The Blessed Scale is a tool used in the field of psychogeriatrics and neuropsychology to evaluate the severity of cognitive symptoms in patients with possible dementia. Developed by neurologist Malcolm JC Blessed and his colleagues at the University of Cambridge in the 1960s, this scale has become a fundamental tool in the assessment of cognitive function in the older adult population. In this article, we will explore in detail what the Blessed Scale is, its parts, what it is for, and how it is used in the clinical evaluation of patients.
What is the Blessed Scale?
The Blessed Scale is an assessment instrument designed to measure the severity of cognitive symptoms in patients with dementia. It is based on clinical observation and caregiver report to determine the degree of cognitive and functional impairment in the individual. The scale consists of two main parts: a section that evaluates activities of daily living and another that evaluates the specific cognitive symptoms present in the patient.
Parts of the Blessed Scale
The Blessed Scale is divided into two fundamental parts:
Part I: Assessment of activities of daily living (ADL)
In this section, the patient's ability to to carry out basic daily tasks, such as dressing, bathing, feeding, using the toilet, and moving from one place to another. Each task is scored on a scale from 0 to 3, where 0 indicates that the patient is able to perform the task without difficulty, and 3 indicates that the task cannot be performed at all. The ADL section total score ranges from 0 to 17, with higher values indicating a greater degree of dependence in activities of daily living.
Part II: Assessment of cognitive symptoms
In this part of the scale, the specific cognitive symptoms present in the patient are evaluated, such as memory loss, temporal and spatial disorientation, difficulty following simple instructions, among others. Each symptom is scored on a scale from 0 to 3, where 0 indicates the absence of the symptom and 3 indicates its severe presence. The total score of the cognitive symptoms section ranges from 0 to 21, where higher values indicate a greater degree of cognitive impairment.
What the Blessed Scale is for
The Scale Blessed serves as a clinical assessment tool to measure the degree of cognitive and functional impairment in patients with dementia. By combining the assessment of activities of daily living with the assessment of cognitive symptoms, this scale provides a comprehensive measure of disease severity and helps healthcare professionals determine the level of dependence and cognitive status of patients.
In addition, the Blessed Scale is used in research and clinical studies to measure the progression of dementia over time, evaluate the effectiveness of pharmacological and non-pharmacological treatments, and compare the effectiveness of different interventions in patients with dementia.
How the Blessed Scale is used
To use the Blessed Scale, it is important to follow a standardized protocol that guarantees validity and the reliability of the results obtained. Below are the steps to use the Blessed Scale appropriately:
1. Preparation and selection of the evaluator
Before beginning the evaluation, it is important to select an evaluator trained in the use of the Blessed Scale. The evaluator may be a health professional, such as a doctor, psychologist, or social worker, who is familiar with the symptoms of dementia and the evaluation process.
2. Interview with the caregiver
The first step in applying the Blessed Scale is to interview the patient's caregiver or close family member to collect information about the individual's activities of daily living and cognitive symptoms. It is important to obtain detailed and objective information that helps determine the appropriate score for each item on the scale.
3. Assessment of activities of daily living
The assessor should observe the patient while performing activities of daily living and, if necessary, collect additional information from the caregiver. Each item in the ADL section is scored according to the patient's level of independence or dependence on that specific task.
4. Assessment of cognitive symptoms
To assess cognitive symptoms, the assessor should ask specific questions to the patient and caregiver about the individual's cognitive status. Each symptom is scored according to its severity and frequency of presentation in the patient.
5. Scoring and analysis of results
Once the evaluation is completed, the scores for activities of daily living and cognitive symptoms are added to obtain a total score on the Blessed Scale. The results are interpreted according to the values established in the scale, where higher scores indicate a greater degree of cognitive and functional impairment in the patient.
In summary, the Blessed Scale is an invaluable tool in the evaluation of dementia in older patients, allowing health professionals to obtain an objective and standardized assessment of the severity of the disease. Its appropriate and consistent use can contribute significantly to the care and treatment of patients with dementia, improving their quality of life and that of their caregivers.