Assessment Scales in Old Age Psychiatry

Assessment Scales in Old Age Psychiatry

Burns A, Lawlor B, Craig S, editors

Martin Dunitz Ltd.; 1999. 302 pp. (paper)

ISBN 1-85317-562-5

Being asked to review Assessment Scales in Old Age Psychiatry was like being let loose in a candy store: fun, filled with many new experiences and ultimately vaguely disappointing, although definitely worth the visit.

About 150 diverse instruments are described, including neuropsychological assessments, tests for activities of daily living and quality of life, and tools for assessing depression and delirium. But to keep with the candy analogy, not all of the goodies are what they seem. Sometimes there is only a list of test contents, at other times only a description, and often there is nothing to help digest a complex mouthful.

The layout of this book is appealing. Each scale is described on one page, and the facing page lays out test elements. There is space on every page for notes and annotations; to use this book effectively, cross-referencing and additional notes from one’s own experience are necessary. Each chapter has an introduction that outlines the purpose of that domain of test and reviews the history of old or modified tests. Some analysis is given about which tests might be more useful for certain circumstances and why. The book usually indicates how long a test should take to administer and who is best suited to give it, along with information on how to score tests and what different total scores mean.

Disappointments include the following. Some of the “additional references” are oriented principally towards researchers or those interested in developing new tools, rather than clinicians. There are too few up-to-date references. For example, references are to articles re-evaluating older tools versus newer techniques, information that is essential where tests are unknown or where a choice has to be made between a tried-and-true older tool and a more recent tool. A few of the tools referred to “updated guidelines,” which may score an old test on a new scale, but unfortunately, in at least one instance, the new guidelines are not referenced and there is no example of the newer scale (for example, see Bartel on pages 132-3). One test is described as a “visual analogue” scale, but lacks a visual presentation. Primary sources are missed in a few cases.

Some information is given on the reliability, validity and accuracy of different tools, but the editors have not done a consistent enough job here. As a result, it is difficult for anyone unfamiliar with a test to choose between tools.

The editors excuse some of their lapses in editing in the introduction. However, I cannot accept their excuses. The job of a technical editor should be an arduous one. The editors of this book have not met the many technical requirements of their task and therefore fail their readers.

Despite my many reservations about this book, if you have the time to do your own homework, and the $77.50, it might be a fun addition to your library.