ORIGINAL RESEARCH article
Front. Dement.
Sec. Dementia Care
Volume 4 - 2025 | doi: 10.3389/frdem.2025.1607566
Physician and professional caregiver perspectives on meaningful change to agitation behaviors in Alzheimer's dementia: Insights from qualitative interviews
Provisionally accepted
- 1OPEN Health, Hingham, MA, United States
- 2Lundbeck LLC, Deerfield, IL, United States
- 3Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, United States
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Background: Agitation is a common neuropsychiatric symptom of Alzheimer’s dementia. Limited qualitative evidence is available to characterize the clinical meaningfulness of changes in agitation behaviors as assessed by the Cohen-Mansfield Agitation Inventory (CMAI). Objective: To collect qualitative data to characterize the magnitude of change in CMAI scores required to represent a clinically meaningful improvement in agitation behaviors from the perspectives of physicians and professional caregivers. Methods: One-on-one qualitative interviews were conducted with 15 Alzheimer’s dementia-treating physicians and 15 professional caregivers. Nine patient vignettes depicting observed changes in CMAI score profiles over a 12-week study period were used as examples of different magnitudes of change in the CMAI total score. Results: The proportion of participants affirming clinical meaningfulness varied for both physicians and caregivers within and across the 9 vignettes presented, however the 4 vignettes corresponding to a CMAI total score reduction of 14 or greater were considered clinically meaningful to all participants. Most physicians (8/13) and caregivers (7/13) found a total score reduction of 5 to be clinically meaningful, and some participants (2 caregivers; 0 physicians) articulated that even minimal changes could be clinically meaningful depending on the type of behavior. Conclusion: Participants who regularly treat people with Alzheimer’s dementia describe significant burden associated with agitation behaviors and provided qualitative examples highlighting that even minor reductions in the frequency of such behaviors can have meaningful benefits for the patient’s care and the burden on professional caregivers and family members.
Keywords: dementia due to Alzheimer's disease, agitation, Neuropsychiatric symptoms, Cohen-Mansfield agitation inventory, vignettes 2, Alzheimer's disease
Received: 07 Apr 2025; Accepted: 19 Aug 2025.
Copyright: © 2025 Smith, Talon, Martinez, McCarrier and Aggarwal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jessica Smith, OPEN Health, Hingham, MA, United States
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