title: KUD--a scale for clinical evaluation of moderate-to-severe dementia.
abstract: OBJECTIVE
  To develop a test of cognitive performance in persons with moderate-to-severe dementia.
  
  
  BACKGROUND
  Various instruments are used to assess the course of dementia and to evaluate treatments in persons with dementia. Most neuropsychological assessments are inappropriate for measuring cognitive abilities in persons with severe dementia, because these persons perform at floor level in such measurements.
  
  
  METHODS
  A cross-sectional research design.
  
  
  METHODS
  The test (Clinical Evaluation of Moderate-to-Severe Dementia; Swedish acronym: KUD) was developed from a pool of 25 test items with the final KUD consisting of 15 items. Reliability and validity were established using 220 subjects (with various dementia diagnoses) with scores of Mini-Mental State Examination between 0-20. Approximately two weeks after the first test, 116 of the original 220 subjects were retested.
  
  
  RESULTS
  A factor analysis with the 15-item scale revealed an interaction factor comprising three items and a cognitive performance factor with 12 items. The internal consistence reliability was 0·93 for the KUD (Cronbach's alpha). Test-retest reliability was also high (0·92) and correlation between the KUD and the MMSE (≤20) was high (r=0·80).
  
  
  CONCLUSIONS
  The KUD seems to be a valid, reliable performance-based assessment scale for measuring cognitive performance in persons with MMSE score below 12 or 15 points.
  
  
  CONCLUSIONS
  It is of outmost interest that cognitive performance can be easily followed for persons with moderate-to-severe dementia in, for example, drug therapies and other therapies, but also in terms of treatment of and support to the person based on his or her abilities.
authors: School of Health Sciences, Jönköping University, Jönköping, Sweden.
authors: Iréne
authors: I
authors: Ericsson
authors: Bo
authors: B
authors: Malmberg
authors: Sven
authors: S
authors: Langworth
authors: Anders
authors: A
authors: Haglund
authors: Ann-Helene
authors: AH
authors: Almborg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index