One aspect that we do not usually give importance to until it begins to fail is our cognitive system. Many consider that our memory, orientation, attention and other capabilities will always be intact. Nevertheless, From the age of 60, these higher level capacities may deteriorate to serious deficiencies.. Therefore, it is essential to design questionnaires to be able to evaluate all these variables. In this article we will address the famous Pfeiffer scale and what is its purpose
As stated by the team of Martínez de la Iglesia and Dueñas Herrero (2001), "Cognitive disorders, including dementia, are some of the most frequent pathologies in this age group". The authors also give approximate figures: "It has been estimated that between 5% and 10% of the Spanish population over 65 years of age has alterations of this type. The figure increases significantly with age, becoming more than 20% in people over 85 years ".
Pfeiffer scale: geriatric patient and assessment
The Pfeiffer scale also known as SPMSQ (Short Portable Mental Status Questionnaire) This is a brief questionnaire composed of ten questions that measure the degree of cognitive impairment. The areas evaluated are: short and long term memory, information on everyday events, the ability to calculate and orientation. Martínez de la Iglesia and Dueñas Herrero (2001), point out that among the main advantages of this questionnaire "Its applicability is found to people with low levels of schooling, and high specificity and sensitivity (over 90%)."
"The young man must not be happy, but the old man who has lived a beautiful life."
-Epicuro de Samos-
The Pfeiffer scale is supplied, above all, to geriatric patientsHowever, it can also be applied to a younger population range if circumstances require. The Spanish Society of Geriatrics and Gerontology (SEGG) in its "Treaty of geriatrics for residents" (2006), defines the geriatric patient as one who meets three or more of the following characteristics:
- Age over 75 years.
- Presence of relevant pluripatology.
- The main process or disease has a disabling nature.
- Existence of accompanying or predominant mental pathology.
- Social problem in relation to their state of health.
The objective of the Pfeiffer scale is encompassed within the framework of a more complete geriatric evaluation to ensure correct patient care. The SEGG lists the different objectives of this assessment:
- Improve diagnostic accuracy based on a fourfold diagnosis: clinical, functional, mental and social.
- Discover treatable problems not previously diagnosed.
- Establish an appropriate treatment based on the quadruple diagnosis.
- Improve functional and cognitive status.
- Improve Life Quality.
- Know the patient's resources and their socio-family environment.
- Place the patient in the medical and social level most appropriate to their needs.
- Avoid dependence whenever possible, and thereby reduce the number of admissions in hospitals and institutions.
- Reduce mortality.
Pfeiffer scale: questions and correction
As noted above, the Pfeiffer scale consists of ten questions, so it is quick to apply. What are the issues that form it? An example of the questionnaire is shown below:
- What day is today? (Month, day and year).
- What weekday is today?
- What is this site called?
- What is your phone number? (If there is not, the street address).
- How old are you?
- How much was born?
- Who is the current president of the country?
- Who was the previous president?
- Tell me your mother's first name.
- Starting from 20, subtract 3 in 3 successively.
For a response to be considered as correct, the following evaluation criteria will be taken into account:
- It is considered correct only if it says the exact day, month and year.
- It will be marked as correct only says the day.
- The score will be accepted as valid if it describes the name of the residence, place, house, hospital, etc.
- There are two possibilities of giving it as correct: if the number is confirmed with a relative or if you repeat the same number twice. The same goes for the address.
- It will be correct if it corresponds to the date of birth.
- It is considered valid if you provide the exact day, month and year.
- The last name of the president will suffice.
- Like the previous one, it will be enough only with the last name.
- The verification of the response can be seen in the clinical record, but it must be correct for punctual as valid.
- He will score as correct if he is able to say the entire series: 20-17-14-11-8-5-2.
An error equals one point. A score equal to or greater than three could indicate cognitive impairment. In that case, dementia criteria should be assessed.
- Maximum score: 8 errors.
- 0-2 errors: normal.
- 3-4 errors: mild cognitive impairment.
- 5-7 errors: moderate cognitive impairment, pathological.
- 8-10 errors: significant cognitive impairment.
If the subject does not have basic studies or studies, one more error will be accepted. If you have higher education, one less error.
Usually, I never usually include personal opinions in the articles, however, this time I can't help doing it. I did psychology practices in a nursing home. For several weeks I evaluated a large number of inmates and the first questionnaire was always the Pfeiffer scale. At that time, I discovered how ten seemingly simple questions to answer could be a real ordeal for some elders or simply were unable to answer them.
At that time I did not feel psychologist or psychology student, I felt human. Where do I want to go? That I could also find myself in that situation. My identification with them was such that I saw myself sitting in a chair in front of a young evaluator asking me about the current day and not knowing what to answer. Without a doubt, I was fully aware of the imperative need to take care of our elders and offer them our best services.
"The secret of a good old age is nothing but a covenant honored with loneliness."
-Gabriel Garcia Marquez-
They took care of us when we still couldn't fend for ourselves. Now that we can, it is up to us to take care of the older population and not only to provide them with the best psychological and medical methods, but with love and affection. Because if I noticed something at the time, it was the great loneliness they suffer. That is why, it is so important to develop tools for a better quality of life, but above all, and even if they do not remember their date of birth, never deprive them of a hug full of love.
Martínez de la Iglesia, J., Dueñas Herrero, R., Onís, M., Aguado, C., Albert, C and Luque, R. (2001). Adaptation and validation in Spanish of the Pfeiffer questionnaire (SPMSQ) to detect the existence of cognitive impairment in people over 65 years. Clinical Medicine, 117, 129-134.
Spanish Society of Geriatrics and Gerontology. (2006).Treaty of geriatrics for residents. Madrid: SEGG.