Minimum Data Set Plus (MDS+) scores compared with scores from five rating scales

OBJECTIVE: To compare mandated Minimum Data Set Plus (MDS+) ratings of behavior, function, mood, communication, and cognition to ratings of these domains using analogous research instruments. DESIGN: Cross-sectional correlational study of criterion-related validity. SETTING: Three nursing homes in Rochester, New York. PARTICIPANTS: Fifty-two nursing home residents. MEASUREMENTS: Nursing home staff completed the MDS+ for each subject. Research scales were completed by trained research clinicians, independently of and blinded to the MDS+ results, using the Mini-Mental State Exam (MMSE), Brief Psychiatric Rating Scale (BPRS), Dementia Mood Assessment Scale (DMAS), Psychogeriatric Dependency Rating Scale (PGDRS), and Physical Signs and Symptoms Scale (PSMS). RESULTS: MDS+ measures of functional status, cognitive impairment, and communication were highly correlated with comparable research rating scale scores. Pearson correlation between MDS-functional status and PSMS scores was 0.89, between MDS-dementia and BPRS Factor 3 (representing cognitive dysfunction) and MMSE scores was 0.85 and 0.77, respectively, and between MDS-communication and MMSE and PGDRS Item 6 (assessing communication) scores was 0.74 and 0.62, respectively. Behavior and mood scores did not correlate nearly as well with comparable research scale scores. Pearson correlation between MDS- behavior and PGDRS and BPRS total scores was 0.54 and 0.51, respectively , and between MDS-mood and BPRS Factor 1 (depression) and DMAS 1-17 subtotal (mood disturbance) scores was 0.20 and 0.20, respectively. CONCLUSION: This preliminary study in a small sample shows marked agreement between three of the five MDS+ components analyzed and comparable research rating scales and confirms that behavior and mood are difficult to assess with simple instruments.

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