A Confirmatory and an Exploratory Factor Analysis of the Cohen-Mansfield Agitation Inventory (CMAI) in a European Case Series of Patients with Dementia: Results from the RECage Study.

CMAI RECage study confirmatory factor analysis exploratory factor analysis new model of scoring

Journal

Brain sciences
ISSN: 2076-3425
Titre abrégé: Brain Sci
Pays: Switzerland
ID NLM: 101598646

Informations de publication

Date de publication:
03 Jul 2023
Historique:
received: 12 06 2023
revised: 29 06 2023
accepted: 30 06 2023
medline: 29 7 2023
pubmed: 29 7 2023
entrez: 29 7 2023
Statut: epublish

Résumé

One of the most widely used instruments for assessing agitation in dementia patients is the Cohen-Mansfield Agitation Inventory (CMAI), nevertheless no global score has been proposed. The aim of this study is: (a) to conduct a confirmatory (CFA) and exploratory factor analysis (EFA) of CMAI on people with dementia and Psychological and Behavioral Symptoms (BPSD), and (b) to propose an alternative structure, based on clinical criteria including all CMAI items. Confirmatory and exploratory factor analyses were carried out on the CMAI 29 items administered at baseline to 505 patients with dementia (PwD) and BPSD enrolled in the international observational RECage study. The three-factor structure has not been confirmed by the CFA, whilst the EFA was carried out respectively on 25 items disregarding 4 items with a prevalence ≤5% and then on 20 items disregarding 9 items with a prevalence ≤10%. The four-factor structure explaining 56% of the variance comprised Physically Aggressive behavior, Verbally Aggressive behavior, Physically non-aggressive behavior, and Physically and verbally aggressive behavior. A new grouping of all items according to a clinical criterion is proposed, allowing for a more sensible evaluation of the symptoms leading to better differentiation.

Sections du résumé

BACKGROUND BACKGROUND
One of the most widely used instruments for assessing agitation in dementia patients is the Cohen-Mansfield Agitation Inventory (CMAI), nevertheless no global score has been proposed. The aim of this study is: (a) to conduct a confirmatory (CFA) and exploratory factor analysis (EFA) of CMAI on people with dementia and Psychological and Behavioral Symptoms (BPSD), and (b) to propose an alternative structure, based on clinical criteria including all CMAI items.
METHODS METHODS
Confirmatory and exploratory factor analyses were carried out on the CMAI 29 items administered at baseline to 505 patients with dementia (PwD) and BPSD enrolled in the international observational RECage study.
RESULTS RESULTS
The three-factor structure has not been confirmed by the CFA, whilst the EFA was carried out respectively on 25 items disregarding 4 items with a prevalence ≤5% and then on 20 items disregarding 9 items with a prevalence ≤10%. The four-factor structure explaining 56% of the variance comprised Physically Aggressive behavior, Verbally Aggressive behavior, Physically non-aggressive behavior, and Physically and verbally aggressive behavior.
CONCLUSIONS CONCLUSIONS
A new grouping of all items according to a clinical criterion is proposed, allowing for a more sensible evaluation of the symptoms leading to better differentiation.

Identifiants

pubmed: 37508955
pii: brainsci13071025
doi: 10.3390/brainsci13071025
pmc: PMC10376951
pii:
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : European Commission
ID : No 779237

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Auteurs

Bruno Mario Cesana (BM)

Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro" Faculty of Medicine and Surgery, University of Milan, 20122 Milan, Italy.

Eleni Poptsi (E)

Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece.
Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece.

Magda Tsolaki (M)

Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece.
1st Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece.

Sverre Bergh (S)

Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, 2313 Ottestad, Norway.
Norwegian National Centre for Aging and Health, Sykehuset i Vestfold, 3103 Tønsberg, Norway.

Alfonso Ciccone (A)

Department of Neurology with Neurosurgical Activity "Carlo Poma" Hospital, ASST di Mantova, 46100 Mantua, Italy.

Emmanuel Cognat (E)

Cognitive Neurology Centre, Lariboisière-Fernand Widal Hospital GHU AP-HP Nord, 75010 Paris, France.

Andrea Fabbo (A)

Geriatric Service-Cognitive Disorders and Dementia, Department of Primary Care, Local Health Authority of Modena (AUSL), 41124 Modena, Italy.

Sara Fascendini (S)

FERB Alzheimer Centre, 24025 Gazzaniga, Italy.

Giovanni B Frisoni (GB)

Division of Geriatrics and Rehabilitation, University Hospitals of Geneva, 1205 Geneva, Switzerland.

Lutz Frölich (L)

Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany.

Maria Cristina Jori (MC)

Mediolanum Cardio Research, 20123 Milan, Italy.

Patrizia Mecocci (P)

Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Division of Clinical Geriatrics, NVS Department, Karolinska Institutet Stockholm, 17177 Stockholm, Sweden.

Paola Merlo (P)

Neurological Unit (PM), U.V.A. Centre, Humanitas Gavazzeni, 24125 Bergamo, Italy.

Oliver Peters (O)

Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, 12203 Berlin, Germany.

Carlo Alberto Defanti (CA)

FERB Alzheimer Centre, 24025 Gazzaniga, Italy.

Classifications MeSH