Baylor profound mental status examination: A brief staging measure for profoundly demented Alzheimer disease patients

There is no brief patient-derived rating scale for staging and following pr ofoundly demented Alzheimer disease (AD) patients. We developed the Baylor Profound Mental Status Examination (BPMSE) modeled after the Mini-Mental St ate Examination (MMSE) to meet this need. The BPMSE consists of 25 cognitiv e questions that assess orientation, language, attention, and motor functio ning; 10 examiner ratings of presence or absence of problem behaviors; and 2 qualitative observations of language and social interaction. Two hundred eight probable or possible AD patients (MMSE scores of 20 or less) received the BPMSE. Some were also rated on the clinical dementia rating (CDR) and Lawton activities of daily living (ADL). A ceiling effect occurred at MMSE scores above 11. BPMSE cognitive scores and MMSE scores correlated signific antly (r = 0.76, p < 0.0001). Subareas of the BPMSE also intercorrelated si gnificantly. The BPMSE correlated with both CDR and ADL scores (p < 0.001). Internal consistency, interrater reliability, and test-retest stability we re excellent. There was no floor effect, and BPMSE scores continued to decl ine after the MMSE reached 0. The BPMSE is a quick and easy staging tool wi th excellent validity and test-retest stability that measures cognitive fun ction successfully in patients with MMSE scores below 12. The scale is sens itive to longitudinal change and continues to assess decline when performan ce has reached the lowest levels on conventional measures.