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Neuropsychiatric Inventory - Clinician Version (NPI-C)
Copyright belongs to Jeffrey L. Cummings, MD. For additional information and test materials, visit: Neuropsychiatric Inventory-Clinician NPI-C©
Non-funded academic research: if the project is not explicitly funded, but funding comes from overall departmental funds, from the University or individual funds then fees are waived. Funded academic research, including projects receiving funding from commerce, government, EU, and commercial studies (industry, CRO, any for-profit companies) should contact Dr. Cummings via MAPI Research Trust, to negotiate fees.
Exploratory: Amyotrophic Lateral Sclerosis (ALS)
Short Description of Instrument
Construct measured: Psychopathology in dementia
Generic vs. disease specific: Generic
Means of administration: Caregiver self-report form
Intended respondent: Caregiver  
#  of items: 14 domains measured, with varying numbers of questions to measure them
# of subscales and names of sub-scales: No subscales  
# of items per sub-scale: N/A
Purpose of Tool: Screening  
Used in: This recently developed tool has not yet been used in clinical trials.  
Administration time: 10-45 minutes
Background: The NPI-C uses more specific ratings for each item within a domain, allowing for ratings for frequency, severity and distress to be calculated individually and summed to create a total domain score. This scoring system allows for more sensitivity, to track symptom change across time.   
The NPI-C involves the adoption of an expert clinical rating system using a "LEAD" standard (longitudinal data, expert rater, all data). Using this system, the rater interviews the caregiver (as in the original NPI), then interviews the patient, to compare caregiver insights with patient's perceptions. The clinician uses additional data, including chart reviews and other caregiver interviews, interpreting these data using clinical judgment.  
The NPI-C is translated into French, Greek, Hungarian, Italian, Portuguese, and Spanish, to facilitate international collaboration.  
Strengths:  This scale allows expert clinicians to incorporate data from all sources, generating better validity by reducing caregiver bias. It has been widely translated, making it a likely tool to be used in multi-center clinical trials.
Weaknesses:  Caregiver ratings can be biased due to misinterpretation of complex clinical syndromes that are not in the common lexicon (e.g. .delusions, hallucinations, apathy). The measure does not specifically adjust for motor neuron disease, so the confounds of motor weakness, dysarthria, and fatigue complicate item ratings. More staff resources are used with the NPI-C because of the expert rater (LEAD) system. Copyright fees will likely apply for funded research projects.
Psychometric Properties
Feasibility: The measure is rather simple to administer, instructing caregivers to rate each domain. Interviews are then conducted with patients and chart reviews are conducted.
Reliability: Inter-rater reliability was generally strong to moderate.
Validity: Correlations for all NPI-C domains were moderate to strong, when convergent validity was tested with outside measures.
Sensitivity to Change: Unknown.
Relationships to other variables: Unknown.
The NPI-C includes 2 domains not included in the NPI. Scoring for the NPI-C was revised to measure an additional 2 domains, based upon prevalence data suggesting that agitation and anger should be separated into two distinct categories, and adding "aberrant vocalization" to the domain list.
de Medeiros K, Robert P, Gauthier S, Stella F, Politis A, Leoutsakos J, Taragano F, Kremer J, Brugnolo A, Porsteinsson AP, Geda YE, Brodaty H, Gazdag G, Cummings J, Lyketsos C. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia. Int Psychogeriatr. 2010;22(6):984-994.
Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, Lopez OL, DeKosky ST. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci. 2000;12(2):233-239.


Document last updated July 2018