Abstract
Aggressive behaviour is the most disturbing and distressing behaviour displayed by elderly people. The prevalence of aggressive behaviour is around 50% among psychogeriatric patients.OBJECTIVEThis study sought to analyze the psychometric properties and diagnostic accuracy of the French version of the Rating Scale for Aggressive Behaviour in the Elderly (F-RAGE).METHODSThe F-RAGE was administered to 79 patients hospitalized in a geriatric psychiatry department. A psychiatrist, who was blind to the subjects' RAGE scores, performed the diagnosis for aggressivity based on global clinical impression. The F-RAGE and MMSE were applied by a trained researcher blind to subjects' clinical diagnoses while the Cohen-Mansfield Agitation Inventory and Neuropsychiatric Inventory were administered by medical and nursing staff. Internal consistency, reliability, cut-off points, sensitivity and specificity for F-RAGE were estimated.RESULTSF-RAGE showed satisfactory validity and reliability measurements. Regarding reliability, Cronbach's α coefficient was satisfactory with a value of 0.758. For diagnostic accuracy, a cut-off point of 8 points (sensitivity=74.19%; specificity=97.98%) and area under curve of 0.960 were estimated to distinguish between aggressive patients and control subjects.DISCUSSIONF-RAGE showed acceptable psychometric properties, supported by evidence of validity and reliability for its use in the diagnosis of aggressive behaviour in elderly.
Highlights
Aggressive behaviour (AB) is the most disturbing and distressing behaviour displayed by older patients in long-term care facilities or in psychogeriatric units
The F-RAGE and Mini-Mental State Examination (MMSE) were applied by a trained researcher blind to subjects’ clinical diagnoses while the Cohen-Mansfield Agitation Inventory and Neuropsychiatric Inventory were administered by medical and nursing staff
The average MMSE score was 17.9±7.1 (2-30) (Table 1) and 36 subjects had been diagnosed as suffering from dementia according to DSM-IV-TR
Summary
Aggressive behaviour (AB) is the most disturbing and distressing behaviour displayed by older patients in long-term care facilities or in psychogeriatric units. Patel and Hope[1] defined AB as an overt act, involving the delivery of noxious stimuli to (but not necessarily aimed at) another object, organism or self, which is clearly not accidental It affects older patients themselves and their informal and formal caregivers. Dementia is the leading cause of disruptive behaviours and Alzheimer’s disease accounts for 60%-80% of such cases in the elderly.[3] Male gender and being in the younger strata of the older adult population are individual factors associated with AB. Psychiatric diseases such as depression, schizophrenia, anxiety, hallucination and delusion have been linked to AB.[2,5]
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