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Assessing Alzheimer severity with a global clinical scale
J W Ashford1, V Kumar, M Barringer
1Southern Illinois University School of Medicine, Department of Psychiatry, Springfield.
International Psychogeriatrics
|January 1, 1992
Summary
Accurate dementia severity assessment is crucial. This study found that combining the Mini-Mental State Exam (MMS), Activities-of-Daily-Living (ADL), and Clinical Dementia Rating (CDR) scales provides a reliable measure for diagnosing dementia progression.
Area of Science:
- Neurology
- Geriatrics
- Psychometry
Background:
- Precise dementia severity determination is essential for effective patient management.
- Existing assessment tools require refinement for direct comparability across disease stages.
Purpose of the Study:
- To evaluate the reliability and validity of modified Mini-Mental State Exam (MMS), Activities-of-Daily-Living (ADL), and Clinical Dementia Rating (CDR) scales.
- To assess the utility of these comparable scales in determining dementia severity across a wide spectrum of impairment.
Main Methods:
- Modified MMS, ADL, and CDR scales were administered to 112 outpatients and 45 nursing home residents with varying dementia severity.
- Correlations between the scales were analyzed, particularly within the probable Alzheimer's disease patient subgroup.
Main Results:
- The scales demonstrated high correlations, especially in probable Alzheimer's disease patients (e.g., Global Assessment of Dementia [GAD] vs. ADL: r = 0.91).
- Scores on individual scales were generally similar for probable Alzheimer's disease patients.
- Discrepancies in scores were linked to the presence of comorbidities.
Conclusions:
- The modified MMS, ADL, and CDR scales are reliable, valid, and useful for assessing dementia severity.
- Averaging scores from these scales offers increased precision for a more accurate dementia severity indication.
- These comparable scales aid in understanding dementia progression from mild to profound impairment.