Residential Care/Assisted Living Staff May Detect Undiagnosed Dementia Using the Minimum Data Set Cognition Scale

Abstract

The MDS-COGS is a simple, brief screen that RC/AL staff can complete. It will identify with high specificity a subset of residents with undetected dementia, allowing rapid identification of those likely to need dementia care. Caution needs to be exercised in light of its low sensitivity, because some with milder dementia will not be detected. Further work is needed to determine whether staff can and will use the MDS-COGS as a trigger for more-thorough assessment and to guide care and improve outcomes.

Dementia Prevalence And Care In Assisted Living

“…That said, it is important to note that although the MDS-COGS is a proxy-rated measure that has been validated in comparison to expert clinical rating, it is not very accurate in detecting mild dementia. 5 In terms of care provision, a similar caveat related to charts is indicated: Staff provide care based more on residents' needs than on what is written on their charts. 5,16 The most important issue relating to care for people with dementia is the extent to which their care needs are being met.…”

“…5 In terms of care provision, a similar caveat related to charts is indicated: Staff provide care based more on residents' needs than on what is written on their charts. 5,16 The most important issue relating to care for people with dementia is the extent to which their care needs are being met. The cross-sectional design of the NSRCF cannot address that point.…”

“…10 To categorize the extent of cognitive impairment-none, mild, moderate, or severewe used the Minimum Data Set Cognition Scale (MDS-COGS), which has been used and validated in numerous studies of nursing homes and assisted living residences. 5,9,11,12 The MDS-COGS is a nine-item measure that assesses memory, awareness of surroundings, decision making ability, understanding, and dressing performance. 5 Scores range from 0 to 10.…”

“…5,9,11,12 The MDS-COGS is a nine-item measure that assesses memory, awareness of surroundings, decision making ability, understanding, and dressing performance. 5 Scores range from 0 to 10. Zero is no cognitive impairment (for purposes of comparison, the comparable Mini-Mental State Examination [MMSE] scores are greater than 23), 1-2 is mild impairment (MMSE, 19-23), 3-5 is moderate impairment (MMSE,(12)(13)(14)(15)(16)(17)(18), and 6-10 is severe impairment (MMSE, less than 12).…”

“…Studies of a limited number of assisted living residences suggest that in some cases, as many as two-thirds of residents have dementia, and 90 percent have some degree of cognitive impairment. 5 When people with dementia require residential care, their living options typically include assisted living residences and nursing homes (both those with special dementia care and those without it). Research into the special care provided by nursing homes has not shown overwhelmingly favorable results.…”