BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet

Test: Cognitive Assessment Scale for the Elderly (CASE)

Year: 1994

Domain: Psychological

Assessment Tool Category: Diagnosis of Cognitive Impairments

Variations/Translations: CASE was adapted from the original tool PECPA-2r (Protocole d’examen cognitif de la personne âgée).

Setting: Non-institutionalized seniors

Method of Delivery: This instrument works favourably with trained mental health providers and includes both a questionnaire and interview.

Description: CASE is an adapted translation of the PECPA-2r. The diverse potential uses of the CASE include screening of organic brain syndromes in the elderly, monitoring interventions, and specific use in clinical trials. The CASE features the capacity to distinguish the normal aging process and light deficits related to cerebral morbidity. However, the CASE sub-tests do not directly measure cognitive functioning. The abilities measured by the scale imply many cognitive mechanisms (eg. encoding, consolidation, lexical facility, naming, conceptualization, etc.). The tool is composed of 103 items grouped into ten different cognitive ability categories: (1) Temporal Orientation; (2) Spatial Orientation; (3) Attention-Concentration and Calculation; (4) Immediate Recall; (5) Language (6) Remote Memory; (7) Judgment and Abstraction; (8) Agnosia; (9) Apraxia; (10) Recent Memory.

Scoring/Interpretation: Each set of tasks produces a score on a 10-point scale, plus an overall score varying from 0 to 100. The scoring sheet offers not only a summary table of the results but also a cognigram, or cognitive efficiency profile, that illustrates areas of deterioration. Normative data permit comparisons of overall scores with normal subjects in various age and education groups, as well as with subjects diagnosed with an organic cerebral syndrome (normative data is available on the web site). Scoring of the CASE must be done according to the criteria defined in the Administration and Scoring Guide. The results are usually interpreted according to three levels of analysis: 1) the total score alone, 2) the profile of cognitive functioning with the cognigram and 3) a qualitative analysis of all the sub-tests of the scale.

Time to Administer: Total administration time is approximately 45 minutes.

Availability: The tool is available free of charge at http://www.sepec.ca/case.pdf

Software: N/A

Website: http://www.sepec.ca/case.htm#Origins

Quantitative/Qualitative: Quantitative

Validity (Quantitative): CASE concurrent validity is demonstrated by its capacity to discriminate the normal subjects from those with a diagnosis of organic brain syndrome. Based upon discriminating criteria of a) a global score of less than 80, b) a cognigram containing three or more sub-tests with a score of 7 or less, and c) a total score standardized for age and education level, the sensitivity varied between 0.85 and 0.91 and the specificity between 0.95 and 0.97. The total standardized score has proven to be the most discerning criteria and its use is strongly recommended.

Reliability (Quantitative): The CASE reliability coefficient was estimated with the Spearman-Brown formula through a split-half procedure. The reliability coefficient (0.95) indicated a very high internal consistency.

References:

von Hunten, A., Brull, J., Jung, A., Simms, K., Taillefer, D., Geneau, D., & Duc, R. (2006). The «Protocole d'Examen Cognitif de la Personne Agée - Lausanne» (PECPA-L): A Cognitive Assessment Tool for the French-Speaking Elderly in Switzerland. European Neurology, 55, 22-30.

Geneau, D. & Taillefer, D. (1995). Le Protocole d’Examen Cognitif de la Personne Âgée (PECPA-2). Allocution présentée au 1er Colloque de Psychogériatrie du C.C.F.P., St-Hyacinthe, Québec.

Geneau, D. & Taillefer, D. (1996). Le "Protocole d'Examen Cognitif de la Personne Âgée - Version Révisée" (PECPA-2r): Normalisation par groupes d'âge et antécédents éducationnels chez des sujets québécois francophones. Allocution présentée au 2ième Colloque de Psychogériatrie du C.C.F.P., St-Hyacinthe, Québec.

Comments: The evaluation setting should have proper lighting, be well ventilated and be free of all distractions. The subject should be comfortably seated at a table with a smooth, flat surface of proper height. The examiner must always verify that the subject has adequate vision and hearing. The material booklet should remain out of sight until needed. The examiner should be sufficiently familiar with the administration procedure so as to, without hesitation, be able to follow the manual, observe the subject and record his answers. Any attempt to present an etiological diagnosis by using only the CASE is not recommended. This procedure should be supported by a multidisciplinary investigation and a clinical exam by a psychiatrist, neurologist or geriatrician, extended neuropsychological assessment, brain imaging, laboratory tests, etc.