BCAT® Test System
The BCAT Test System consists of five assessment tools that allow the clinician or administrator to accurately assess current cognitive and mood functioning. All five tools can be completed interactively on our website, and each produces a test report. Cognition is at the base of almost all aspects of care, and accurate assessment of cognitive functioning is critical to effective care.
While each test can be administered independently, we recommend "pattern" administrations. This is the most effective way to get an accurate assessment on your patient's current cognitive functioning. We describe test administration patterns below. All BCAT Test System tools are designed for rapid administration and can be repeated to track progress over time. While the full BCAT test usually can be completed in 10-15 minutes, the other screening instruments take less than three minutes to individually complete.The BCAT and the BCAT-SF assess global cognitive functioning, the Kitchen Picture Test assesses practical judgment, the BCIS assesses cognition and behavior for those with severe dementia, and the BADS assesses depression and anxiety.
The Brief Cognitive Assessment Tool (BCAT)
The BCAT was designed as a multi-domain cognitive tool that assesses orientation, verbal recall, visual recognition, visual recall, attention, abstraction, language, executive functions, and visuo-spatial processing. There are 21 items and the total possible score is 50 points. The full BCAT can be administered in 10-15 minutes by professionals and techs, is sensitive to the full spectrum of cognitive functioning (normal, MCI, mild dementia, moderate-severe dementia), produces separate Memory Factor and Executive Functions Factor scores, and can predict basic and instrumental activities of daily living (ADL, IADL). The BCAT has also been shown to help predict discharge residential dispositions, facilitate Advance Directives determinations, aid in fall prevention programs, and help with non-pharmacological behavior management.
Key benefits of the BCAT include:
- Ability to differentiate Mild Cognitive Impairment (MCI) from dementia
- Ability to predict functional (IADL) status
- Can be administered in 10-15 minutes
- Created for providers of rehabilitation therapy, mental health, and primary care
- Created for use in independently-living, assisted-living and nursing facilities
- Emphasis placed on contextual memory and executive functions (with specific scores for each)
The BCAT can be downloaded and used as a paper-and-pencil instrument, but it should be scored online through this website. This is the only way to get factor scores, clinical considerations, and a test report.
The Brief Cognitive Assessment Tool Short Form (BCAT-SF)
The BCAT-SF was designed as a shorter version of the full BCAT. The Short Form can be administered in five minutes or less. While it is not as robust or comprehensive as the full BCAT, the short version has strong reliability, construct validity, and predictive validity. When time is particularly limited (e.g., primary care settings), the six-item, 21-point short form is a dependable cognitive screening tool. The Short Form can differentiate between person with and without dementia. It can be downloaded or used as an online tool.
One commonly asked question is when the BCAT-SF (Short Form) is appropriate versus administering the full BCAT. The BCAT-SF is designed for situations in which the provider has only a few minutes to give a cognitive screening tool. It provides information about cognitive impairment and can differentiate between demented and non-demented persons. However, the Short Form does note differentiate among normal, MCI, and dementia patients, nor does it provide specific information about memory and executive functions. That is why we recommend using the full BCAT whenever possible.
The Brief Cognitive Impairment Scale (BCIS)
The BCIS was designed to assess the cognitive functioning of patients with severe dementia. The BCIS is a 14-item, 18-point scale. It was developed to not only track cognitive changes in severely demented patients specifically, but to provide information to better manage behavior problems. We recommend using the BCIS when severe cognitive impairment has already be established, or when the patient scores under 25 on the BCAT. It is most effective in confirming severe impairment and tracking cognitive changes over time in advanced dementia.
The Kitchen Picture Test (KPT)
The KPT was designed as a visually presented test of practical judgment. The KPT is a unique illustration of a kitchen scene in which three potentially dangerous situations are unfolding. Patients are asked to describe the scene as fully as they can, to identify the three problem situations, to rank the order of importance of each situation in terms of dangerousness, and to offer solutions that would resolve the three problems. The KPT has been found to have construct validity (it measures the construct "judgment"), and can be used to differentiate between those who have dementia and those who do not.
The Brief Anxiety and Depression Scale (BADS)
The BADS was designed as a "process" screening instrument to very rapidly assess anxiety and depression status. This screening tool provides separate anxiety and depression factor scores. While one should not make a mood diagnosis on the basis of the BADS alone, this measure is highly accurate in identifying individuals with high likelihoods of having clinical anxiety and/or depression. The BADS consisted of eight questions, and it can be administered in less than five minutes. It is ideal for clinical situations in which the provider wants to track mood status over time. In this respect, the instrument can be administered multiple times during the course of treatment. The BADS can be administered by a clinician, by proxy (a knowledgeable informant), or as a self-report measure. It can be used with both cognitively intact and cognitively impaired.
The BADS test report provides useful “real time” information.