THE BEHAVIOR PATHOLOGY IN ALZHEIMER'S DISEASE RATING SCALE (BEHAVE-AD): RELIABILITY AND ANALYSIS OF SYMPTOM CATEGORY SCORES

Abstract

The interrater reliability of the Behavior Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), a psychiatric rating scale especially designed for the evaluation of behavioral disturbances in dementia patients, was studied in both English-speaking US patients and a French-speaking elderly patient population from France. Additionally, the quantitative relationship between severity of Alzheimer's disease (AD) and mean scores on each of the BEHAVE-AD categories and mean total BEHAVE-AD score was determined in a separate study of 140 patients diagnosed as having probable AD. In both reliability studies significant correlations were obtained for all BEHAVE-AD symptom category scores and for mean total BEHAVE-AD scores. Analysis of BEHAVE-AD scores as a function of disease severity demonstrated a non-linear relationship between severity of behavioral symptoms and the global and cognitive advance of AD. Moreover, score analysis of the BEHAVE-AD indicates that these behavioral disturbances become most severe in the moderate and moderately severe stages of the illness. The results of these studies provide support for the reliability of the BEHAVE-AD. Additionally, the BEHAVE-AD provides basic knowledge about the nature and severity of the behavioral symptoms in AD. The latter information may be useful for the development of appropriate and effective psychopharmacologic intervention strategies for these difficult to manage behaviors. Furthermore, these results have implications for the methodology of pharmacologic trials of putative cognitive-enhancer compounds in AD.