Clinical dementia rating: experience of a multi-racial Asian population

In this study, the authors describe how the Clinical Dementia Rating (CDR) scale fits into the overall evaluation process in an outpatient memory clinic. Based on a retrospective review of 329 patients attending the clinic from 1994 to 1999, the evidence for the validity of the Clinical Dementia Rating's overall ability to stage dementia severity is presented. The Clinical Dementia Rating showed convergent validity when compared against clinical features, mental status, and psychometric test scores, and DSM III-R measures of dementia severity, thus underscoring the trans-cultural feasibility of the Clinical Dementia Rating instrument. The Clinical Dementia Rating is also congruent with the DSM-IV approach of identifying dementia, and demonstrates better discriminatory ability in the milder dementia stages compared with DSM III-R. Future research should focus on addressing the limitations of the Clinical Dementia Rating in other social settings, advanced cases, as well as detecting clinically significant change.