Assessments for NCSD

Last updated on 15/05/2023

Assessing the non-cognitive symptoms of dementia involves looking at different changes in behaviour, emotions, and mental health. These symptoms can greatly affect a person’s daily life and well-being.

 


Assessing Common Non-Cognitive Symptoms

Here are some common non-cognitive symptoms and how to assess them:

  1. Psychiatric Symptoms:

    • Depression: Look for signs of ongoing sadness, loss of interest in things, changes in appetite or sleep, and feelings of guilt or worthlessness.
    • Anxiety: Watch for excessive worry, restlessness, irritability, trouble sleeping, and physical signs like a racing heart or shortness of breath.
    • Psychosis (Hallucinations or Delusions): Check for false beliefs or perceptions and how they affect the person's behaviour and daily life.
  2. Behavioural Symptoms:

    • Agitation and Aggression: Look for signs of restlessness, verbal or physical aggression, pacing, or disruptive behaviours.
    • Wandering: Observe if the person walks or moves aimlessly, often without a clear purpose or in a dangerous way.
    • Sundowning: Be aware of increased confusion, agitation, or restlessness in the late afternoon or evening.
  3. Sleep Disturbances:

    • Insomnia: Assess if the person has trouble falling asleep, staying asleep, or wakes up too early.
    • Excessive Daytime Sleepiness: Check for tiredness during the day, often leading to frequent naps or dozing off.
  4. Apathy:

    • Look for a lack of motivation or interest in activities and interactions.

 


 

Assessment Approaches for Non-Cognitive Symptoms:

  1. Clinical Interviews: Talk with the person with dementia and their family or caregivers to learn more about the symptoms and how they affect daily life.

  2. Rating Scales: Use standard scales like the Neuropsychiatric Inventory (NPI) or the Behavioural Pathology in Alzheimer's Disease (BEHAVE-AD) to assess how severe and frequent the symptoms are.

  3. Direct Observation: Watch the person’s behaviour in different settings to see if there are any noticeable symptoms or patterns.

  4. Collaboration with Other Healthcare Professionals: Work with specialists, like psychiatrists, geriatricians, or neurologists, for further insight on managing non-cognitive symptoms.

It’s important to note that assessing non-cognitive symptoms requires a healthcare professional with experience in dementia care. This assessment helps create an effective management plan, including medication, non-medical treatments, and support for both the person and their caregivers.


 

 

Detection tools Description
Antecedent-Behaviour-Consequence (ABC) An ABC chart is an observational tool that records details about a behaviour to help understand what it is communicating.
Neuropsychiatric Inventory (NPI) A questionnaire that assesses 12 neuropsychiatric symptoms, usually done through an interview (NPI-NH) or a score sheet (NPI-Q).
Behavioural Symptoms in Alzheimer’s Disease (BEHAVE-AD) A clinical scale to assess six behavioural symptoms, administered by interview.
Resident Assessment Instrument (RAI) A structural assessment tool used for care planning in nursing homes.
Cohen-Mansfield Agitation Inventory (CMAI) A questionnaire that measures 29 types of agitated behaviour on a 7-point Likert scale.