BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Blessed - Dementia Scale (BLS-D), Blessed-Ross Dementia Scale, or Newcastle Dementia Scale Year: 1968 Domain: Biological, Psychological, Social Assessment Tool Category: Dementia/Alzheimer's; Physical Functioning/ADLs Variations/Translations: N/A Setting: Clinical Method of Delivery: Administered by clinician Description: The BLS-D is a clinical rating scale with 22 items that measure changes in performance of everyday activities (eight items), self-care habits (three items), and changes in personality, interests, and drives (11 items). Ratings are based on information from relatives or friends and concern behavior over the preceding six months. The content of each rating is indicated, but precise question phrasing is not indicated. Scoring/Interpretation: – Scores for each item: - Total incapacity in an activity is rated 1 and partial - Variable or intermittent incapacity is awarded a half-point Overall scores range from 0 (normal) to 28 (extreme incapacity); a cognitive subscale omits the personality questions (12–22) and has a range from 0 (normal) to 17 (severely demented) Time to Administer: 10-15 minutes Availability: Test available online at http://www.strokecenter.org/trials/scales/blessed_dementia.html Software: N/A Website: Same as above Quantitative/Qualitative: Quantitative Validity (Quantitative): Dementia Scale scores correlated 0.77 with a count of plaques in the brains of 60 elderly patients. The correlation with duration of survival was 0.40. The Dementia Scale correlated 0.80 with the Clinical Dementia Rating; the equivalent correlation for the cognitive subscale was 0.84. Scores differed significantly between patients with Alzheimer’s disease (AD) and other forms of senile dementia and between different severities of AD defined pathologically. Erkinjuntti et al. tested the BLS-D as a screening test for dementia and concluded that it performed better if the personality items were left out. Sensitivity was 90% and specificity 85% in a small study of dementia. The equivalent results for the Cambridge Mental Disorders of the Elderly Examination CAMCOG test were 90% and 76%, respectively; those for the 3MS were 80% and 96%, respectively. Reliability (Quantitative): The inter-rater reliability for two raters was r= 0.59 (intraclass correlation = 0.30). Internal consistency was rated high. References: Blessed, G., Tomlinson, B.E., & Roth, M.. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 1114, 797-811. McDowell, I. & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires. (2nd ed.). New York: Oxford University Press. Stern, Y., Hesdorffer, D., Sano, M., & Mayeux, R. (1990). Measurement and prediction of functional capacity in Alzheimer’s disease. Neurology, 40, 8-14. Zillmer, E.A., Fowler, P.C., Gutnick, H.N., & Becker, E. (1990). Comparison of two cognitive bedside screening instruments in nursing home residents: a factor analytic study. Journal of Gerontology, 45, 69-74. Comments: This test is one of four made by Blessed that comprise the Blessed Information-Memory-Concentration Test (IMC). This test is an early form of an informant-based instrument.