Validation of the Cohen-Mansfield Agitation Inventory Observational (CMAI-O) tool

Abstract

Objectives: Behaviours associated with agitation are common in people living with dementia. The Cohen-Mansfield Agitation Inventory (CMAI) is a 29-item scale widely used to assess agitation completed by a proxy (family carer or staff member). However, proxy informants introduce possible reporting bias when blinding to the treatment arm is not possible, and potential accuracy issues due to irregular contact between the proxy and the person with dementia over the reporting period. An observational measure completed by a blinded researcher may address these issues, but no agitation measures with comparable items exist.Design: Development and validation of an observational version of the CMAI (CMAI-O), to assess its validity as an alternative or complementary measure of agitation.Setting: Fifty care homes in England.Participants: Residents (N = 726) with dementia.Measurements: Two observational measures (CMAI-O and PAS) were completed by an independent researcher. Measures of agitation, functional status, and neuropsychiatric symptoms were completed with staff proxies.Results: The CMAI-O showed adequate internal consistency (α =.61), criterion validity with the PAS (r =.79, p =