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Title: The merits and problems of Neuropsychiatric Inventory as an assessment tool in people with dementia and other neurological disorders
Authors: Lai, CKY 
Keywords: Measurement
Neuropsychiatric symptoms
Outcome assessment
Issue Date: 2014
Publisher: Dove Medical Press
Source: Clinical interventions in aging, 2014, v. 9, p. 1051-1061 How to cite?
Journal: Clinical interventions in aging 
Abstract: Objective: The Neuropsychiatric Inventory (NPI) is one of the most commonly used -assessment scales for assessing symptoms in people with dementia and other neurological disorders. This paper analyzes its conceptual framework, measurement mode, psychometric properties, and merits and problems.
Method: All articles discussing the psychometric properties and factor structure of the NPI were searched for in Medline via Ovid. The abstracts of these papers were read to determine their relevance to the purpose of this paper. If deemed appropriate, a full paper was then obtained and read.
Results: The NPI has reasonably good content validity and internal consistency, and good test-retest and interrater reliability. There is limited information about its sensitivity, specificity, positive and negative predictive values, and, in particular, responsiveness. Merits of the NPI include being comprehensive, avoiding symptom overlap, ease of use, and flexibility. It has problems in scoring (no multiples of 5, 7, and 11) and, therefore, analysis using parametric tests may not be appropriate. The use of individual subscales also warrants further investigation.
Conclusion: In terms of its content and concurrent validity, intra- and interrater reliability, test-retest reliability, and internal consistency, the NPI can be considered as valid and reliable, and can be used across different ethnic groups. The tool is most likely unable to deliver as good a performance in terms of discriminating between different disorders. More studies are required to further evaluate its psychometric properties, particularly in the areas of factor structure and responsiveness. The clinical utility of the NPI also needs to be further explored.
ISSN: 1176-9092
EISSN: 1178-1998
DOI: 10.2147/CIA.S63504
Rights: © 2014 Lai. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at:
The following publication Lai, C. K. Y. (2014). The merits and problems of Neuropsychiatric Inventory as an assessment tool in people with dementia and other neurological disorders. Clinical Interventions in Aging, 9, 1051-1061 is available at
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