[Spanish tools of cognitive and behavior assessment of alzheimer´s disease in severe state.] / Escalas de valoración cognitiva y conductual en español para la demencia severa.

BACKGROUND: There are different scales in Spanish for cognitive and behavioral assessment of patients with severe dementia. The objective of this study was to select those scales that are more accessible, useful and with better psychometric properties, both for clinical practice and for research. METHODS: Literature review, by experts in the field, of scales of cognitive and behavioral assessment in dementia in the main scientific databases. Published in Spanish or English, excluding those not validated in Spanish. RESULTS: 11 bibliographical references were selected. Cognitive scales: Severe Impairment Battery was the one with the most cognitive areas, its abbreviated version (SIB-s) had the best internal consistency (α=0.96), Baylor Profound Mental Status Examination had very good psychometric properties with 0.99 reliability and excellent concurrent validity with Mini-Mental State Examination (r=-0.91). Severe Cognitive Impairment Profile was the only one that allowed establishing subgroups of cognitive impairment. Behavioral scales: Neuropsychiatric Inventory was the gold standard in dementias, but there was only one specific scale for severe Alzheimer's disease, the Baylor Profound Mental Status Examination behavioral subscale. CONCLUSIONS: In Spanish severe dementia, Severe Cognitive Impairment Profile and the Neuropsychiatric Inventory are the gold standard tool for cognitive assessment for research studies, and the Baylor Profound Mental Status Examination is the most useful for daily clinical practice.

OBJETIVO: Existen diferentes escalas en español para la valoración cognitiva y conductual de los pacientes con demencia severa. El objetivo de este estudio fue seleccionar aquellas escalas más accesibles, útiles y con mejores propiedades psicométricas, tanto para la práctica clínica como para fines investigadores. METODOS: Se realizó una revisión bibliográfica, por expertos en la materia, de escalas de valoración cognitiva y conductual sobre demencia en las principales bases de datos científicas. Debían estar publicadas en español o inglés, excluyendo aquellas no validadas al español. RESULTADOS: Se seleccionaron 11 referencias bibliográficas. En cuanto a escalas cognitivas: la Severe Impairment Battery era la que más áreas cognitivas en-globaba; su versión abreviada (SIB-s) presentaba la mejor consistencia interna (α=0,96); el Baylor Profound Mental Status Examination presentaba muy buenas propiedades psicométricas, con fiabilidad 0,99 y excelente validez concurrente con el Mini-Mental State Examination (r=-0,91); el Severe Cognitive Impairment Profile era la única que permitía establecer subgrupos de deterioro cognitivo. En cuanto a escalas conductuales: el Neuropsychiatric Inventory era el gold standard en demencias. Solo había una escala específica para la enfermedad de Alzheimer, el Baylor Profound Mental Status Examination subescala conductual. CONCLUSIONES: En demencias severas, el Severe Cognitive Impairment Profile y el Neuropsychiatric Inventory son las herramientas más completas para estudios de investigación, y el Baylor Profound Mental Status Examination la más útil para la práctica clínica.

Escalas de valoración cognitiva y conductual en español para la demencia severa / Spanish tools of cognitive and behavior assessment of alzheimer's disease in severe state

OBJETIVO: Existen diferentes escalas en español para la valoración cognitiva y conductual de los pacientes con demencia severa. El objetivo de este estudio fue seleccionar aquellas escalas más accesibles, útiles y con mejores propiedades psicométricas, tanto para la práctica clínica como para fines investigadores. MÉTODOS: Se realizó una revisión bibliográfica, por expertos en la materia, de escalas de valoración cognitiva y conductual sobre demencia en las principales bases de datos científicas. Debían estar publicadas en español o inglés, excluyendo aquellas no validadas al español. RESULTADOS: Se seleccionaron 11 referencias bibliográficas. En cuanto a escalas cognitivas: la Severe Impairment Battery era la que más áreas cognitivas englobaba; su versión abreviada (SIB-s) presentaba la mejor consistencia interna (α=0,96); el Baylor Profound Mental Status Examination presentaba muy buenas propiedades psicométricas, con fiabilidad 0,99 y excelente validez concurrente con el Mini-Mental State Examination (r=-0,91); el Severe Cognitive Impairment Profile era la única que permitía establecer subgrupos de deterioro cognitivo. En cuanto a escalas conductuales: el Neuropsychiatric Inventory era el gold standard en demencias. Solo había una escala específica para la enfermedad de Alzheimer, el Baylor Profound Mental Status Examination subescala conductual. CONCLUSIONES: En demencias severas, el Severe Cognitive Impairment Profile y el Neuropsychiatric Inventory son las herramientas más completas para estudios de investigación, y el Baylor Profound Mental Status Examination la más útil para la práctica clínica

