The Halifax Mental Status Scale: Development of a new test of mental status for use with elderly clients.

Abstract

The development and preliminary investigations of the validity of the Halifax Mental Status Scale (HMSS) are described. The HMSS was constructed to find a balance between ease of administration and broad sampling of behavior. The initial study examined its use in residential care facilities, and it was found to be internally consistent and reliable over retest intervals of a few weeks and 1 year when a sample of 63 subjects was examined. In another sample, it also differentiated groups of subjects with different nursing care requirements (n = 25). Factor analysis of the total residential group (N-88) suggested that the HMSS samples distinct domains of cognitive functioning. The second study examined the HMSS as a screening instrument with outpatients. The HMSS summary score and factor scores differentiated groups with dementia due to Alzheimer's disease (n = 27) and stroke (n = 20) from healthy control subjects (K = 22) and subjects with depression (« = 8).Information about the mental status of a client is important to any health care professional caring for elderly clients because of the prevalence of dementia in this population (Ineichen, 1987). Standardized tests of mental status have become widelyused as screening instruments and considerable effort has been devoted to the development of very brief diagnostic tests. As a result, most mental status assessments sample only a limited range of abilities, such as general knowledge, orientation, concentration, and memory for individual words or phrases

Cognitive screening in a population‐based sample of community‐living elderly: Effects of age and education on the construct of cognitive status

“…The current study extends our analysis of the psychometric properties of the HMSS (Fisk et al, 1991) to a representative sample of communityliving elderly subjects. Concurrent validity of the HMSS was evident in its high-order correlation with the 3MS.…”

“…The 3MS (Teng and Chui, 1987) is an expanded version of the MMSE (Folstein et al, 1975) that includes an expanded scoring system and additional items such as a 'similarities' subtest of verbal abstraction. The 3MS yields a maximum total score of 100.…”

“…The merit of this broader approach to screening for cognitive impairment can be tested, in part, by examining the sensitivity and specificity of the HMSS in an unbiased (ie community-based) sample. In constructing the HMSS we recognized that the additional items could result in a non-unitary factor structure and our initial factor analyses of the HMSS subscales revealed a consistent latent factor structure regardless of the number of factors extracted, the method of extraction employed or the subject sample (Fisk et al, 1991). This raises the important issue of whether 'cognitive status' (as measured by such a screening instrument) is a unitary or heterogeneous construct.…”

“…Most cognitive status tests are designed to be very brief screening instruments and thus examine only a limited range of abilities such as general knowledge, orientation, concentration and memory for individual words or phrases (Blessed et al, 1968;Katzman et al, 1983;Pfeiffer, 1975;Qureshi and Hodkinson, 1974; Thompson and Blessed, 1987). An improve-ment on this is the widely used Mini-Mental State Examination (MMSE;Folstein et al, 1975). It includes one constructional item and some tests of language abilities, but in terms of the criteria suggested by DSM-111-R (APA, 1987), it remains an incomplete cognitive screening test.…”

“…The Halifax Mental Status Scale (HMSS) (Fisk et al, 1991) was designed to provide a more broad view of a subject's cognitive functioning and to be more consistent with the DSM-111-R diagnostic criteria for dementia (APA, 1987). Thus, in addition to items that assess general knowledge, orientation, concentration, memory for a phrase and memory for objects, a number of items were added to examine verbal comprehension, object naming, manual praxis and visual constructional ability.…”