A sample of 261 elderly patients, most with a diagnosis of dementia, consecutively admitted to a geriatric psychiatry assessment ward, was assessed using the cognitive assessment scale (CAS) and behaviour rating scale (BRS) of CAPE. Scores of patients alive at four follow-up intervals were compared with those of non-survivors. On CAS, survivors scored significantly better at 18- and 48-month follow-up; and better, but not significantly so, at nine- and 36-month follow-up. On BRS, survivors scored significantly better at all four follow-up intervals. Only at 36-month follow-up did the scales predict survival of individual patients more efficiently than did base rates.
To assess the inter‐scorer reliability of the scoring of errors on the Pm (Maze) test of the Cognitive Assessment Scale (CAS) of CAPE, 100 mazes were scored by each of four scorers. Inter‐scorer agreement was found to be too low to justify the Pm test being used clinically as an independent measure. When Pm was summed with Information‐Orientation and Mental Ability to produce a total CAS score, the effect of this low agreement was greatly reduced, but still affected the CAS grades of approximately 7 per cent of cases. This is a high proportion to result from scoring differences on an objective test, and suggests that more adequate scoring instructions are required.
The problem of estimating a patient's CAS total score on CAPE when the Pm (maze) test cannot be administered because of sensory or physical--rather than cognitive--disability is considered. Analysis of the scores of 250 elderly subjects who attempted all three CAS tests suggests that 'proration' of total CAS scores from I/O and MA scores, while preferable to alternative methods, results in error in a significant proportion of cases and should be used only with caution.
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