Morris J N, Fries B E, Mehr D R, Hawes C, Phillips C, Mor V, Lipsitz L A
Hebrew Rehabilitation Center for Aged, Boston.
J Gerontol. 1994 Jul;49(4):M174-82. doi: 10.1093/geronj/49.4.m174.
Chronic cognitive impairment is a major problem in U.S. nursing homes, yet traditional assessment systems in most facilities included only limited information on cognitive status. Following the Congressional mandate in the Omnibus Reconciliation Act of 1987 (OBRA '87), U.S. nursing homes now complete the Minimum Data Set (MDS), a standardized, comprehensive assessment of each resident's functional, medical, psychosocial, and cognitive status. We designed a Cognitive Performance Scale (CPS) that uses MDS data to assign residents into easily understood cognitive performance categories.
Information was drawn from three data sets, including two multistate data sets constructed for the Health Care Financing Administration. The prevalence and reliability of the MDS cognitive performance variables were established when assessed by trained nursing personnel. Five selected MDS items were combined to create the single, functionally meaningful seven-category hierarchical Cognitive Performance Scale.
The CPS scale corresponded closely with scores generated by the Mini-Mental State Examination and the Test for Severe Impairment, nursing judgments of disorientation, and neurological diagnoses of Alzheimer's disease and other dementias.
The new CPS provides a functional view of cognitive performance, using readily available MDS data. It should prove useful to clinicians and investigators using the MDS to determine a resident's cognitive assets.
慢性认知障碍是美国养老院中的一个主要问题，但大多数机构的传统评估系统仅包含有限的认知状态信息。根据1987年《综合预算协调法案》（OBRA '87）中的国会授权，美国养老院现在要完成最低数据集（MDS），这是对每位居民的功能、医疗、心理社会和认知状态进行的标准化综合评估。我们设计了一种认知表现量表（CPS），该量表利用MDS数据将居民归入易于理解的认知表现类别。
信息取自三个数据集，包括为医疗保健财务管理局构建的两个多州数据集。由经过培训的护理人员进行评估时，确定了MDS认知表现变量的患病率和可靠性。将五个选定的MDS项目合并，以创建单一的、具有功能意义的七类别分层认知表现量表。
CPS量表与简易精神状态检查表和严重损伤测试所产生的分数、护理人员对定向障碍的判断以及阿尔茨海默病和其他痴呆症的神经学诊断密切相关。
新的CPS利用现成的MDS数据提供了认知表现的功能视图。它对使用MDS来确定居民认知状况的临床医生和研究人员应该会很有用。
