Kørner Alex, Brogaard Anette, Wissum Irene, Petersen Ulla
Department of Geriatric Psychiatry, Psychiatric Centre North Zealand, Dyrehavevej 48, DK-3400 Hilleroed, Denmark.
Nord J Psychiatry. 2012 Jun;66(3):198-202. doi: 10.3109/08039488.2011.614959. Epub 2011 Oct 13.
An instrument of assessing the cognitive status of the severely demented is needed.
To validate the Danish version of the cognitive part of the Baylor Profound Mental State Examination (BPMSE-cog).
Participants were residents in dementia care units. The Mini-Mental State Examination (MMSE), the Severe Impairment Battery (SIB), the Geriatric Deterioration Scale (GDS) and the Disability Assessment of Dementia (DAD) were co-administered. Three assessments were performed: at baseline, 1 week and 6 months later. At visits 1 and 3, participants were assessed blinded by a geriatric psychiatrist (GDS, MMSE and diagnosis) and by a registered nurse (BPMSE-cog, SIB, DAD). At visit 2, assessments were made by the RN only. Test-retest and inter-rater reliabilities were calculated. External validity was assessed in terms of correlation to MMSE, SIB, GDS and DAD; internal validity was assessed using Cronbach's alpha, Mokken/Loevinger coefficients and the item response analysis.
Inter-rater reliability and test-retest reliability were very high for total scale as well as for the subscales. The external validity was satisfactory with correlation coefficients: MMSE: 0.74; SIB: 0.89; the GDS 0.83; DAD: 0.67 (P < 0.001). Results further indicate that there is a ceiling but no floor effect of the BPMSE-cog. The internal validity was highly satisfactory demonstrating sufficient internal consistency and homogeneity of the scale. The item response analysis showed an even distribution of the 25 items.
The BPMSE-cog is a very stable and strong scale and is recommended as a severity measurement for the cognitive performance of patients suffering from severe dementia.
需要一种评估重度痴呆患者认知状态的工具。
验证贝勒深度精神状态检查（BPMSE）认知部分丹麦语版本的有效性。
参与者为痴呆症护理病房的居民。同时进行简易精神状态检查表（MMSE）、严重损害量表（SIB）、老年衰退量表（GDS）和痴呆症残疾评估（DAD）。共进行了三次评估：基线时、1周后和6个月后。在第1次和第3次就诊时，由老年精神科医生（GDS、MMSE和诊断）和注册护士（BPMSE认知部分、SIB、DAD）对参与者进行盲法评估。在第2次就诊时，仅由注册护士进行评估。计算重测信度和评分者间信度。通过与MMSE、SIB、GDS和DAD的相关性评估外部效度；使用克朗巴赫α系数、莫肯/洛温格系数和项目反应分析评估内部效度。
总量表及各分量表的评分者间信度和重测信度都非常高。外部效度令人满意，相关系数分别为：MMSE：0.74；SIB：0.89；GDS：0.83；DAD：0.67（P<0.001）。结果进一步表明，BPMSE认知部分存在天花板效应但不存在地板效应。内部效度非常令人满意，表明该量表具有足够的内部一致性和同质性。项目反应分析显示25个项目分布均匀。
BPMSE认知部分是一个非常稳定且有效的量表，推荐作为重度痴呆患者认知表现的严重程度测量工具。
