For Use With Global Deterioration Scale (GOS)
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Brief Cognitive Rating Scale (BCRS)
Pt Name____________________________ Medication:____________________________ Age_______________ Sex ____ M____ F____ ______________________________________ Diagnosis:___________________________ ___________________________ Date:_______________________________
Axle Rating (Circle Highest Score) 1 2 3 4 5 6 7
Axis 1: Concentration
1 - No objective or subjective evidence of deficit in concentration
2 - Subjective decrement in concentration ability
3 - Minor objective signs of poor concentration (e.g. on subtraction of serial 7s from 100).
4 - Definite concentration deficit for persons of their background (e.g. marked deficit on serial 7s; frequent deficit in subtraction of serial 4s from 40)
5 - Marked concentration deficit (e.g,, giving months backwards or serial 2s from 20).
6 - Forgets the concentration task. Frequently begins to count forward when asked to count backwards from 10 by 1s.
7- Marked difficulty counting forward to 10 by 1s.
Axis 2: Recent Memory
1 - No objective or subjective evidence of deficit in recent memory.
2 - Subjective impairment only (e.g., forgetting names more than formally).
3 - Deficit in recall of specific events evident upon detailed questioning. No deficit in the recall of major recent event.
4 - Cannot recall major events of previous weekend or week. Scanty knowledge (not detailed) of current events, favorite TV shows etc.
5 - Unsure of weather: may not know current President or current address.
6 - Occasional knowledge of some recent events. Little or no idea of current address
7- No knowledge of any recent events.
Axis 3: Past Memory
I - No subjective or objective impairment in past memory
2- Subjective impairment only. Can recall two or more primary school teachers.
3 - Some gaps in past memory upon detailed questioning. Able to recall at least one childhood teacher and/or one childhood friend.
4 - Clear cut deficit. The spouse recalls more of the patients past than the patient. Cannot recall childhood friends and/or teachers butknows the names of most schools attended. Confuses chronology in reciting personal history.
5 - Major past events sometimes not recalled (e.g,, names of schools attended).
6 - Some residual memory of past (e.g.. may recall country of birth or former occupation).
7- No memory of past
Axis IV: Orientation
I - No deficit in memory for time, place. identity of self and others
2 - Subjective impairment only. Knows time to nearest hour, location.
3 - Any mistake in time> 2 hrs: day of week> 1 day; date> 3 days.
4 - Mistakes in month> 10 days or year> 1 month.
5 - Unsure of month and/or year and/or season: unsure of locale.
6 - No idea of date. Identifies spouse but may not recall name. Knows own name.
7 - Cannot identify spouse. May be unsure of personal identity.
Axis V: Functioning and Self-Care
I - No difficulty, either subjectively or objectively.
2 - Complains of long forgetting location of objects, Subjective work difficulties.
3 - Decreased job functioning evident to co-workers. Difficulty in traveling to new locations.
4 - Decreased ability to perform complex tasks (e.g. planning dinner for guests, handling finances. marketing, etc.). 5 - Requires assistance in choosing proper clothing
6 - Requires assistance in feeding, and/or toileting, and/or bathing, and/or ambulating.
7 - Requires constant assistance in all activities of daily living.
Total Score_________________ divide by 5.0 _________= Stage on Global Deteriation Scale
Ratings: Taking into account the subject's level or education cultural background, etc. the interviewer rates each clinical axis on the BCRS on a scale ranging from 1 to 7. These scale points define the degree of inpairment on each axis as follows
1 - Normal, no cognitive decline present. Average or better performance.
2 - Very mild. Subjective impairment in comparison with 5 or 10 years previous.
3 - Mild. Minimal impairment which is clinically verifiable with detailed questioning
4 - Moderate. Marked impairment which is readily evidenced clinically.
5- Moderately Severe. Severe impaiment on assesment.
6 - Sever. Very severe impairment; some residual capacity in some assesment areas.
7 - Very severe. Very severe impairment, little residual capacity elicited in assessments.
Axis 1: Concentration - Assessing concentration and attentiveness. Taking into account educational level, ask "How far did you go in school? How are you at subtraction? What is 7 from 100, 7 from 93, 7 from 86" (if can't do ask 4s if can't do ask 2s).
Axis 2: Inpairment of Recent Memory - Ask - "What did you do last weekend? What did you have for breakfast? What is the weather like today? Who is the president, the Governor", etc.
Axis 3: Impairment of Past Memory - Ask - "What primary school did you attend? Where was it located? Who were you prinary school teachers? Where were you born? Who were your childhood friends? What kinds of things did you do with your childhood friends?"
Axis 4: Orientation - Ask hour, day of week, date, place, identity or self.
Axis 5: Functioning and Self-Care.
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