MDS COGNITIVE PERFORMANCE SCALE(C)

Background. Chronic cognitive impairment is a major problem in U.S. nu rsing homes, yet traditional assessment systems in most facilities inc luded only limited information on cognitive status. Following the Cong ressional mandate in the Omnibus Reconciliation Act of 1987 (OBRA '87) , U.S. nursing homes now complete the Minimum Data Set (MDS), a standa rdized, comprehensive assessment of each resident's functional, medica l, psychosocial, and cognitive status. We designed a Cognitive Perform ance Scale (CPS) that uses MDS data to assign residents into easily un derstood cognitive performance categories. Methods. Information was dr awn from three data sets, including two multistate data sets construct ed for the Health Care Financing Administration, The prevalence and re liability of the MDS cognitive performance variables were established when assessed by trained nursing personnel. Five selected MDS items we re combined to create the single, functionally meaningful seven-catego ry hierarchical Cognitive Performance Scale. Results. The CPS scale co rresponded closely with scores generated by the Mini-Mental State Exam ination and the Test for Severe Impairment, nursing judgments of disor ientation, and neurological diagnoses of Alzheimer's disease and other dementias. Conclusion. The new CPS provides a functional view of cogn itive performance, using readily available MDS data. It should prove u seful to clinicians and investigators using the MDS to determine a res ident's cognitive assets.