The Test for Severe Impairment: An Instrument for the Assessment of Patients with Severe Cognitive Dysfunction

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Abstract
To develop a reliable and valid test of cognitive function suitable for patients with severe cognitive impairment. Administration of a test; test-retest reliability; comparison to traditional test. Chronic long-term-care facility. The participants were 40 elderly residents with severe cognitive impairment. Results of the Test for Severe Impairment (TSI) and its subsections (language, memory, executive function, and motor performance); correlation of test and retest scores; correlation of TSI with Mini-Mental State Exam. The TSI was significantly correlated with the Mini-Mental State Exam (r = 0.83, P less than or equal to 0.0001). Test-retest reliability was high (r = 0.96, P less than 0.0001). The internal reliability of the test was also good (alpha = 0.90). Preliminary result of a factor-analysis suggests that factor scores may be derived that relate to memory, language production, and knowledge of body parts. The TSI is a valid and reliable test of cognitive function in patients with severe cognitive impairment. It is appropriate to use it as a unified scale.