J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 7, Number 1, January 2015, pages 21-28

Validity and Reliability of the European Portuguese Version of Neuropsychiatric Inventory in an Institutionalized Sample

**Table 1.** Demographic and Clinical Characteristics of Sample
n = 166
Age (years) mean (SD)	80.9 (10.2)
Gender, n (%)
Male	16 (10)
Female	150 (90)
Marital status, n (%)
Single	51 (31)
Married	12 (7)
Divorced/separated	17 (11)
Widowed	86 (51)
Education, n (%) (n = 164)
< 4 years	88 (53)
4 years	53 (33)
> 4 years	23 (15)
Institutionalization, n (%)
0 - 4 years	110 (64)
5 - 9 years	25 (15)
10 - 14 years	16 (11)
≥ 15 years	15 (10)
MMSE, n (%) (n = 163)
No cognitive deficit	66 (40.5)
Cognitive deficit	97 (59.5)
GDS, n (%) (n = 158)
No depression	85 (54)
Depression	73 (46)
IAFAI, mean (SD)
Total disability	47 (25)

Table 1. Demographic and Clinical Characteristics of Sample

n = 166

Age (years) mean (SD)

80.9 (10.2)

Gender, n (%)

Male

16 (10)

Female

150 (90)

Marital status, n (%)

Single

51 (31)

Married

12 (7)

Divorced/separated

17 (11)

Widowed

86 (51)

Education, n (%) (n = 164)

< 4 years

88 (53)

4 years

53 (33)

> 4 years

23 (15)

Institutionalization, n (%)

0 - 4 years

110 (64)

5 - 9 years

25 (15)

10 - 14 years

16 (11)

≥ 15 years

15 (10)

MMSE, n (%) (n = 163)

No cognitive deficit

66 (40.5)

Cognitive deficit

97 (59.5)

GDS, n (%) (n = 158)

No depression

85 (54)

Depression

73 (46)

IAFAI, mean (SD)

Total disability

47 (25)

**Table 2.** Frequency of NPI Domains
NPI domains	Not present n (%)	Present n (%)
Delusions	130 (78)	36 (22)
Hallucinations	154 (93)	12 (7)
Agitation/aggression	141 (85)	25 (15)
Depression/dysphoria	134 (81)	32 (19)
Anxiety	149 (90)	17 (10)
Elation/euphoria	161 (97)	5 (3)
Apathy/indifference	154 (93)	12 (7)
Disinhibition	157 (95)	9 (5)
Irritability/lability	137 (83)	29 (17)
Aberrant motor behavior	159 (96)	7 (4)
Sleep/nighttime behavior disorders	77 (46)	89 (54)
Appetite and eating changes	155 (93)	11 (7)

Table 2. Frequency of NPI Domains

NPI domains

Not present n (%)

Present n (%)

Delusions

130 (78)

36 (22)

Hallucinations

154 (93)

12 (7)

Agitation/aggression

141 (85)

25 (15)

Depression/dysphoria

134 (81)

32 (19)

Anxiety

149 (90)

17 (10)

Elation/euphoria

161 (97)

5 (3)

Apathy/indifference

154 (93)

12 (7)

Disinhibition

157 (95)

9 (5)

Irritability/lability

137 (83)

29 (17)

Aberrant motor behavior

159 (96)

7 (4)

Sleep/nighttime behavior disorders

77 (46)

89 (54)

Appetite and eating changes

155 (93)

11 (7)

**Table 3.** Correlations Between NPI, MMSE and GDS
NPI domains (FxS)	MMSE r_s (P)	GDS r_s (P)
Spearman test; *Correlation is significant at the 0.05 level.
Delusions	-0.177*(0.024)	0.126 (0.114)
Hallucinations	-0.060 (0.443)	0.074 (0.357)
Agitation/aggression	-0.090 (0.252)	-0.014 (0.857)
Depression/dysphoria	-0.010 (0.901)	0.166* (0.038)
Anxiety	0.007 (0.928)	0.027 (0.736)
Elation/euphoria	-0.076 (0.337)	-0.104 (0.192)
Apathy/indifference	-0.118 (0.133)	0.081 (0.309)
Disinhibition	-0.174*(0.026)	0.006 (0.943)
Irritability/lability	0.079 (0.316)	-0.037 (0.649)
Aberrant motor behavior	-0.182*(0.02)	-0.013 (0.873)
Total	-0.132 (0.092)	0.115 (0.151)
Sleep/nighttime behavior disorders	0.058 (0.465)	0.069 (0.391)
Appetite and eating changes	0.016 (0.839)	0.047 (0.557)

Table 3. Correlations Between NPI, MMSE and GDS

NPI domains (FxS)

MMSE r_s (P)

GDS r_s (P)

Spearman test; *Correlation is significant at the 0.05 level.

