MDS Cognitive Performance Scale(C)

Morris, John N.; Fries, Brant E.; Mehr, David R.; Hawes, Catherine; Phillips, Charles D.; Mor, Vincent; Lipsitz, Lewis A.

doi:10.1093/geronj/49.4.m174

Cited by 1,604 publications

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“…Patients diagnosed with dementia, both referrals and non referrals to EDs over a 12-month period had significant physical decline, a high percentage of multicomorbidity and used a great number of drugs, in particular neuroleptica. Underestimated and undetected dementia has previously been described (29,32), which is confirmed by the present study. NH patients are the most vulnerable members of society and many are at risk of ED referrals.…”

Section: Resultssupporting

confidence: 91%

“…Thus, education and practical training in the use of the instrument is essential. The RAI/MDS interrater reliability was tested with acceptable to good figures (29,32). Improvement measures were to provide education and practical training of the instrument.…”

Section: Methodsological Considerationsmentioning

confidence: 99%

“…Items representing two RAI/MDS scales were used; the Cognitive Performance Scale (CPS-scale), which ranges from 0-6 (normal cognitive capacity to severe cognitive dysfunction) (32) and the Activities of Daily Living (ADL) scale, which ranges from 4-18 (totally independent to totally dependent) and has a cut-off limit of > 10 denoting severe functional impairment (33).…”

Section: Data Collectionmentioning

confidence: 99%

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Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity

Mamhidir

Wimo

Kihlgren

2012

The Journal of nutrition, health and aging

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Objectives:The objective was to describe the extent to which nursing home patients had cognitive impairments and were diagnosed with dementia. Furthermore, to describe and compare multicomorbidity, health status and drug use in the three subgroups; dementia diagnosis/not referred, dementia diagnosis/referred and no dementia diagnosis/not referred to an emergency department (ED) over a one-year period. Methods: A crosssectional follow-up study was carried out in Sweden. RAI/MDS assessments were conducted on 719 patients in 24 nursing homes, of whom 209 were referred to EDs during a one-year period, accounting for 314 visits. This study involved an extensive examination of the population. Results: The 719 patients were reported to suffer from comprehensive cognitive impairments, which not accorded with the dementia diagnoses, they were significantly fewer. Cognitive decline or dementia diagnosis contributed to a significant decrease of referrals to EDs. Patients with dementia diagnosis/not referred had difficulties understanding others, as well as impaired vision and hearing. Patients with dementia diagnosis/referred usually understood messages. Low BMI, daily pain, multicomorbidity and high drug consumption occurred in all groups. Patients with no dementia diagnosis/not referred had significantly less multicomorbidity. Neuroleptica was significantly more prevalent among those with dementia diagnosis. Conclusion: Dementia remains undetected. Patients with cognitive decline and dementia are probably as sick as or even worse than others but may, due to low priority be undertreated or referrals avoided with the objective to provide good care in the setting. Observational studies are needed to identify what is done and could be done in referral situations. Key words:Nursing home, dementia, cognitive impairment, referrals, emergency department. 891The Journal of Nutrition, Health & Aging© Volume 16, Number 10, 2012 Received November 25, 2011 Accepted for publication January 19, 2012 07 MAMHIDIR/p/c_04 LORD_c 04/12/12 10:31 Page891 (17), the mean number of prescribed drugs was 10.3 per patient. The proportion of individuals prescribed psychotropic drugs was 80% in NHs and 85% in special care units for dementia. According to Olsson et al. (17), anticholinergic drugs were prescribed for approximately 20% of all NH patients and a high rate of psychotropic drug use (>=80%) was reported.Dementia is becoming a greater problem in health care globally (18), due to an increase in the number of people affected. In Sweden, the number of people suffering from dementia increased from 133, 000 to 148, 000 between 2000 and 2008 (14). Disorders such as dementia that cause cognitive impairment are common in long term institutional care. Mamhidir et al. (19) found that cognitive impairment was present in 67% of NH patients and Nordberg et al. (20) reported 62%. Such patients often exhibit symptoms that are difficult to interpret. Although they have the same illnesses as younger patients, their symptoms differ as they...

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Section: Resultssupporting

confidence: 91%

Section: Methodsological Considerationsmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

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Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity

Mamhidir

Wimo

Kihlgren

2012

The Journal of nutrition, health and aging

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“…Scales for physical function and cognition can be constructed from the RAI-HC (16,17). The higher the score, the more disabled the client.…”

Section: Other Health and Functional Status Indicatorsmentioning

confidence: 99%

Unintended weight loss in the elderly living at home: The aged in home care project (ADHOC)

Sørbye¹,

Schroll

Finne-Soveri³

et al. 2008

The Journal of nutrition, health and aging

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Abstract:Objective: To describe associations between unintended weight loss (UWL) and characteristics of nutritional status. Design: A comparative cross-sectional assessment study at 11 sites in Europe. The target population was a stratified random sample of 4,455 recipients of home care (405 in each random sample from 11 urban areas) aged 65 years and older. Measurements: the Resident Assessment Instrument for Home Care, version 2.0. Epidemiological and medical characteristics of clients and service utilisation were recorded in a standardized, comparative manner. UWL was defined as information of 5% or more weight loss in the last 30 days (or 10% or more in the last 180 days). Results: The final sample consisted of 4,010 persons; 74% were female. The mean ages were 80.9 ± 7.5 years (males) and 82.8 ± 7.3 years (females). No associations were found between single diagnoses and UWL, except for cancer. Cancer patients were excluded from further analyses. Persons with a Cognitive Performance Scale value (CPS) > 3 (impaired) had increased risk of UWL (OR = 2.0) compared with those scoring < 3 (less impaired). Only in the oldest group did we find a significant association between UWL and reduction in ADL and IADL functions, comparing those who scored 3 or less with those who scored more than 3 (disabled). A binary logistic regression model explained 26% of UWL: less than one meal/day, reduced appetite, malnutrition, reduced social activity, experiencing a flare-up of a recurrent or chronic problem, and hospitalisation were important indicators. Conclusion: We recommend a regular comprehensive assessment in home care to identify clients with potential risk factors for weight loss and malnutrition, in particular those discharged from hospital, and those with physical dependency or cognitive problems. This study may provide incentives to create tailored preventive strategies.

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“…Cognitive status was measured by the Cognitive Performance Scale [146], which ranges from 0 to 6, with 0 indicating intact cognition and 6 indicating most severe cognitive impairment. …”

Section: Cognitive Statusmentioning

confidence: 99%

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

Xing¹,

Mukamel²,

Glance³

et al. 2016

WHM

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2013ii Biographical SketchThe author was born in Shanghai, China. She attended Shanghai Second Medical This dissertation provides evidence that linking Medicaid reimbursement rate to each NH's own expenditures and incentivizing NHs to invest in direct care were effective ways in achieving quality improvement. Refinements of current Medi-Cal reimbursement policy might be needed to encourage NHs to make larger investments. However, maximizing NHs' spending on direct care cannot be relied on as the only policy strategy to improve quality of care. vii Contributors and Funding SourcesThis work was supervised by a dissertation committee consisting of Professors

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MDS Cognitive Performance Scale(C)

Abstract: The new CPS provides a functional view of cognitive performance, using readily available MDS data. It should prove useful to clinicians and investigators using the MDS to determine a resident's cognitive assets.

Cited by 1,604 publications

References 0 publications

Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity

Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity

Unintended weight loss in the elderly living at home: The aged in home care project (ADHOC)

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

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