Abstract: Evaluation of suffering level in end-stage dementia by Min- Suffering State Examination (MSSE), SM-EOLD and CAD-EOLD scales.

7th Asia/Oceania Regional Congress of Gerontology,
Tokyo, Japan, 2003

Geriatrics & Gerontology International 2003; 3, suppl 1:S73

Evaluation of Suffering Level in End-Stage Dementia by Mini-Suffering Stage Examination, SM-EOLD and
CAD-EOLD Scales

B.Z. Aminoff, MD, PhD, E. Puritz, MD, R. Medina, RN, S. Noy, MD, PhD, A. Adunsky, MD

Geriatric Division, The Chaim Sheba Medical Center, Tel-Hashomer, Israel

Assessment of suffering is extremely important in dying end-stage dementia patients. We developed the (MSSE) scale, the first objective tool for evaluation of suffering level in end-stage dementia.
Results of a preliminary study were presented at the IVth European Congress of Gerontology, Berlin, 1999;at the 17th World Congress of Gerontology, Vancouver, 2001, and at the 8th International Conference on Alzheimer Disease and Related Disorders, Stockholm, 2002.
The MSSE Scale comprises 10 items, range 0-10; range 7-10 is a high level of suffering. The MSSE scale has significant reliability with Cronbach alpha = 0.735.
The purpose of the study was to evaluate the validity of the MSSE scale versus Comfort Assessment in Dying with Dementia (CAD-EOLD) and Symptom Management at End-of-Life with Dementia (SM-EOLD) scales (Volicer L, et al., Boston, 2001).
Two hundred and forty-four patients with severe cognitive (MMSE-0/30) and functional decline (FIM-18/126) were independently examined by the MSSE, SM-EOLD and CAD-EOLD scales. A high Pearson correlation was proved between the MSSE, CAD-EOLD (r=-0.796, P <0.0001) and SM-EOLD (r=0.574, P <0.0001) scales. We conclude that the MSSE scale is a reliable and valid clinical tool and is recommended for evaluation of the severity of the patient’s condition and the level of suffering in end-stage dementia.