The Danish version of the Baylor Profound Mental State Examination

Abstract

Background: An instrument of assessing the cognitive status of the severely demented is needed. Aim: To validate the Danish version of the cognitive part of the Baylor Profound Mental State Examination (BPMSE-cog). Design: 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. Results: 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. Conclusion: 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.