The Danish version of the Baylor Profound Mental State Examination

An instrument of assessing the cognitive status of the severely demented is needed.

To validate the Danish version of the cognitive part of the Baylor Profound Mental State Examination (BPMSE-cog).

Participants were residents in dementia care units. The Mini-Mental State Examination (MMSE), the Severe Impairment Battery (SIB), the Geriatric Deterioration Scale (GDS) and the Disability Assessment of Dementia (DAD) were co-administered. Three assessments were performed: at baseline, 1 week and 6 months later. At visits 1 and 3, participants were assessed blinded by a geriatric psychiatrist (GDS, MMSE and diagnosis) and by a registered nurse (BPMSE-cog, SIB, DAD). At visit 2, assessments were made by the RN only. Test-retest and inter-rater reliabilities were calculated. External validity was assessed in terms of correlation to MMSE, SIB, GDS and DAD; internal validity was assessed using Cronbach's alpha, Mokken/Loevinger coefficients and the item response analysis.

Inter-rater reliability and test-retest reliability were very high for total scale as well as for the subscales. The external validity was satisfactory with correlation coefficients: MMSE: 0.74; SIB: 0.89; the GDS 0.83; DAD: 0.67 (P < 0.001). Results further indicate that there is a ceiling but no floor effect of the BPMSE-cog. The internal validity was highly satisfactory demonstrating sufficient internal consistency and homogeneity of the scale. The item response analysis showed an even distribution of the 25 items.

The BPMSE-cog is a very stable and strong scale and is recommended as a severity measurement for the cognitive performance of patients suffering from severe dementia.