The MDS Cognition Scale: A Valid Instrument for Identifying and Staging Nursing Home Residents with Dementia Using the Minimum Data Set

Abstract

OBJECTIVE: We report the development and validation of an MDS-based cognitive index, the MDS Cognition Scale (MDS-COGS), by evaluating it against two popular dementia rating scales, the Global Deterioration Scale (GDS) and the Mini-Mental State Examination (MMSE).DESIGN: A Cross-sectional study.PARTICIPANTS: Two hundred nursing home residents.MEASUREMENTS: Each study participant was assessed on the GDS and the MMSE by trained medical students. At the same time, but independent of the medical students, a geriatric nurse completed the Minimum Data Set (MDS) instrument on each participant.MAIN RESULTS: The Cognitive Performance Scale (CPS), a categorical measure of cognition that uses MDS items, was compared with the GDS in 133 subjects, using a spli~-sample technique. The GDS was found to be more appropnate as a 4-stage than a 7-stage scale, with GDS stages 1-4 acting as a single stage. The CPS showed very poor percent agreement with GDS stages 5 and 7 (50% or less) and, therefore, was revised by adding other MDS predictors. The new instrument, designated MDS-COGS, is a 0-10 point scale generated from eight MDS cognitive items. The MDS-COGS was then validated against the 4-stage GDS and MMSE in the remaining 67 nursing home residents. Chance-corrected agreement (kappa) between the MDS-COGS and GDS in the 67 subjects was 0.80 (95% CI = 0.70, 0.88), and percent agreement with GDS stages 5 and 7 was 60% and 850/0, respectively. The MDS-COGS was also demonstrated to be a valid measure of cognitive impairment as defined by the MMSE, with sensitivity, specificity, chance-corrected agreement (kappa), and area under the ROC curve, all above 0.80. CONCLUSIONS: The MDS Cognition Scale, the MDS-COGS, provides a valid measure of the presence .and seve~ity of cognitive impairment in nursing home reslden~s using

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

“…Cognitive status was evaluated using both the Short Portable Mental Status Questionnaire (SPMSQ, 0-10 errors) (Pfeiffer, 1975), which was adapted to the institutional setting, and the Minimum Data Set Cognition Scale (MDS-COGS, 0-10 points) (Hartmaier et al 1994;Gruber-Baldini et al 2000), which obtained an assessment from the main caregivers based on selected Minimum Data Set questions. This latter scale was used because the SPMSQ could only be administered to 61% of residents for logistic reasons.…”

Dementia Prevalence And Care In Assisted Living

“…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.…”

Elderspeak Communication: Impact on Dementia Care

“…The MDS-COGs score was computed for each participant using MDS data as a measure of cognition. 37 The mean age of residents in our sample was 82.9 years with a range of 69-97. Five (25% were male) and one (5%) was African American; the remaining subjects were Caucasian women.…”