title: Comparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini-Mental State Exam for the detection of cognitive impairment in nursing home residents.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of an outcome measurement scale of the Minimum Data Set of the Resident Assessment Instrument for nursing homes (MDS/RAI-NH), the Cognitive Performance Scale (CPS) and the Mini-Mental State Exam (MMSE) for the detection of cognitive impairment. The Cambridge Examination for Mental Disorders of the Elderly--Revised (CAMDEX-R) was used as the reference standard.
  
  
  METHODS
  This study was part of a larger prospective study (QUALIDEM) involving a diagnostic procedure and two-year follow-up on the quality of primary care for demented patients. CAMDEX-R and MDS/RAI-NH were administered to 198 residents, aged 65 or more, living in 42 low and high care institutions for aged people.
  
  
  METHODS
  Indicators of diagnostic accuracy: sensitivity, specificity, predictive values, likelihood ratios, odds ratio and area under receiver operating characteristics curve (AUC).
  
  
  RESULTS
  The CAMDEX-based prevalence of cognitive impairment was 75%. The diagnostic values of a CPS score of two or more for the detection of cognitive impairment were: sensitivity = 0.81; specificity = 0.80; PPV = 0.92; NPV = 0.57. The diagnostic values of a MMSE score of less than or equal 23 were: sensitivity = 0.97; specificity = 0.59; PPV = 0.88; NPV = 0.85. For CPS, the area under the receiver operating characteristic (ROC) curve was 0.87 (95% CI, 0.81-0.91), and not significantly different (p = 0.63) from the MMSE score, 0.88 (0.83-0.93).
  
  
  CONCLUSIONS
  CPS and MMSE demonstrated similar performance to detect cognitive impairment in nursing home residents.
authors.affiliation: Department of General Practice, KULeuven, Belgium.
authors.forename: Louis
authors.initials: L
authors.lastname: Paquay
authors.forename: Jan
authors.initials: J
authors.lastname: De Lepeleire
authors.forename: Birgitte
authors.initials: B
authors.lastname: Schoenmakers
authors.forename: Michel
authors.initials: M
authors.lastname: Ylieff
authors.forename: Ovide
authors.initials: O
authors.lastname: Fontaine
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D003657:Decision Making; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data*; D009426:Netherlands; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D009735:Nursing Homes; D011320:Primary Health Care / Q000592:standards; D011446:Prospective Studies; D011594:Psychometrics / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results