Validating a Severe Cognitive Impairment Rating Scale in Patients with Dementia: A preliminary study

• Main Authors: Jia Wei Li, 李家維
• Other Authors: M. Y. Ho
• Format: Others
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/01724997801601320123

碩士 === 長庚大學 === 職能治療學系 === 101 === The assessment of cognitive functions and the severity of cognitive declines in patients with dementia is an important issue in clinical neuropsychology. However, the assessment has been predominantly administered for early-staged dementia screening in Taiwan. There is general lack of assessment tools for monitoring the dementia patients whose course of illness has reached its late stage. The employment of the existing screening tests on patients with late-staged dementia can produce floor effects, which renders the testing of the preserved cognitive abilities in more severely demented patients impossible. The aim of this study was to examine the applicability of the Severe Cognitive Impairment Profile (SCIP), which has been widely used for testing patients with severe dementia abroad, in Taiwanese patients. This was a cross-sectional study. Patients (N = 114, aged between 46-90 years) with dementia at different level of severity were recruited for validating the test. The internal consistency for each subscale of the test was used to represent its reliability. The concurrent and convergent validities were also examined by correlation analyses between the SCIP and other dementia screening tests. According to the severity level of dementia, all participants were allocated to 4 groups: Normal/questionable dementia group (n = 22), mild dementia group (n = 38), moderate dementia group (n = 36), and severe dementia group (n = 18). The performance of these four groups on the SCIP was compared. The results of this study showed that if four testing items were deleted, the internal consistency for each subscale ranged between .79 and .97. The correlation coefficients for the total scores of the SCIP and four other dementia-screening tests ranged between .80 and .87. In addition, moderate to high correlation (r = .36-.91) can be observed between the scores for the subscales of the SCIP and the other screening tests that share common constructs. The results of group comparisons showed the performance on the SCIP declined as the severity increased; and significant differences between each pair of groups were also detected on most subscale scores, which were generally in agreement with the course of cognitive declines in patients with dementia. The results also indicated that a subgroup of 18 severe demented patients obtained 45% of total possible points on the SCIP, compared with an average of 13% of total possible points on the MMSE. It appears that the SCIP was able to avoid the floor effects of other standardized tests in patients of advanced dementia. The results of the present study indicate the psychometric properties for the SCIP were acceptable, and to some extent, it can detect the differences between the performances of demented patients with different level of severity. Thus, these preliminary results are in support of the applicability of the SCIP to Taiwanese patients with dementia.