BACKGROUND: There are different scales in Spanish for cognitive and behavioral assessment of patients with severe dementia. The objective of this study was to select those scales that are more accessible, useful and with better psychometric properties, both for clinical practice and for research. METHODS: Literature review, by experts in the field, of scales of cognitive and behavioral assessment in dementia in the main scientific databases. Published in Spanish or English, excluding those not validated in Spanish. RESULTS: 11 bibliographical references were selected. Cognitive scales: Severe Impairment Battery was the one with the most cognitive areas, its abbreviated version (SIB-s) had the best internal consistency (α=0.96), Baylor Profound Mental Status Examination had very good psychometric properties with 0.99 reliability and excellent concurrent validity with Mini-Mental State Examination (r=-0.91). Severe Cognitive Impairment Profile was the only one that allowed establishing subgroups of cognitive impairment. Behavioral scales: Neuropsychiatric Inventory was the gold standard in dementias, but there was only one specific scale for severe Alzheimer's disease, the Baylor Profound Mental Status Examination behavioral subscale. CONCLUSIONS: In Spanish severe dementia, Severe Cognitive Impairment Profile and the Neuropsychiatric Inventory are the gold standard tool for cognitive assessment for research studies, and the Baylor Profound Mental Status Examination is the most useful for daily clinical practice

Validation Prognostic of the Baylor Profound Mental Status Examination.

BACKGROUND: There are no validated prognostic instruments to evaluate severe Alzheimer's disease (AD) patients. OBJECTIVE: To validate the prognostic value of the Baylor Profound Mental Status Examination (BPMSE). METHODS: We selected 200 patients with severe AD. The following prognostic variables were collected: hospitalization, use of the emergency room, death, and prescription of drugs. ROC curve analysis was performed to see the overall behavior of the test when predicting the adverse event. We analyzed the AUC ROC and the best cut point was determined, and by using contingency tables, the risk was calculated. RESULTS: For a BPMSE ≥16 points, there was a risk of 1.8 (95% CI 0.9-3.4) of prescription of psychotropic drugs in 12 months. For memantine in 12 months, for a BPMSE ≥16 points, there was a risk of 2.9 (95% CI 1.1-7.2). Emergency room visits, for a BMPSE ≤15 points, showed a risk of 1.7 (95% CI 1-3.2). The risk of hospitalization at 12 months, for a BPMSE ≤15, was 1.4 (95% CI 0.8-2.6). When comparing medians, patients with a higher BPMSE were prescribed more drugs at 12 months. CONCLUSIONS: BPMSE has a limited predictive value for the variables studied.

Validation of the Spanish version of the Baylor Profound Mental Status Examination.

BACKGROUND: There are no short valid instruments to evaluate cognitive status in severe Alzheimer's disease (AD) patients in the Spanish language. OBJECTIVE: To validate the Spanish version of the Baylor Profound Mental Status Examination (BPMSE-Sp). METHODS: The Baylor Profound Mental Status Examination (BPMSE) was translated to Spanish and back translated. Validation was conducted in 100 patients with severe probable AD with a Mini-Mental State Examination (MMSE) <12. We assessed internal consistency (Cronbach's alpha), concurrent validity (Pearson's correlations) with the MMSE, Severe Impairment Battery (SIB), Neuropsychiatric Inventory Short Form (NPI-Q) and the Functional Assessment Staging and reliability. RESULTS: The mean age of patients was 84.9; 74% were female; 64% were institutionalized. The mean MMSE was 5.6; the mean BPMSE-Sp was 13.6; the mean BPMSE-Sp behavior was 1.2; the mean SIB was 42.2; and the mean NPI-Q was 4.7. BPMSE-Sp presented good internal consistency (Cronbach α= 0.84). There were significant correlations between the BPMSE-Sp and MMSE (r = 0.86, p <  0.001), and between the BPMSE-Sp and SIB (r = 0.92, p <  0.001). Inter-rater and test-retest reliability were in both cases excellent, ranging between 0.96 and 0.99 (p <  0.001). BPMSE-Sp had fewer floor and ceiling effects than the MMSE. CONCLUSIONS: The BPMSE-Sp is a valid tool for use in daily practice and research in the evaluation of cognitive function of patients with severe AD.