The canine cognitive dysfunction rating scale (CCDR): a data-driven and ecologically relevant assessment tool

Canine cognitive dysfunction (CCD) is an age-related neurobehavioural syndrome which, although common, is severely under-diagnosed in community-based dogs. Using data from a large cross-sectional survey of older dogs (n=957), this study aimed to develop a clinical scale for assessing CCD. Data-driven analytical techniques were used to distil 27 significant behavioural items (previously identified as relevant to CCD) into an assessment tool with maximal cognito-behavioural breadth whilst maintaining clinical utility. The resulting CCD rating scale (CCDR) comprised 13 behavioural items, of which three were sensitive to the severity of the disease stage. When tested on an independent survey sample, the CCDR had an overall 98.9% diagnostic accuracy with a 77.8% positive predictive value and a 99.3% negative predictive value. Test-re-test reliability of the CCDR over 2months was also high (r=0.73, P<0.0001). In conjunction with veterinary assessment, the CCDR could be a valuable tool in research and clinical settings for both the assessment and longitudinal tracking of cognitive change.