Reliability And Validity Of The Chinese Version Of The Cohen-Mansfield Agitation Inventory Scale In Patients With Dementia

Objective : The purpose of this study is to develop the Chinese version of Cohen-Mansfield Agitation Inventory(CMAI)based on the original CMAI under the unique cultural background and environment in China,determine whether the items in the new scale are consistent with the latest definition developed by the International Association of Geriatric Psychiatry in 2013,and test the reliability and validity of the developed Chinese version of CMAI.Methods:We recruited 60 outpatients/caregivers who met the criteria for the diagnosis of dementia in the Department of Neurology in the 1st affiliated Hospital of China Medical University from January 2016 to October 2017.The cognitive function was assessed with the Mini-Mental State Examination(MMSE).At the same time,The developed Chinese version of CMAI and Neuropsychiatric inventory(NPI)were administered to the caregivers of 60 subjects with dementia.We evaluated the reliability of the Chinese version of CMAI by calculating the Cronbach’s coefficient.the test-retest reliability and the interrater reliability.Exploratory factor analysis was used to examine the construct validity of.the new scale.Spearman rankings were used to compare the correlation between the new and original CMAI scales with the aggressive / aggressive domains and abnormal behavior domains in the NPI.Results:60 patients/caregivers were selected to the final analysis,including 22 males and38 females.The average age of the males is 69.79±7.96 years old,the average age of females is 69.79±8.91 years old.The average MMSE score is 17.08±5.37 and the average score of developed Chinese version of CMAI is 47.08±19.74.81.6% of the patients showed at least one agitation symptom within 2 weeks and mostly were verbally agitated behaviors and physically nonaggressive behaviors.The symptoms with the highest incidence were repetitive sentences or questions(63.3%),general restlessness(43.3%),paces,aimless wandering(43.3%).Reliability analysis:The test-retest reliability of the total developed Chinese version of CMAI score is 0.898.The inter-rater reliability is 0.903,and the Cronbach’s alpha coefficient of the scale is 0.922,which demonstrated substantially high levels ofreliabilities.Validity analysis : Factor analysis identified five factors which includes: physically aggressive behaviors,physically nonaggressive behaviors,verbally agitated behaviors,psychic factor and hiding/hoarding.Conclusion:Dementia patients with agitation symptoms in the department of Neurology usually have the characteristics as following:1)most of them lived in communities rather than institutions 2)A large number of patients in the department of Neurology were in a state of mild to moderate dementia;3)The incidence of physically nonaggressive behaviors and verbally agitated behaviors were higher than others.4)The developed Chinese version of CMAI was found to be a reliable and valid instrument for evaluating agitation and the improvement of agitation symptoms before and after intervention for patients.