VALIDATION OF THE MINIMUM DATA SET COGNITIVE PERFORMANCE SCALE - AGREEMENT WITH THE MINI-MENTAL-STATE-EXAMINATION

Background. Almost all nursing homes in the United States are required by the 1987 Omnibus Budget Reconciliation Act to assess each resident 's functional, medical, psychosocial, and cognitive status using a sta ndard instrument known as the Minimum Data Set (MDS). We report a vali dation study to show that the MDS Cognitive Performance Scale (CPS), a cognitive measure generated from 5 MDS items (comatose status, decisi on making, short-term memory, making self understood, and eating) can be used to detect cognitive impairment as defined by the Mini-Mental S tate Examination (MMSE). Methods. Two hundred subjects were randomly r ecruited from 8 nursing home facilities in North Carolina. Two medical students administered the MMSE, while a geriatric research nurse was responsible for collecting MDS cognitive items, which included the 5 i tems required for generating CPS scores. Cognitive impairment was defi ned by MMSE scores adjusted for education. Agreement between the CPS a nd the MMSE in identifying cognitively impaired subjects was then eval uated. Results. The CPS showed substantial agreement with the MMSE in the identification of cognitive impairment; the sensitivity was .94 (9 5% confidence interval [CI]: .90, .98), the specificity was .94 (95% C I: .87, .96), and the diagnostic accuracy as measured by the area unde r the receiver operating characteristics (ROC) curve was .96 (95% CI: .88, 1.0) Conclusions. The MDS Cognitive Performance Scale, when perfo rmed by a trained research nurse using recommended protocols, provides a valid measure of cognitive status in nursing home residents.