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The Dementia Rating Scale (DRS) is a brief neuropsychological assessment battery designed to assess five areas of cognitive functioning in the elderly. The relationship between DRS performance and everyday functioning was examined for 50 psychogeriatric patients. Everyday functioning was assessed with a standardized performance measure examining self-care, safety, money management, cooking, medication administration, and community utilization. Regression analyses were conducted for each of the six functional domains. In addition, correlations between the DRS subscales and the functional areas were computed. Results revealed significant predictive relationships (p <.01) between performance on the DRS and most functional domains. The multiple Rs ranged from .52 - .70, accounting for 27% to 49% of the variance. The Initiation/Perseveration subscale was most heavily weighted in each analysis. Significant correlations were obtained between subdomains of cognition and most functional areas. The findings provide evidence of relationships between DRS performance and functional ability.

The Dementia Rating Scale (DRS) is a brief neuropsychological assessment battery designed to assess five areas of cognitive functioning in the elderly. The relationship between DRS performance and everyday functioning was examined for 50 psychogeriatric patients. Everyday functioning was assessed with a standardized performance measure examining self-care, safety, money management, cooking, medication administration, and community utilization. Regression analyses were conducted for each of the six functional domains. In addition, correlations between the DRS subscales and the functional areas were computed. Results revealed significant predictive relationships (p <.01) between performance on the DRS and most functional domains. The multiple Rs ranged from .52 - .70, accounting for 27% to 49% of the variance. The Initiation/Perseveration subscale was most heavily weighted in each analysis. Significant correlations were obtained between subdomains of cognition and most functional areas. The findings provide evidence of relationships between DRS performance and functional ability.

Despite their increasing representation in the population, little is known about the neuropsychological test performance of the oldest old, particularly those who live in residential settings. Limited published data and clinical experience suggest that this group is more likely to perform in the impaired range on standardized tests when cut-offs developed with younger groups are used. We examined the Dementia Rating Scale (DRS) performance of 82 nondemented nursing home residents, aged 80 to 99, with a mean education level of 11 years. Using published norms and cutoffs, a large percentage of this sample performed in the impaired range, particularly on the initiation and conceptualization subtests and on the total score. Education, but not age, was significantly related to performance in this sample. Percentages of patients misclassified were substantial in all groups, but were higher in those with less than 13 years of education. Using a lower total-score cutoff of 110 reduced the percentage of misclassifications markedly. We recommend the development and use of revised cutoff scores for the evaluation of very elderly nursing home residents.

The utility of the Clock Drawing Test (CDT) in localizing lesions has not been thoroughly examined to date. In the present study, six scoring systems (Freedman et al., 1994; Ishiai, Sugishita, Ichikawa, Gono, & Watabiki, 1993; Mendez, Ala, & Underwood, 1992; Rouleau, Salmon, Butters, Kennedy, & McGuife, 1992; Sunderland et al., 1989; Tuokko, Hadjistavropoulos, Miller, & Beattie, 1992; Watson, Arfken, & Birge, 1993; Wolf-Klein, Silverstone, Levy, & Brod, 1989) were used to assess clock drawings by 76 stroke patients and 71 normal controls. Significant differences were found between normals and stroke patients on all scoring systems for both quantitative and qualitative features of the CDT. Quantitative indices were not helpful in differentiating between various stroke groups (left versus right versus bilateral stroke; cortical versus subcortical stroke; anterior versus posterior stroke). Qualitative features were helpful in lateralizing lesion site and differentiating subcortical from cortical groups. Correlational analyses revealed that CDT performance was related to visuospatial processing and measures commonly used in cognitive screening.

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The Hooper Visual Organization Test (HVOT) is a measure of visuospatial processing commonly employed in neuropsychological assessment. Despite the well-documented relationship between visuospatial abilities and right hemisphere function, the literature has not supported a right hemisphere association with HVOT performance. The current study was conducted to examine laterality differences in HVOT performance. Sixty-seven geriatric stroke patients (44 right CVAs, 23 left CVAs) were administered the HVOT and the Mini-Mental State Exam (MMS). Results revealed significant differences between CVA groups for total score, with right CVA patients performing more poorly. Qualitative error analyses revealed highest frequencies for part responses and don't know/no response errors. Between-group differences were seen for part and unformed/unassociated errors (higher right CVA rates), and language-based errors (higher left CVA rates). Findings are consistent with theories of brain lateralization and suggest that whereas HVOT performance predominantly involves right hemisphere functions, left hemisphere dysfunction may also lead to impaired performance, and the two can be discriminated by qualitative analysis of errors.