Biopsychosocial assessment tools for the elderly – Assessment summary sheet

Test: Mental Status Questionnaire (MSQ)

Year: 1960

Domain: Psychological

Assessment Tool Category: Cognitive Function

Variations/translations: Short Portable Mental Status Questionnaire (SPMSQ), 1975

Setting: Any setting of elderly persons

Method of delivery: Interviewer asks questions, requires verbal responses

Description: The Mental Status Questionnaire (MSQ) provides a brief, objective, and quantitative measurement of cognitive functioning of elderly people. It was intended for use with patient or community samples but results show it to be less appropriate in community studies. The ten items in the MSQ were selected as the most discriminating of 31 questions taken from existing mental status examinations and from clinical experience. The questions cover orientation in time and place, remote memory, and general knowledge. The Short Portable Mental Status Questionnaire (SPMSQ) is a variation created by Pfeiffer (1975), adding an item of serial subtractions.

Scoring/interpretation: The MSQ score counts the number of errors, so a score of 0 is ideal; omissions are counted as errors. Three groups of severity of chronic brain syndrome were proposed according to number of errors made: 0-2 errors – none or minimal; 3-8 errors – moderate; 9 or 10 errors – severe. The SPMSQ established four categories: intact mental functioning, borderline or mild organic impairment, definite but moderate organic impairment, and severe organic impairment.

Time to administer: Few minutes

Availability: contact author

Software: N/A

Website: http://www.npcrc.org/usr_doc/adhoc/psychosocial/SPMSQ.pdf

Qualitative/Quantitative: Quantitative

Validity: Kahn et al.(1960a, 1960b) compared the MSQ to the Face-Hand Test and to psychiatric evaluations of 1,077 institutionalized patients. The results showed a strong association between MSQ scores and diagnoses of chronic brain syndrome (CBS). In a community survey of 487 elderly people, the MSQ was 64% sensitive and 99% specific in detecting CBS, at a cutting-point of three. Fillenbaum (1980) compared the MSQ, SPMSQ and psychiatrists clinical diagnosis of organic mental disorder, and found 55% sensitivity, 96% specificity for SPMSQ.

Reliability: Lesher and Whelihan (1986) obtained test-retest reliability of 0.87 at two to four weeks; split-half reliability was 0.82, and alpha was 0.81. Wilson and Brass (1973) reported an unpublished study in which, over four administrations of the MSQ at 3-week intervals, scores changed one point or less in 75% of repeat administrations.

References:

Fillenbaum, G.G. (1980). Comparison of two brief tests of organic brain impairment. Journal of the American Geriatrics Society, 28, 8, 381-384.

Kahn, R.L., Goldfarb, A.I., Pollack, M. & Gerber, I.E. (1960a). The relationship of mental and physical status in institutionalized aged persons. American Journal of Psychiatry, 117, 120-124.

Kahn, R.L., Goldfarb, A.I., Pollack, M. & Peck, A. (1960b). Brief objective measures for the determination of mental status in the aged. American Journal of Psychiatry, 117, 326-328.

Lesher, E.L. & Whelihan, W.M. (1986). Reliability of mental status instruments administered to nursing home residents. Journal of Consulting and Clinical Psychology, 54, 5, 726-727.

Nelson, A., Fogel, B.S., & Faust, D. (1986). Bedside cognitive screening instruments. A critical assessment. The Journal of Nervous and Mental Disease, 174, 2, 73-83.

Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of American Geriatrics Society, 23, 433-41.

Wilson, L.A. & Brass, W. (1973). Brief assessment of the mental state in geriatric domiciliary practice. The usefulness of the mental status questionnaire. Age and Ageing, 2, 92-101.

Comments – Nelson et al. (1986) compared five cognitive screening instruments including the MSQ and SPMSQ, noting that all of the available tools had issues with false negative scores.