To measure the changes and progress of dementias, there is the Blessed Scale, a tool that has been very reliable in identifying cases of people with this type of condition. Let's see more about what it is, its history, what items it has and its psychometric properties.
The Blessed Dementia Scale (Blessed Dementia Scale), more popularly known as the Blessed Scale, is a hetero-applied psychodiagnostic instrument (it is not the patient who answers it, but an informant) specially focused to assess dementia.
This scale was designed with the intention of being able to quantify the degree of intellectual and personality deterioration of elderly people who showed symptoms of having some type of dementia.
History
The Blessed Scale was developed in 1968 by G. Blessed and his colleagues B. E. Tomlinson and M. Roth. The Blessed Scale was originally developed as an attempt to compare the deterioration of intelligence and personality caused by an underlying neuropathy in patients with dementia symptoms.
Over the years, a revised version was made, the "Revised Dementia Scale", introduced in 1988. This only included the items that reflected the changes seen by the informants in the daily activities and habits of the evaluated person. This new version was more sensitive and specific than the original scale when discriminating what was the severity of the evaluated.
The scale has turned out to be so important in the evaluation of dementia that its items have been included in other instruments. Some examples of this are the case of the standardized interview with close people as part of the "Cambridge Mental Disorders of the Elderly Examination" and the battery of the "Consortium to Establish a Registry for Alzheimer's Disease", an American institution in charge of establishing how many cases of There is Alzheimer's in the United States and how they progress.
The Blessed Scale is a semi-structured instrument with heteroapplied application, since it is not the evaluated patient who answers it, but a relative, friend or close person who knows it. This informant should indicate what changes they have seen in the patient's behavior in the last 6 months. As we have seen, the group that is usually evaluated with this instrument are elderly people with suspected dementia, taking about 10 minutes to administer.
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The Blessed Scale is used to assess the person's mental state, how he develops in his daily activities. It is quick to apply and easy to administer, and it also quantifies the degree of dementia and its severity. It is quite useful for general practitioners and psychologists, both to identify a possible case of dementia and to assess its progression over time. It is preferred over MMSE because the Blessed Scale has the advantage that it measures functional aspects of dementia.
The scale consists of 22 items that are asked to an informant close to the patient, questions which are collected in the following 3 main areas:
1. Changes in the execution of activities of daily living
This area consists of 8 items, which ask about daily tasks, handling and use of money, remembering lists, orienting yourself around the house and in the urban space, recognizing family members, valuing the environment, remembering recent events and recalling the past.
In this section, a score of 1 is an indicator of complete inability to perform the task asked, a score of ½ is an indicator of partial, variable or intermittent disability for that activity and a score of 0 indicates that the patient has no problem in do that homework.
2. Changes in habits
This area consists of 3 items that evaluate aspects related to eating, dressing, and potty training. This section is scored from 0 to 3, being the part that contributes the most to the overall score of the questionnaire.
3. Changes in personality, interests and impulses
This area consists of 11 items that assess changes in personality and impulses, such as increasing withdrawal, increased egocentrism, in addition to loss of interest in feelings, dull affect, loss of emotional control, laughter for no apparent reason, less emotional response and indiscretions sexual.
If the behavior is present it is scored with 1 and if it is absent it is scored with 0.
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