BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Cognitive Capacity Screening Examination (CCSE) Year: 1977 Domain: Psychological Assessment Tool Category: Mental Health, Dementia/Alzheimer's Variations/Translations: N/A Setting: Clinical Method of Delivery: By health professional Description: 30-item test designed to assist the clinician in identifying organic mental syndromes, particularly delirium, among medical patients. CCSE assesses judgment, mental speed, and sustained effort. Scoring/Interpretation: An overall score counts the number of questions answered correctly; 19 or 20 was recommended as the cutting-point for further examination Time to Administer: 10-15 minutes Availability: Can be purchases from author – John W. Jacobs 180 East 79th Street New York, NY 10075 Software: N/A Website: N/A Quantitative/Qualitative: Quantitative Validity (Quantitative): For 24 patients undergoing psychiatric consultation, sensitivity was 94% and specificity was 71%. As a demonstration of specificity, mean scores for patients with schizophrenia and others with depression fell above the cutting-point, suggesting that these patients had not been falsely classified as having cognitive disorders. Beresford et al. reported a sensitivity of 84% and a specificity of 94% using a cutting-point of 19 or 20. In a study of 65 elderly hospitalized patients, the CCSE correctly identified 100% of patients diagnosed with organic mental syndrome and 78% of stroke patients; specificity was 82%. Schwamm et al. found a false negative rate of 53% for the CCSE compared with 43% for the Mini-Mental State Examination. Foreman reported correlations of 0.63 with the Short Portable Mental Status Questionnaire, 0.83 with the Dementia Rating Scale, and 0.88 with the Mini-Mental State Exam. Scores on the CCSE varied by educational level. The correlation with the FAQ was -0.60, whereas the correlation with education was 0.56. Reliability (Quantitative): Two psychiatrists applied the CCSE twice within 24 hours to 50 consecutive patients. The Pearson correlation was 0.92 (kappa 0.62). In another case, there was complete agreement among three examiners for six subjects, three of whom were demented. However, correction was not made for length of time between examinations or other intervening variables. Internal consistency alpha was 0.97 for 63 patients. References: McDowell, I. & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires. (2nd ed.). New York: Oxford University Press. Schwamm, L.H., Van Dyke, C., Kiernan, R.J., Merrin, E.L., Mueller, J. (1987). The Neurobehavioral Cognitive Status Examination: comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population. Ann Intern Med, 107, 486–491. Comments: The CCSE is known in general as a broad test screening tool. More information is required after the results are obtained.