The Multidimensional Observation Scale for Elderly Subjects (MOSES): studies in adults with intellectual disability

This report describes the results of five studies aimed at evaluating the usefulness, reliability, and validity of the Multidimensional Observation Scale for Elderly Subjects (MOSES) in the assessment of change in ageing persons with intellectual disability. Three hundred and thirty-six individuals with an average age of 49.8 years, including an equal number of men and women, were participants in one or more of the five studies. There were 220 participants with Down syndrome, 81 persons without Down syndrome with intellectual disability, and 35 persons from the general ageing population who were clinically diagnosed with Alzheimer's disease using NINCD/ADRDA criteria. Persons with Down syndrome 40 years of age and older could be distinguished from their younger peers with Down syndrome by statistically significant poorer scores on the MOSES, with those 50 years of age and older showing the worst scores. Comparisons of adults with intellectual disability diagnosed with dementia of the Alzheimer type (DAT), using DSM-IV criteria, with or without Down syndrome, as well as comparisons of patients with clinically diagnosed depression, provided evidence that subtests of the MOSES were sensitive to DAT but less so to depression. These clinical groups also showed significantly poorer scores on the MOSES when compared with those of the normative sample. It was concluded that the MOSES is a behavioural observation scale that can provide useful information in clinical settings as well as in research.