[A battery of neuropsychological tests for severe dementia. An evaluation study]

All patients with Alzheimer's disease progress, more or less rapidly, to a stage where they can no longer be tested with the standard neuropsychological tools. The Severe Impairment Battery (SIB) is a neuropsychological tool used to evaluate patients with severe dementia. Its maximum score is 133. The purpose of this study was to assess the reliability of a French version of SIB. Fifty-four patients with Alzheimer's disease (mean Mini Mental State examination [MMS] 10.11 +/- 6.38) entered the study. Their mean SIB score was 88.4 +/- 33.3. The patients who were most affected (MMS below 5) were distributed by SIB from 7 to 80 points. An inter-examinator study of 36 patients yielded a correlation coefficient r = 0.9957 (P = 0.0001). In an inter-test study of 17 patients the correlation coefficient was also very high (r = 0.874, P = 0.0001). Thus, SIB seems to be a reliable tool to evaluate cognitive functions in cases of severe dementia. The distribution of scores obtained by SIB in patients with an MMS below 10 demonstrates that even within groups of subjects with severe dementia distinctions can be made between their remaining capabilities. Using SIB in these patients should improve our knowledge of the natural course of the disease and give better correlation between clinical data and neuropathological and neurobiochemical tests on the one hand, and enable us to adjust to their condition the departments where these patients are treated on the other hand.