How Well Does the Brief Interview for Mental Status Identify Risk for Cognition Mediated Functional Impairment in a Community Sample?
Objective
To determine the adequacy of the Brief Interview for Mental Status (BIMS) compared with other screening tools in identifying individuals with limitations in functional cognition and instrumental activities of daily living (IADL).


Design
Cross-sectional observational study.


Setting
Midsized midwestern city.


Participants
We assessed a convenience sample of community dwelling individuals (N=197) aged 55 years and older who were living independently.


Main Outcome Measures
Participant scores on the BIMS, Mini-Cog, Menu Task, and Montreal Cognitive Assessment (MoCA) were compared with the Performance Assessment of Self-Care Skills Checkbook Balancing and Shopping tasks (PCST), which are known to predict impairment in complex IADLs associated with a diagnosis of mild cognitive impairment. Multiple logistic regression analyses controlling for participant demographics, as well as sensitivity and specificity, were computed for each screening measure using the PCST as the criterion measure.


Results
The Mini-Cog, Menu Task, and MoCA identified 25.89%, 32.49%, and 47.21% more individuals, respectively, as impaired than the BIMS. In multiple logistical regression analyses, the BIMS correctly identified 58% of those impaired on the PCST. However, each of the alternate screening measures correctly identified at least 70% of individuals as impaired on the PCST.


Conclusions
In this community sample, the BIMS was insensitive to subtle impairments with the potential to compromise community living, suggesting that the BIMS may be inappropriate for use outside nursing home settings.
['Marks|Timothy S|TS|', 'Giles|Gordon M|GM|', 'Al-Heizan|Muhammad O|MO|', 'Edwards|Dorothy F|DF|']
Cognition Activities of daily living AUC, area under the curve BIMS, Brief Interview for Mental Status CI, confidence interval CMS, Center for Medicare and Medicaid Services Diagnostic Testing and Procedures IADL, instrumental activities of daily living MoCA, Montreal Cognitive Assessment OR, odds ratio PASS, Performance Assessment of Self-Care Skills PCST, Checkbook Balancing and Shopping tasks