Inconclusiveness of psychometric testing of medication adherence questionnaires.

PURPOSE: To propose a paradigm change for the validation procedures of medication adherence questionnaires. METHODS: A total of 121 validation procedures of unique questionnaires for medication adherence were analyzed. RESULTS: "Construct validity" and "internal consistency" were most often assessed, and test results varied largely. A more in-depth analysis indicated that the assessment of medication non-adherence included distinct but related constructs, such as the extent to which doses are missed, and the attempt to identify different facets of medication-taking behavior. Consequently, each construct requires a different measurement approach with different psychometric tests for establishing its validity and reliability. CONCLUSION: Results show that assessing the validity and reliability of adherence questionnaires with standard procedures including statistical tests is inconclusive. Refinement of the constructs of non-adherence is needed in pharmacy and medical practice. We suggest a distinction between the (i) extent of missed doses over the past 2 weeks, (ii) modifiable reasons for non-adherence behavior, and (iii) unmodifiable factors of non-adherence. Validation procedures and corresponding statistical methods should be selected according to the specific single constructs.

Clinical characteristics of dementia associated with argyrophilic grain disease.

BACKGROUND/AIMS: We aimed at characterizing the clinical features of dementia associated with argyrophilic grain disease (AgD). METHODS: Relatives or close friends of 24 individuals with autopsy-confirmed AgD and 29 patients with autopsy-confirmed Alzheimer's disease (AD) were administered a novel Retrospective Dementia Inventory to assess the cognitive, behavioral and affective symptoms of the deceased patients. RESULTS: AgD patients showed less severe impairments in memory, language, attention and executive function than AD patients. CONCLUSION: Compared to AD patients, individuals suffering from AgD appear to present with comparable deficits in behavior and affect but relatively spared cognitive functioning.