Diagnostic accuracy of the Clinical Dementia Rating Scale for detecting mild cognitive impairment and dementia: A bivariate meta‐analysis

Background: The Clinical Dementia Rating Scale (CDR) is used to rate dementia severity. Its utility in diagnosing mild cognitive impairment (MCI) and its predictive value remain unknown. Aims: The aim of this study was to examine the association between CDR scores and expert MCI diagnosis, and to determine whether baseline CDR scores were predictive of cognitive or functional decline and progression to dementia over 6 years. Methods: At baseline, the sample comprised 733 non-demented participants aged 70-90 years from the longitudinal Sydney Memory and Ageing Study. Global and sum of boxes CDR scores were obtained at baseline. Participants also received comprehensive neuropsychological and functional assessment as well as expert consensus diagnoses at baseline and follow-up. Results: At baseline, CDR scores had high specificity but low sensitivity for broadly defined MCI. The balance of sensitivity and specificity improved for narrowly defined MCI. Longitudinally, all baseline CDR scores predicted functional change and dementia, but CDR scores were not predictive of cognitive change. Conclusion: CDR scores do not correspond well with MCI, except when MCI is narrowly defined, suggesting that the CDR taps into the more severe end of MCI. All CDR scores usefully predict functional decline and incident dementia.

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Diagnosis and staging of mild cognitive impairment, using a modification of the clinical dementia rating scale: the mCDR

International Journal of Geriatric Psychiatry ◽

10.1002/gps.2334 ◽

2010 ◽

Vol 25 (3) ◽

pp. 282-289 ◽

Cited By ~ 22

Author(s):

Ranjan Duara ◽

David A. Loewenstein ◽

Maria T. Greig-Custo ◽

Ashok Raj ◽

Warren Barker ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Rating Scale ◽

Clinical Dementia Rating ◽

Dementia Rating Scale

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Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms

International Psychogeriatrics ◽

10.1017/s1041610217002265 ◽

2017 ◽

Vol 30 (2) ◽

pp. 253-260 ◽

Cited By ~ 11

Author(s):

Kirstie L. McDermott ◽

Nancy Fisher ◽

Sandra Bradford ◽

Richard Camicioli

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Normative Values ◽

Clinical Dementia Rating ◽

Dementia Rating Scale ◽

Over Time

ABSTRACTBackground:We apply recently recommended Parkinson's disease mild cognitive impairment (PD-MCI) classification criteria from the movement disorders society (MDS) to PD patients and controls and compare diagnoses to that of short global cognitive scales at baseline and over time. We also examine baseline prevalence of neuropsychiatric symptoms across different definitions of MCI.Methods:51 PD patients and 50 controls were classified as cognitively normal, MCI, or demented using MDS criteria (1.5 or 2.0 SD below normative values), Clinical Dementia Rating Scale (CDR), and the Dementia Rating Scale (DRS). All subject had parallel assessment with the Neuropsychiatric inventory (NPI).Results:We confirmed that PD-MCI (a) is frequent, (b) increases the risk of PDD, and (c) affects multiple cognitive domains. We highlight the predictive variability of different criteria, suggesting the need for further refinement and standardization. When a common dementia outcome was used, the Level II MDS optimal testing battery with impairment defined as two SD below norms in 2+ tests performs the best. Neuropsychiatric symptoms were more common in PD across all baseline and longitudinal cognitive classifications.Conclusions:Our results advance previous findings on the utility of MDS PD-MCI criteria for PD patients and controls at baseline and over time. Additionally, we emphasize the possible utility of other cognitive scales and neuropsychiatric symptoms.

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Cerebral Metabolic Correlates of the Clinical Dementia Rating Scale in Mild Cognitive Impairment

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988706297093 ◽

2007 ◽

Vol 20 (2) ◽

pp. 84-88 ◽

Cited By ~ 32

Author(s):

Robert Perneczky ◽

Julia Hartmann ◽

Timo Grimmer ◽

Alexander Drzezga ◽

Alexander Kurz

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Rating Scale ◽

Clinical Dementia Rating ◽

Dementia Rating Scale

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Validity of the Clinical Dementia Rating Scale Sum of Boxes in Staging and Detection of Cognitive Impairment in Mexican Americans

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988720973755 ◽

2020 ◽

pp. 089198872097375

Author(s):

