BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Clifton Assessment Procedures for the Elderly (CAPE) Year: 1975 Domain: Psychological Assessment Tool Category: Mental Health, Physical Functioning/ADLs Variations/Translations: An abbreviated form of the CAPE is designed for use in large-scale surveys. Assessment Setting: Clinical Method of Delivery: Staff administered questionnaire Description: The CAPE evaluates the presence and severity of impairment in mental and behavioural functioning. It was intended for elderly long-term psychiatric patients. Consists of two components: the Cognitive Assessment Scale (CAS) and the Behaviour Rating Scale (BRS). The CAS includes a 12-item information and orientation subtest, a brief mental abilities test, and a psychomotor performance test that involves tracing a line through a maze. The BRS contains 18 items and is completed by relatives or staff familiar with the patient’s behaviour. It covers physical disability including ADLs, apathy, communication difficulties and social disturbance. Scoring/Interpretation: The time taken for the maze test and the number of errors on the other tests are converted into a CAS score out of 12. A cutting-point of 8 has been recommended for the CAS, scores of 7 or lower generally indicate dementia or acute organic brain syndrome. BRS scores range from 0 to 36, higher scores indicating greater disability. Scores on the two components are transferred onto a report summarizing raw scores in a 5-category grading of the level of dependency and support likely required. Grade A represents no mental impairment/no significant behavioural disability to Grade E representing maximal impairment/psychogeriatric patients needing intense nursing attention/care. Time to Administer: N/A Availability: Available in book published by the authors or source article (see below). Software: N/A Website: N/A Quantitative/Qualitative: Quantitative Validity (Quantitative): Sensitivity of the CAS was found to be 80%; specificity was found to be 85%. Correlations exist with the MMSE (0.90) and the Wechsler Adult Intelligence Scale (WAIS, 0.37). Factor analysis of the BRS identified three factors: physical disability and communication scales; apathy items; and social disturbance items. Reliability (Quantitative): Intercorrelations among subscale scores range from 0.30-0.78. Test-retest reliability at two to four weeks was 0.84, alpha=0.77. References: Pattie, A.H., Gilleard, C.J. (1975). A brief psychogeriatric assessment schedule: validation against psychiatric diagnosis and discharge from hospital. Br J Psychiatry, 127, 489-493. Pattie, A.H., Gilleard, C.J. (1979). Manual of the Clifton Assessment Procedures for the Elderly (CAPE). Sevenoaks, Kent, UK: Hodder and Stoughton. Comments: There is an issue of how to score maze tests for blind and severely arthritic patients. The original approach of awarding zero to this section may falsely classify physical difficulties as cognitive impairment.