Delusions

-0.177*(0.024)

0.126 (0.114)

Hallucinations

-0.060 (0.443)

0.074 (0.357)

Agitation/aggression

-0.090 (0.252)

-0.014 (0.857)

Depression/dysphoria

-0.010 (0.901)

0.166* (0.038)

Anxiety

0.007 (0.928)

0.027 (0.736)

Elation/euphoria

-0.076 (0.337)

-0.104 (0.192)

Apathy/indifference

-0.118 (0.133)

0.081 (0.309)

Disinhibition

-0.174*(0.026)

0.006 (0.943)

Irritability/lability

0.079 (0.316)

-0.037 (0.649)

Aberrant motor behavior

-0.182*(0.02)

-0.013 (0.873)

Total

-0.132 (0.092)

0.115 (0.151)

Sleep/nighttime behavior disorders

0.058 (0.465)

0.069 (0.391)

Appetite and eating changes

0.016 (0.839)

0.047 (0.557)

**Table 4.** Cronbach’s Alpha (α) for Individual Domains of NPI
NPI domains	FxS (α)	Frequency (α)	Severity (α)	Distress (α)
Delusions	0.727	0.697	0.690	0.721
Hallucinations	0.718	0.680	0.681	0.705
Agitation/aggression	0.706	0.673	0.676	0.692
Depression/dysphoria	0.753	0.735	0.728	0.737
Anxiety	0.765	0.738	0.728	0.757
Elation/euphoria	0.767	0.733	0.735	0.746
Apathy/indifference	0.757	0.733	0.724	0.740
Disinhibition	0.756	0.716	0.716	0.724
Irritability/lability	0.732	0.704	0.703	0.754
Aberrant motor behavior	0.765	0.732	0.732	0.749
Total	0.766	0.737	0.734	0.755

Table 4. Cronbach’s Alpha (α) for Individual Domains of NPI

NPI domains

FxS (α)

Frequency (α)

Severity (α)

Distress (α)

Delusions

0.727

0.697

0.690

0.721

Hallucinations

0.718

0.680

0.681

0.705

Agitation/aggression

0.706

0.673

0.676

0.692

Depression/dysphoria

0.753

0.735

0.728

0.737

Anxiety

0.765

0.738

0.728

0.757

Elation/euphoria

0.767

0.733

0.735

0.746

Apathy/indifference

0.757

0.733

0.724

0.740

Disinhibition

0.756

0.716

0.724

Irritability/lability

0.732

0.704

0.703

0.754

Aberrant motor behavior

0.765

0.732

0.749

Total

0.766

0.737

0.734

0.755

**Table 5.** Test-Retest Reliability
NPI domains	FxS ICC (95% CI)	Distress ICC (95% CI)
ICC: intraclass correlation coefficient; CI: confidence interval.
Delusions	0.936 (0.860, 0.971)	0.958 (0.908, 0.981)
Hallucinations	0.897 (0.780, 0.953)	0.882 (0.750, 0.946)
Agitation/aggression	0.799 (0.596, 0.906)	0.818 (0.630, 0.916)
Depression/dysphoria	0.728 (0.473, 0.870)	0.699 (0.427, 0.855)
Anxiety	0.670 (0.381, 0.840)	0.508 (0.149, 0.749)
Elation/euphoria	0.600 (0.276, 0.802)	0.923 (0.834, 0.965)
Apathy/indifference	0.691 (0.415, 0.851)	0.621 (0.307, 0.813)
Disinhibition	0.296 (-0.104, 0.614)	0.531 (0.179, 0.762)
Irritability/lability	0.524 (0.170, 0.758)	0.542 (0.195, 0.768)
Aberrant motor behavior	0.976 (0.946, 0.989)	1.000 (1.000, 1.000)
Total	0.909 (0.804, 0.959)	0.890 (0.766, 0.950)
Sleep/nighttime behavior disorders	0.650 (0.350, 0.829)	0.741 (0.496, 0.877)
Appetite and eating changes	0.607 (0.286, 0.805)	0.648 (0.347, 0.828)

Table 5. Test-Retest Reliability

NPI domains

FxS ICC (95% CI)

Distress ICC (95% CI)

ICC: intraclass correlation coefficient; CI: confidence interval.

Delusions

0.936 (0.860, 0.971)

0.958 (0.908, 0.981)

Hallucinations

0.897 (0.780, 0.953)

0.882 (0.750, 0.946)

Agitation/aggression

0.799 (0.596, 0.906)

0.818 (0.630, 0.916)

Depression/dysphoria

0.728 (0.473, 0.870)

0.699 (0.427, 0.855)

Anxiety

0.670 (0.381, 0.840)

0.508 (0.149, 0.749)

Elation/euphoria

0.600 (0.276, 0.802)

0.923 (0.834, 0.965)

Apathy/indifference

0.691 (0.415, 0.851)

0.621 (0.307, 0.813)

Disinhibition

0.296 (-0.104, 0.614)

0.531 (0.179, 0.762)

Irritability/lability

0.524 (0.170, 0.758)

0.542 (0.195, 0.768)

Aberrant motor behavior

0.976 (0.946, 0.989)

1.000 (1.000, 1.000)

Total

0.909 (0.804, 0.959)

0.890 (0.766, 0.950)

Sleep/nighttime behavior disorders

0.650 (0.350, 0.829)

0.741 (0.496, 0.877)

Appetite and eating changes

0.607 (0.286, 0.805)

0.648 (0.347, 0.828)