Cut-Point Definition of Agitation

Objective: The goals of this study are to examine the use of the Cohen-Mansfield Agitation Inventory (CMAI) using several cut-points, and to describe the distribution of agitated behaviors in a community dwelling dementia population. Methods: The study consisted of a one-time interview with 99 community-dwelling dementia patient and caregiver dyads. We described the distribution of the 29 items of the CMAI and its three previously validated subscales: physically agitated aggressive behavior, physically nonaggressive agitated behavior, and verbally agitated behavior, as well as a fourth subscale of total aggression, which we created. Three different cut-points: (2,2), (3,3), and (4,4), representing both frequency and disruptiveness ratings, were compared. Results: The study showed that with a cut-point of (2,2), 57% of the patients displayed at least one aggressive trait, 19% were physically aggressive, 40% were agitated, 51% were verbally aggressive, and 33% were part of the total aggression subscale. With a cut-point of (3,3), 47% of the patients displayed at least one aggressive trait, 10% were physically aggressive, 26% were agitated, 37% were verbally aggressive, and 19% were part of the total aggression subscale. Finally, with a cut-point of (4,4), 31% of the patients displayed at least one aggressive trait, 10% were physically aggressive, 14% were agitated, 19% were verbally aggressive, and 16% were part of the total aggression subscale. Conclusion: This study provides data on the frequency and severity of agitation in dementia patients. Furthermore, it offers cut-points that can potentially aid clinicians and researchers to better assess and treat patients with dementia and agitation.