Health of the Nation Outcome Scales for Elderly People (HoNOS 65+)

Background Health of the Nation Outcome Scales (HoNOS) have been developed to measure outcomes in people with mental health problems. Aims The particular physical and cognitive problems affecting older people requires a specific scale for their measurement. We describe the development of such a scale; named HoNOS 65+. Method Pilot, validity and reliability studies were carried out on an amended scale. Validity was assessed by comparison with existing scales reflecting depression. cognitive function, psychiatric symptomatology, activities of daily living and functional abilities. Reliability was measured in two centres. Results HoNOS 65+ was successfully amended to include specific aspects of mental health problems in older people including the phenomenology of depression, delusions occurring in the presence of dementia, incontinence and agitation/restlessness. HoNOS 65+ was able to discriminate between people suffering from organic and functional illnesses. Correlations with other scales indicated reasonable validity Reliability was satisfactory. Conclusions A version of HoNOS 65+ is presented (see pp. 435-438, this issue) which is appropriate for use in elderly people with mental health problems. Declaration of interest Sponsored by REMEDI, the Gatsby Foundation and the Headley Trust.