There was no difference between patients with or without depression (CSDD scores 7 or <7). Cronbach alpha was calculated as 0.86.
Table 1. Mean scores of the scales and their correlations with CMAI scores Mean score of the patients with dementia (n = 34)
MMSE total score IQCODE-T score FAQ score CSDD score NPI score ZCBS score
14.8±6.6 4.1±0.8 17.6±11.2 7.9±6.9 36.4±33.3 40.5±23.3
Pearson correlation coefficient and significance r
p
r = −0.10 r = 0.36 r = 0.29 r = 0.37 r = 0.84 R=0.83
p = 0.57 p = 0.04* p = 0.93 p = 0.03* p < 0.001** p < 0.001**
*p < 0.05, **p < 0.01.
Conclusion: Turkish version of CMAI was a valid and reliable scale for the measurement of the severity of agitation. Inter-rater reliability couldn’t be conducted because of the small sample size of the patients admitted with more than one caregiver. However, internal consistency of the scale was quite high. Agitation levels were positively correlated with cognitive impairment evaluated by the caregiver, but not with MMSE. Also, there were positive correlations between agitation severity and other neuropsychiatric symptoms like depression, hallucinations, delusions, anxiety, disinhibition, irritability and sleep disorders which were assessed by NPI. Higher agitation was related with higher levels of caregiver burden. Therefore, treatment of agitation in these patients is very important for decreasing caregiver burden. References [1] Cohen-Mansfield J. Conceptualization of agitation: results based on the Cohen-Mansfield Agitation Inventory and the Agitation Behavior Mapping Instrument. Int Psychogeriatr. 1996;8 Suppl 3:309−15. [2] Ozel-Kizil ET, Turan ED, Yilmaz E, Cangoz B, Uluc S. Discriminant validity and reliability of the Turkish version of Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-T). Arch Clin Neuropsychol. 2010 Mar;25(2):139−45. [3] Ak¸ca-Kalem S, Hanagasi H, Cummings JL, G¨urvit H. Validation study of the Turkish translation of the Neuropsychiatric Inventory (NPI). 21st International Conference of Alzheimer’s Disease International, Sept. 28-Oct. 1, 2005 Istanbul, Turkey. Abstract Book P47, p. 58.
P.5.a.016 Automated classification of MR images for recognising Alzheimer’s disease in living patients F. Simsek1 ° , F. Polat2 , O. Demirel3 , O. Kitis4 , D. Haznedaroglu5 , 1 Ege University, C. Eker5 , E. Kumral6 , A.S. Gonul5 . Psychiatry Department, Bornova Izmir, Turkey; 2 Ege University, Neurology Department, Bornova Izmir, Turkey; 3 Yasar University, Enformatics Department, Bornova Izmir, Turkey; 4 Ege University, Neuroradiology Department, Bornova Izmir, Turkey; 5 Ege University, Psychiatry Department, Bornova Izmir, Turkey; 6 Ege University, Neurology Department, Bornova Izmir, Turkey Introduction: Alzheimer’s disease (AD) is the most common cause of dementia. In 2000, approximately 25 million people over the age of 60 were diagnosed with dementia worldwide, and the number afflicted is expected to reach over 80 million by 2040. However, in general clinical practice, it is a challenge to clinicians to diagnose AD especially during early stage of the disease because the diagnosis is largely based on time consuming clinical history and examination supported by varies neuropsychological tests. Neuroimaging is preferred for exclusion of other degenerative disease (e.g. vascular dementia) rather than using for diagnoses of AD.
P.5.a. Dementia and neurological disorders − Dementia (clinical)
proportions of patients who experienced each degree of worsening at endpoint (Week 12) and overall (i.e., throughout the trial). Results: On the FLCI, no significant difference was observed between memantine and placebo in the proportion of patients who experienced any decline (endpoint and overall); however, a significantly higher percentage of patients in the placebo group experienced greater-than-mild worsening at endpoint (P = 0.032) and overall (P = 0.013) and greater-than-moderate worsening at endpoint (P = 0.039) but not overall (P = 0.081). On the ASHA-FACS, significantly more caregivers of patients taking placebo relative to memantine reported any worsening overall (P = 0.013) but not at endpoint (P = 0.079); significantly greater-than-mild worsening at endpoint (P = 0.012) and overall (P = 0.018), and significantly greater-than-moderate worsening at endpoint (P = 0.011), though not overall (P = 0.133). Conclusion: These results suggest that memantine treatment of patients with moderate AD may be associated with a prevention of worsening in functional communication. Disclosure statement: Supported by Forest Laboratories, Inc. P.5.a.015 Psychometric properties of the Turkish version of the Cohen-Mansfield agitation inventory E.T. Ozel-Kizil1 ° , G. Bastug1 , S. Erdogan2 , D. Sakarya1 . 