A comparison between two screening instruments for cognitive function; the Mini-Mental State Examination (MMSE) and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS).

• Objectives: To compare two methods for brief assessment of cognitive functions in a neurorehabilitation setting. The Mini Mental State Examination (MMSE) is a well-known instrument for a brief, structured assessment of cognitive function. A more recent instrument, the Barrow Neurological Institute Screen for Higher Cerebral Functions was constructed to cover a broad range of cognitive functions including aspects of affect and awareness. Materials&Methods: 52 patients with neurological diagnosis (stroke, traumatic brain injury, anoxic brain injury, Parkinson´s disease) were assessed with the MMSE and the BNIS. Concordance of the scales was assessed with Goodman-Kruskal´s gamma and scale structure (parallel reliability) was explored with Rank Transformable Pattern of Agreement (RTPA). A linking to the ICF at item-level was performed. Results: 36 men and 16 women (median age 52 years) were recruited. Median number of days between admittance to hospital and screening was 47 (MMSE) and 51 (BNIS). Concordance between the two instruments was good with a gamma coefficient of 0.724 (p=0.0005). RTPA identified different width of the scale steps showing that BNIS discriminated between the subjects that reached the high end of the MMSE scale and MMSE discriminated somewhat better between individuals with lower scores. The MMSE covered 12 ICF categories on Body function and 14 on Activities and Participation. BNIS covered 18 categories on Body functions and 16 on Activities and Participation. Conclusion: The concordance between MMSE and BNIS was good but the scales are not completely interchangeable. The BNIS differentiated those who reached the ceiling on MMSE. More ICF categories on Body function were assessed with the BNIS which might explain this.

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

SAMHÄLLSVETENSKAP  -- Psykologi (hsv//swe)

SOCIAL SCIENCES  -- Psychology (hsv//eng)

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