MDS Cognitive Performance Scale

J Gerontol. 1994 Jul;49(4):M174-82. doi: 10.1093/geronj/49.4.m174.


Background: Chronic cognitive impairment is a major problem in U.S. nursing homes, yet traditional assessment systems in most facilities included only limited information on cognitive status. Following the Congressional mandate in the Omnibus Reconciliation Act of 1987 (OBRA '87), U.S. nursing homes now complete the Minimum Data Set (MDS), a standardized, comprehensive assessment of each resident's functional, medical, psychosocial, and cognitive status. We designed a Cognitive Performance Scale (CPS) that uses MDS data to assign residents into easily understood cognitive performance categories.

Methods: Information was drawn from three data sets, including two multistate data sets constructed for the Health Care Financing Administration. The prevalence and reliability of the MDS cognitive performance variables were established when assessed by trained nursing personnel. Five selected MDS items were combined to create the single, functionally meaningful seven-category hierarchical Cognitive Performance Scale.

Results: The CPS scale corresponded closely with scores generated by the Mini-Mental State Examination and the Test for Severe Impairment, nursing judgments of disorientation, and neurological diagnoses of Alzheimer's disease and other dementias.

Conclusions: The new CPS provides a functional view of cognitive performance, using readily available MDS data. It should prove useful to clinicians and investigators using the MDS to determine a resident's cognitive assets.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / classification
  • Alzheimer Disease / diagnosis
  • Cognition / physiology*
  • Cognition Disorders / classification*
  • Cognition Disorders / diagnosis
  • Coma / physiopathology
  • Communication
  • Decision Making
  • Dementia / classification
  • Dementia / diagnosis
  • Geriatric Assessment*
  • Humans
  • Language
  • Memory / physiology
  • Memory, Short-Term / physiology
  • Mental Recall / physiology
  • Nursing Homes
  • Orientation / physiology
  • Psychomotor Performance / physiology
  • Reproducibility of Results