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Behavioural Neurology Assessment


Mental status examination is used to aid clinical diagnosis of diseases affecting cognitive function. There are several well established formal neuropsychological batteries that assess a broad spectrum of cognitive deficits1 but these are not suited for bedside assessment. To address this issue, we developed “The Behavioural Neurology Assessment” (BNA) designed for use by clinicians as a mental status examination in the ambulatory or inpatient setting.

Our objectives were to:

  1. standardize the administration and scoring of the BNA,
  2. determine the affect of age on BNA variables,
  3. determine the stability and reliability of the BNA,
  4. determine the convergent validity of the BNA compared to the Mini Mental Status Examination (MMSE)2 and
  5. determine the ability of the BNA to discriminate dementia.

The BNA Long Form consists of 24 subtests within separate domains: Attention, Memory, Language, Visuospatial Function, Executive Function, and Praxis.

Standardized normative data was obtained on a sample of 119 healthy subjects ranging in age from 50 to 95. Test-Retest stability was obtained on a sample of 19 subjects and clinical validity was investigated by administering the BNA, along with the MMSE, to 29 patients with dementia and to 29 age-matched healthy subjects (controls).

The BNA has equivalent and superior sensitivity to dementia relative to the MMSE (.93 versus .79) although the specificity of the BNA was equivalent to the MMSE (.93 versus .97). The positive predictive values of the BNA and MMSE are similar, but the BNA provides superior negative predictive value. Moreover, the BNA provides richer qualitative information for diagnosis of dementia.

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1 Lezak MD. Neuropsychological assessment, 3rd ed. New York: Oxford University Press, 1995.
2 Folstein M, Folstein S, McHugh P. “Mini-mental state” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198.