Background: Fl oor effects are present in most dementia assessment tools as dementia progresses
and the in–depth assessment of patients considered more or less on vegetative state is questionable.
Objective: To develop a questionnaire (the “Gatos Clinical Test-GCT”) for the assessment of end-stage demented
patients. Methods: Five hundred patients with dementia of various causes and an MMSE score between
0 and 2 were enrolled in the study. The GCT consists of 14 closed type questions rated on a Likert
scale. The total score is used to evaluate patient’s dementia. Various aspects of validity and reliability (including
face, content and structural validity as well as test-retest reliability) were examined. Results: Three subscales
“Autonomy/Alertness”, “Gnosias” and “Somatokinetic function” were defined, with a Cronbach equal to 0.851, 0.756 and
0.598 respectively. The GCT subscales and total score were statistically significant higher in patients with MMSE score 1
or 2 compared with those with MMSE score 0 (p<0.0005). Patients with GCT total score less than 12.5 had 75% probability
to have zero MMSE score. Conclusion: The “GATOS” questionnaire is a valid and reliable test for patients with severe
dementia, aiming at identification of those patients who could sustain some quality of life. It is a relatively short and easy
to administer tool. As dementia prevalence is expected to rise further worldwide we believe that GCT could offer valuable
services to health professionals, caregivers and patients.
Keywords: Dementia, end-stage, questionnaire, reliability, validity.
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