Parunyou Julayanont ◽

John C. DeToledo

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mexican Americans ◽

Rating Scale ◽

Amnestic Mild Cognitive Impairment ◽

Clinical Dementia Rating ◽

Education Levels ◽

Dementia Rating Scale

Objective: We evaluated the utility of the Clinical Dementia Rating Sum of Boxes score (CDR-SB) in staging and detecting amnestic-mild cognitive impairment (a-MCI) and Alzheimer’s disease (AD) among Mexican Americans. Methods: Receiver operator curves were generated to evaluate the validity of the CDR-SB in staging and detecting a-MCI and AD in 1,073 Mexican Americans (758 controls, 163 a-MCI, and 152 AD). Results: Optimal ranges of the CDR-SB were 0, 0.5-4, 4.5-8.0, 8.5-13 and 13.5-18 for staging the global CDR score of 0, 0.5, 1, 2, and 3, respectively. The CDR-SB ≥ 0.5 differentiated the a-MCI patients from the controls (sensitivity 100% and specificity 99.5%) and ≥ 2.0 distinguished the AD from a-MCI patients (sensitivity 83.6% and specificity 87.1%). These cutoffs were also appropriate for patients with ≤6 years of education. Conclusion: The CDR-SB is useful to detect and stage a-MCI and AD in Mexican Americans with diverse education levels.

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Diagnostic Accuracy of Blood Biomarkers for Alzheimer’s Disease and Amnestic Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Ageing Research Reviews ◽

10.1016/j.arr.2021.101446 ◽

2021 ◽

pp. 101446

Author(s):

Ying-Ren Chen ◽

Chih-Sung Liang ◽

Hsin Chu ◽

Joachim Voss ◽

Xiao Linda Kang ◽

...

Keyword(s):

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Amnestic Mild Cognitive Impairment ◽

Blood Biomarkers

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Relationship between Cognitive Performance and Measures of Neurodegeneration among Hispanic and White Non-Hispanic Individuals with Normal Cognition, Mild Cognitive Impairment, and Dementia

Journal of the International Neuropsychological Society ◽

10.1017/s1355617717000820 ◽

2017 ◽

Vol 24 (2) ◽

pp. 176-187 ◽

Cited By ~ 5

Author(s):

Shanna L. Burke ◽

Miriam J. Rodriguez ◽

Warren Barker ◽

Maria T Greig-Custo ◽

Monica Rosselli ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Performance ◽

Entorhinal Cortex ◽

Rating Scale ◽

Structural Mri ◽

Diagnostic Group ◽

Disease Stage ◽

Clinical Dementia Rating ◽

Mild Dementia

AbstractObjectives:The aim of this study was to determine the presence and severity of potential cultural and language bias in widely used cognitive and other assessment instruments, using structural MRI measures of neurodegeneration as biomarkers of disease stage and severity.Methods:Hispanic (n=75) and White non-Hispanic (WNH) (n=90) subjects were classified as cognitively normal (CN), amnestic mild cognitive impairment (aMCI) and mild dementia. Performance on the culture-fair and educationally fair Fuld Object Memory Evaluation (FOME) and Clinical Dementia Rating Scale (CDR) between Hispanics and WNHs was equivalent, in each diagnostic group. Volumetric and visually rated measures of the hippocampus entorhinal cortex, and inferior lateral ventricles (ILV) were measured on structural MRI scans for all subjects. A series of analyses of covariance, controlling for age, depression, and education, were conducted to compare the level of neurodegeneration on these MRI measures between Hispanics and WNHs in each diagnostic group.Results:Among both Hispanics and WNH groups there was a progressive decrease in volume of the hippocampus and entorhinal cortex, and an increase in volume of the ILV (indicating increasing atrophy in the regions surrounding the ILV) from CN to aMCI to mild dementia. For equivalent levels of performance on the FOME and CDR, WNHs had greater levels of neurodegeneration than did Hispanic subjects.Conclusions:Atrophy in medial temporal regions was found to be greater among WNH than Hispanic diagnostic groups, despite the lack of statistical differences in cognitive performance between these two ethnic groups. Presumably, unmeasured factors result in better cognitive performance among WNH than Hispanics for a given level of neurodegeneration. (JINS, 2018,24, 176–187)

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