Psychology RootsPhysical and Mental Impairment-of-Function Evaluation
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About Physical and Mental Impairment-of-Function Evaluation
Scale Name
Physical and Mental Impairment-of-Function Evaluation
Author Details
Lee Gurel
Translation Availability
English
Background/Description
The Physical and Mental Impairment-of-Function Evaluation (PAMIE), developed by Lee Gurel in 1972, is a clinical rating scale designed to assess physical, psychological, and social disability in chronically ill, institutionalized elderly patients. Published in Journal of Gerontology (1972), the PAMIE consists of 77 items, primarily focusing on observable behaviors over the past week, completed by a caregiver or clinician familiar with the patient. The first three items use a specific scoring system, while the remaining items employ a yes/no format, with roman numerals indicating the ten factors: I. Self-care, II. Belligerence/Irritability, III. Mental Confusion, IV. Anxiety/Depression, V. Bedfast/Moribund, VI. Behavioral Deterioration, VII. Paranoia/Suspicion, VIII. Sensory/Motor Function, IX. Withdrawn/Apathetic, and X. Ambulation. Unassigned items do not load on factors.
The scale takes 10–15 minutes to complete, with factor scores summed into three general categories: physical infirmity (I, V, VIII, X), psychological deterioration (III, VI, IX), and psychological agitation (II, IV, VII). Unweighted scores are preferred due to equivalent results with weighted scores. The PAMIE was validated with institutionalized elderly samples (mean age ≈ 65–85 years, mixed gender, U.S.-based), correlating with disability measures. It is used in geriatrics, psychiatry, and long-term care to evaluate impairment.
Administration, Scoring and Interpretation
- Obtain the PAMIE from Gurel (1972) or Journal of Gerontology, ensuring ethical permissions.
- Explain to caregivers/clinicians (familiar with elderly 65+ patients) that the scale assesses patient disability, emphasizing confidentiality and voluntary participation.
- Administer the 77-item rating scale in institutional settings, with the caregiver/clinician scoring based on observed behaviors over the past week, using the provided scoring system.
- Estimated completion time is 10–15 minutes.
- Ensure a supportive environment; provide care resources (e.g., referrals) and adapt for accessibility (e.g., clear instructions, assistance) if needed.
Reliability and Validity
The PAMIE demonstrates solid psychometric properties (Gurel, 1972). Internal consistency is high (Cronbach’s alpha ≈ 0.80–0.90 across factors, N not specified). Test-retest reliability is moderate to high (r ≈ 0.75–0.85) over short intervals. Inter-rater reliability is supported by caregiver/clinician consistency (specific r not provided).
Convergent validity is supported by correlations with other disability scales (e.g., Katz ADL Index, r ≈ 0.70–0.80). Discriminant validity is evidenced by its ability to differentiate factor-based impairment categories (e.g., physical vs psychological), with factor scores effectively reflecting distinct domains. Factor analysis confirms the ten-factor structure, supporting construct validity. The PAMIE reliably evaluates impairment. Pairing with the Mini-Mental State Examination or Dementia Rating Scale enhances comprehensive assessment.
Available Versions
77-Items
Reference
Gurel, L., Linn, M. W., & Linn, B. S. (1972). Physical and mental impairment-of-function evaluation in the aged: The PAMIE scale. Journal of Gerontology, 27(1), 83-90.
Important Link
Scale File:
Frequently Asked Questions
What does the PAMIE measure?
It measures physical, psychological, and social disability in elderly patients.
Who is the target population?
Chronically ill, institutionalized elderly (65+) in clinical settings.
How long does it take to administer?
Approximately 10–15 minutes.
Can it inform interventions?
Yes, it assesses impairment to guide geriatric care and treatment plans.
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