Document Type
Article
Publication Title
Current medical research and opinion
Abstract
OBJECTIVE: Although agitation is a common neuropsychiatric symptom in Alzheimer's dementia, it can be challenging to recognize and diagnose. Caregivers of individuals with Alzheimer's dementia are often the first to encounter agitation behaviors but may struggle to recognize and communicate symptoms to healthcare professionals (HCPs). Here, we describe the development and evaluation of the Agitation in Alzheimer's Screener for Caregivers (AASC), a practical screening tool to identify agitation symptoms and facilitate caregiver-HCP communication.
METHODS: The AASC was developed based on the International Psychogeriatric Association (IPA) criteria for agitation in cognitive disorders, input from multidisciplinary experts, and qualitative interviews with caregivers of patients with Alzheimer's dementia. Thereafter, a 2-phase quantitative evaluation study was conducted to refine the AASC and assess the predictive validity of the final tool against IPA criteria. Data were collected from caregiver-HCP dyads, where caregivers completed the AASC and HCPs used IPA criteria to inform their assessment of agitation.
RESULTS: A total of 226 caregiver-HCP dyads were quantitatively evaluated. The mean age of caregivers was 61 years; many were spouses/partners (46%), White (60%), and female (62%), providing an average of 60 h of care weekly (range: 9-168 h). Following initial assessment and refinement, the final AASC, evaluated in a subset of 105 dyads, showed a 73.3% agreement with IPA criteria, with sensitivity of 0.77, specificity of 0.70, and kappa and F1 scores of 0.47 and 0.71, respectively. Most patients were classified as having mild (41%) to moderate (37%) Alzheimer's dementia, while 22% had severe disease.
CONCLUSION: The AASC is a reliable, easy-to-use, 2-item screener for the presence and impact of agitation, in agreement with IPA criteria. The AASC supports caregivers and HCPs by providing an accessible framework for recognizing agitation throughout all stages of Alzheimer's dementia and prompting comprehensive assessment for diagnosis and appropriate treatment planning.
First Page
1
Last Page
13
DOI
10.1080/03007995.2025.2606562
Publication Date
12-24-2025
Recommended Citation
Clevenger C, Jackson WC, Stroud J, Brubaker M, Patel M, Bucior I, Bratlee-Whitaker E, Brown TM, Fehnel S, Peschin S, Cummings J, Grossberg G. Development and evaluation of the agitation in Alzheimer's screener for caregivers (AASC): a clinical tool to screen for agitation. Curr Med Res Opin. 2025 Dec 24:1-13. doi: 10.1080/03007995.2025.2606562. Epub ahead of print. PMID: 41441560.