Abstract
Previous publications have shown a high diagnostic sensitivity and specificity of three short clinical rating scales for Alzheimer's disease (AD), frontotemporal dementia (FTD), and vascular dementia (VaD) validated against neuropathological (NP) diagnoses. In this study, the aim was to perform an exploratory factor analysis of the items in these clinical rating scales. The study included 190 patients with postmortem diagnoses of AD (n = 74), VaD (n = 33), mixed AD/VaD (n = 31), or FTD (n = 52). The factor analysis produced three strong factors. Factor 1 contained items describing cerebrovascular disease, similar to the Hachinski Ischemic Score. Factor 2 enclosed major clinical characteristics of FTD, and factor 3 showed a striking similarity to the AD scale. A fourth symptom cluster was described by perception and expression of emotions. The factor analyses strongly support the construct validity of the diagnostic rating scales.
Highlights
Dementia is a clinical syndrome with a marked variety of aetiology, clinical profile, severity, and clinical course
Petrovic et al [5] identified four symptom clusters based on factor analysis of the Neuropsychiatric Inventory (NPI) in patients with dementia: psychosis, psychomotor, mood liability, and instinctual factors
Another factor analysis of ten NPI items in probable Alzheimer’s disease (AD) resulted in three subsyndromes: mood, psychotic, and frontal [6], and a factor analysis of the 12 item NPI showed the presence of four behavioural subsyndromes called hyperactivity, psychosis, affective symptoms, and apathy [7]
Summary
Dementia is a clinical syndrome with a marked variety of aetiology, clinical profile, severity, and clinical course. Factor analysis of 16 symptoms of the Brief Psychiatric Rating Scale (BPRS) in 87 geropsychiatric patients resulted in five clinical dimensions: withdrawn depression, agitation, cognitive dysfunction, hostile suspiciousness, and psychotic distortion [4]. Petrovic et al [5] identified four symptom clusters based on factor analysis of the Neuropsychiatric Inventory (NPI) in patients with dementia: psychosis, psychomotor, mood liability, and instinctual factors. Another factor analysis of ten NPI items in probable AD resulted in three subsyndromes: mood, psychotic, and frontal [6], and a factor analysis of the 12 item NPI showed the presence of four behavioural subsyndromes called hyperactivity, psychosis, affective symptoms, and apathy [7]. Factor analysis of the 53 clinical items of the OBS scale revealed three factors
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