1 Ankara University, Department of Psychiatry Geriatric Psychiatry Unit, Ankara, Turkey; 2 Ankara University, Department of Neurology, Ankara, Turkey Purpose: The Cohen-Mansfield Agitation Inventory (CMAI) is a widely used scale for the assessment of the severity of agitation in dementia patients (1). In this study, we aimed to examine psychometric properties of the Turkish version of the scale and also to investigate the association of agitation behaviour with other measures of dementia like functioning, depression and other neuropsychiatric symptoms. The relationship between caregiver burden and agitation was also studied. Methods: DSM-IV dementia patients (n = 34), who were admitted to an outpatient geriatric psychiatry unit between JanuaryMarch 2010 with their caregivers, were included. Turkish versions of Mini Mental State Examination (MMSE), Cornell Scale for Depression in Dementia (CSDD), Neuropsychiatric Inventory (NPI), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-T), Functional Activities Questionnaire (FAQ), Zarit Caregiver Burden Scale (ZCBS) were applied to either patients or their caregivers (2,3). The CMAI is a scale consisting of 29 items rated from 1-never to 7-a few/several times in an hour. Total score is calculated by adding the item scores. The original forms (long and short forms) of CMAI was translated into Turkish by two authors after getting permission from the author of the original scale (1). For concurrent validity of CMAI, Pearson correlation test was used to evaluate the relationship between CMAI and NPI. For internal consistency, Cronbach alpha value was calculated. Also, the associations between CMAI scores and other scale scores were analyzed by Pearson correlation test. Results: Mean age of the patients was 76.4±5.6, total years of education was 4.6± 3.3. More than half of the patients were male (n = 20, 58.8%). Most of their caregivers were their children (82.4%). Mean CMAI score of the patients was 59.7 ±28.1. Table-1 shows mean scores and standart deviations of the scales and correlations with CMAI scores. There was no difference between patients with or without depression (CSDD scores 7 or <7). Cronbach alpha was calculated as 0.86.
Table 1. Mean scores of the scales and their correlations with CMAI scores Mean score of the patients with dementia (n = 34)
MMSE total score IQCODE-T score FAQ score CSDD score NPI score ZCBS score
14.8±6.6 4.1±0.8 17.6±11.2 7.9±6.9 36.4±33.3 40.5±23.3
Pearson correlation coefficient and significance r
p
r = −0.10 r = 0.36 r = 0.29 r = 0.37 r = 0.84 R=0.83
p = 0.57 p = 0.04* p = 0.93 p = 0.03* p < 0.001** p < 0.001**
*p < 0.05, **p < 0.01.
Conclusion: Turkish version of CMAI was a valid and reliable scale for the measurement of the severity of agitation. Inter-rater reliability couldn’t be conducted because of the small sample size of the patients admitted with more than one caregiver. However, internal consistency of the scale was quite high. Agitation levels were positively correlated with cognitive impairment evaluated by the caregiver, but not with MMSE. Also, there were positive correlations between agitation severity and other neuropsychiatric symptoms like depression, hallucinations, delusions, anxiety, disinhibition, irritability and sleep disorders which were assessed by NPI. Higher agitation was related with higher levels of caregiver burden. Therefore, treatment of agitation in these patients is very important for decreasing caregiver burden. References [1] Cohen-Mansfield J. Conceptualization of agitation: results based on the Cohen-Mansfield Agitation Inventory and the Agitation Behavior Mapping Instrument. Int Psychogeriatr. 1996;8 Suppl 3:309−15. [2] Ozel-Kizil ET, Turan ED, Yilmaz E, Cangoz B, Uluc S. Discriminant validity and reliability of the Turkish version of Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-T). Arch Clin Neuropsychol. 2010 Mar;25(2):139−45. [3] Ak¸ca-Kalem S, Hanagasi H, Cummings JL, G¨urvit H. Validation study of the Turkish translation of the Neuropsychiatric Inventory (NPI). 21st International Conference of Alzheimer’s Disease International, Sept. 28-Oct. 1, 2005 Istanbul, Turkey. Abstract Book P47, p. 58.
P.5.a.016 Automated classification of MR images for recognising Alzheimer’s disease in living patients F. Simsek1 ° , F. Polat2 , O. Demirel3 , O. Kitis4 , D. Haznedaroglu5 , 1 Ege University, C. Eker5 , E. Kumral6 , A.S. Gonul5 . Psychiatry Department, Bornova Izmir, Turkey; 2 Ege University, Neurology Department, Bornova Izmir, Turkey; 3 Yasar University, Enformatics Department, Bornova Izmir, Turkey; 4 Ege University, Neuroradiology Department, Bornova Izmir, Turkey; 5 Ege University, Psychiatry Department, Bornova Izmir, Turkey; 6 Ege University, Neurology Department, Bornova Izmir, Turkey Introduction: Alzheimer’s disease (AD) is the most common cause of dementia. In 2000, approximately 25 million people over the age of 60 were diagnosed with dementia worldwide, and the number afflicted is expected to reach over 80 million by 2040. However, in general clinical practice, it is a challenge to clinicians to diagnose AD especially during early stage of the disease because the diagnosis is largely based on time consuming clinical history and examination supported by varies neuropsychological tests. Neuroimaging is preferred for exclusion of other degenerative disease (e.g. vascular dementia) rather than using for diagnoses of AD.