L Volicer1, A C Hurley, D C Lathi, N W Kowall. 1. Geriatric Research, Education and Clinical Center, E.N. Rogers Memorial Veterans Hospital, Bedford, Massachusetts.
Abstract
BACKGROUND: In late stages of dementia of the Alzheimer type (DAT), most scales measuring only cognitive or functional deficits lose their sensitivity to detect further disease progression. METHODS: By combining ratings of cognitive (speech, eye contact) and functional deficits (dressing, eating, ambulation) with occurrence of pathological symptoms (sleep-wake cycle disturbance, muscle rigidity/contractures), a scale was developed (BANS-S) which does not lose its sensitivity until the patient reaches a vegetative state. BANS-S was tested on three Special Care Dementia Units. RESULTS: Data from 74 patients with the clinical diagnosis of DAT indicated that BANS-S has good reliability and reproducibility. BANS-S scores correlated with scores of Mini-Mental State Examination, Katz ADL, Test for Severe Impairment, and Language Assessment. In 25 patients with the diagnosis of DAT confirmed by autopsy, BANS-S scores determined within 3 months of death correlated with density of neurofibrillary tangles in CA2 and CA3 areas of the hippocampus. CONCLUSION: BANS-S may be a useful tool for the evaluation of different treatment strategies in severe DAT and for the correlation of clinical and pathological findings.
BACKGROUND: In late stages of dementia of the Alzheimer type (DAT), most scales measuring only cognitive or functional deficits lose their sensitivity to detect further disease progression. METHODS: By combining ratings of cognitive (speech, eye contact) and functional deficits (dressing, eating, ambulation) with occurrence of pathological symptoms (sleep-wake cycle disturbance, muscle rigidity/contractures), a scale was developed (BANS-S) which does not lose its sensitivity until the patient reaches a vegetative state. BANS-S was tested on three Special Care Dementia Units. RESULTS: Data from 74 patients with the clinical diagnosis of DAT indicated that BANS-S has good reliability and reproducibility. BANS-S scores correlated with scores of Mini-Mental State Examination, Katz ADL, Test for Severe Impairment, and Language Assessment. In 25 patients with the diagnosis of DAT confirmed by autopsy, BANS-S scores determined within 3 months of death correlated with density of neurofibrillary tangles in CA2 and CA3 areas of the hippocampus. CONCLUSION:BANS-S may be a useful tool for the evaluation of different treatment strategies in severe DAT and for the correlation of clinical and pathological findings.
Authors: Jane L Givens; Holly G Prigerson; Dan K Kiely; Michele L Shaffer; Susan L Mitchell Journal: Am J Geriatr Psychiatry Date: 2011-06 Impact factor: 4.105
Authors: Jane L Givens; Sara Spinella; Claire K Ankuda; Erika D'Agata; Michele L Shaffer; Daniel Habtemariam; Susan L Mitchell Journal: J Am Geriatr Soc Date: 2015-06-01 Impact factor: 5.562
Authors: Angela G Catic; Andrea I Berg; Julie A Moran; Julie R Knopp; Jane L Givens; Dan K Kiely; Nicky Quinlan; Susan L Mitchell Journal: J Am Geriatr Soc Date: 2013-11-01 Impact factor: 5.562
Authors: Simon M Cohen; Angelo E Volandes; Michele L Shaffer; Laura C Hanson; Daniel Habtemariam; Susan L Mitchell Journal: J Pain Symptom Manage Date: 2018-09-29 Impact factor: 3.612
Authors: Alyssa B Dufour; Michele L Shaffer; Erika M C D'Agata; Daniel Habtemariam; Susan L Mitchell Journal: J Am Geriatr Soc Date: 2015-11-28 Impact factor: 5.562