Skip to main content

ORIGINAL RESEARCH article

Front. Neurol.
Sec. Dementia and Neurodegenerative Diseases
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1455787

Italian standardization of the BPSD-SINDEM scale for the assessment of neuropsychiatric symptoms in persons with dementia

Provisionally accepted
Federico Emanuele Pozzi Federico Emanuele Pozzi 1Fabrizia D'Antonio Fabrizia D'Antonio 2*Marta Ada Zuffi Marta Ada Zuffi 3Oriana Pelati Oriana Pelati 3Davide Vernè Davide Vernè 4Massimiliano Panigutti Massimiliano Panigutti 5Margherita Alberoni Margherita Alberoni 4Maria G. Di Maggio Maria G. Di Maggio 6Alfredo Costa Alfredo Costa 7Lucio Tremolizzo Lucio Tremolizzo 1Elisabetta Farina Elisabetta Farina 4
  • 1 IRCCS San Gerardo dei Tintori Foundation, Monza, Italy
  • 2 Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
  • 3 Neurology Department, MultiMedica Castellanza, Italy, Castellanza, Italy
  • 4 Fondazione Don Carlo Gnocchi Onlus (IRCCS), Milan, Lombardy, Italy
  • 5 Sapienza University of Rome, Rome, Lazio, Italy
  • 6 Other, Lecco, Italy
  • 7 Unit of Behavioral Neurology, Neurological Institute Foundation Casimiro Mondino (IRCCS), Pavia, Lombardy, Italy

The final, formatted version of the article will be published soon.

    Introduction: Behavioral and Psychological Symptoms of Dementia (BPSD) are a heterogeneous set of psychological reactions and abnormal behaviors in people with dementia (PwD). Current assessment tools, like the Neuropsychiatric Inventory (NPI), only rely on caregiver assessment of BPSD, and are therefore prone to bias.A multidisciplinary team developed the BPSD-SINDEM scale as a threepart instrument, with two questionnaires administered to the caregiver (evaluating BPSD extent and caregiver distress) and a clinician-rated observational scale. This first instrument was tested on a sample of 33 dyads of PwD and their caregivers, and the results were qualitatively appraised in order to revise the tool through a modified Delphi method. During this phase the wording of the questions was slightly changed, and the distress scale was changed into a coping scale based on the high correlation of extent and distress (r=0.94). The final version consisted of three 17-item subscales, evaluating BPSD extent and caregiver coping, and the unchanged clinician-rated observational scale.Results: This tool was quantitatively validated in a sample of 208 dyads. It demonstrated good concurrent validity, with the extent subscale correlating positively with NPI scores (r=0.64, p<0.001) and the coping subscale inversely correlating with NPI-distress (r=-0.20, p=0.004).Diagnosis (Lewy Body Dementia, Frontotemporal Dementia), medication (antidepressants, antipsychotics), caregiver and PwD age predicted BPSD burden on the BPSD-SINDEM scales.Caregiver coping was influenced by diagnosis (Alzheimer's and Lewy Body Dementia) and benzodiazepine.Discussion: The BPSD-SINDEM scale offers a more comprehensive approach compared to NPI, by combining caregiver ratings with clinician observations. The scale's design allows for rapid administration in diverse clinical contexts, with the potential to enhance the understanding and management of BPSD.

    Keywords: BPSD, Dementia, Alzheimer's disease, Psychometric, Neuropsychiatric inventory

    Received: 28 Jun 2024; Accepted: 01 Nov 2024.

    Copyright: © 2024 Pozzi, D'Antonio, Zuffi, Pelati, Vernè, Panigutti, Alberoni, Di Maggio, Costa, Tremolizzo and Farina. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fabrizia D'Antonio, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.