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Int Psychogeriatr. 2015 Jan;27(1):7-17. doi: 10.1017/S1041610214001963. Epub 2014 Oct 14.

Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition.

Author information

1
Cleveland Clinic Lou Ruvo Center for Brain Health,Las Vegas,Nevada,USA.
2
Roper St. Francis Hospital,The Clinical Biotechnology Research Institute,South Carolina,USA.
3
Centre for Health Brain Ageing,The University of New South Wales,Sydney,New South Wales,Australia.
4
Mount Sinai School of Medicine,New York,New York,USA.
5
Brighton and Sussex Medical School,Trafford Centre for Medical Research,University of Sussex,Brighton,East Sussex,UK.
6
New York State Psychiatric Institute,Riverside Drive,New York,New York,USA.
7
McGill Center for Studies in Aging,Douglas Mental Health University Institute Montreal,Montreal,Quebec,Canada.
8
Institute of Psychiatry,King's College of London,London,UK.
9
Sunnybrook Research Institute,University of Toronto,Toronto,Ontario,Canada.
10
The Johns Hopkins Memory and Alzheimer's Treatment Center,The Johns Hopkins Bayview Medical Center,Baltimore,Maryland,USA.
11
VA Puget Sound Health Care System,Columbian Way,Seattle,Washington,USA.
12
Monroe Community Hospital,Rochester,New York,USA.
13
Department of Neuroscience,Hospital Julio Mendez,University of Buenos Aires,Buenos Aires,Argentina.
14
CHDI Foundation,Princeton,New Jersey,USA.
15
Department of Psychiatry,University of Connecticut Health Center,Farmington,Connecticut,USA.
16
Alzheimer's Disease International,London,UK.

Abstract

BACKGROUND:

Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. There is no consensus definition of agitation and no widespread agreement on what elements should be included in the syndrome. The International Psychogeriatric Association formed an Agitation Definition Work Group (ADWG) to develop a provisional consensus definition of agitation in patients with cognitive disorders that can be applied in epidemiologic, non-interventional clinical, pharmacologic, non-pharmacologic interventional, and neurobiological studies. A consensus definition will facilitate communication and cross-study comparison and may have regulatory applications in drug development programs.

METHODS:

The ADWG developed a transparent process using a combination of electronic, face-to-face, and survey-based strategies to develop a consensus based on agreement of a majority of participants. Nine-hundred twenty-eight respondents participated in the different phases of the process.

RESULTS:

Agitation was defined broadly as: (1) occurring in patients with a cognitive impairment or dementia syndrome; (2) exhibiting behavior consistent with emotional distress; (3) manifesting excessive motor activity, verbal aggression, or physical aggression; and (4) evidencing behaviors that cause excess disability and are not solely attributable to another disorder (psychiatric, medical, or substance-related). A majority of the respondents rated all surveyed elements of the definition as "strongly agree" or "somewhat agree" (68-88% across elements). A majority of the respondents agreed that the definition is appropriate for clinical and research applications.

CONCLUSIONS:

A provisional consensus definition of agitation has been developed. This definition can be used to advance interventional and non-interventional research of agitation in patients with cognitive impairment.

PMID:
25311499
PMCID:
PMC4301197
DOI:
10.1017/S1041610214001963
[Indexed for MEDLINE]
Free PMC Article

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