The Dementia Rating Scale (DRS) in the diagnosis of vascular dementia

Abstract

The Dementia Rating Scale (DRS) is considered a very useful instrument to assess patients with dementia. The tasks are grouped into five subscales, each one evaluating different cognitive areas, namely: Attention, Initiation/Perseveration (I/P), Construction, Conceptualization and Memory.ObjectiveTo verify the ability of the DRS in discriminating vascular dementia (VaD) patients from healthy controls and VaD from Alzheimer disease (AD) patients.MethodsThe DRS was applied to 68 patients with mild dementia (12 with VaD and 56 with AD) and 60 healthy controls. The clinical diagnosis was made by two neurologists based on the patients´ history, laboratory and neuroimaging results and neuropsychological tests.ResultsIn the comparison between VaD patients and controls, the subscales I/P, Memory, Conceptualization and Attention were those displaying best discrimination between the two groups. The cutoff <124 yielded 93.3% of sensitivity and 91.7% of specificity for the diagnosis of VaD. Only the I/P subscale differentiated VaD from AD patients.ConclusionsThe DRS was found to be a useful instrument to discriminate VaD patients from controls. VaD patients showed worse performance in tasks of executive functions than AD patients. Executive dysfunction, evaluated through the I/P subscale of the DRS, might be useful in differentiating between VaD and AD patients.

Normative Data for Healthy Middle-Aged and Elderly Performance on the Addenbrooke Cognitive Examination-Revised

“…All participants scored Z123 points on the Mattis Dementia Rating Scale, 24 had no complaints of cognitive decline or history of neurologic or psychiatric illness, and did not use drugs that could affect the central nervous system. None of the participants fulfilled the Diagnostic and Statistical Manual-IV criteria for depression; all scored <8 points on the Cornell Scale for Depression in Dementia.…”

Brazilian Version of the Addenbrooke Cognitive Examination-revised in the Diagnosis of Mild Alzheimer Disease

“…[10][11][12][13][14][15][16][17][18][19] Mioshi et al 20 revised the ACE in 2006 and showed similar diagnostic accuracy and psychometric properties of the Addenbrooke Cognitive Examination-revised (ACE-R) in relation to the ACE. 24,25 The control group was composed of 62 healthy agematched and education-matched elderly volunteers selected in the community, especially in senior groups. We have previously adapted and published the Brazilian version of the battery.…”

“…In addition to the MMSE score and the 100 points for the total score, the ACE-R offers 5 subdomain scores (orientation/attention, memory, verbal fluency, language, and visuospatial). All subjects scored Z123 points on the DRS, 24,25 had no complaints of cognitive decline or history of neurologic or psychiatric illness, and were not using of any drug that could affect the central nervous system. 21 The aims of this study were to investigate the performance of patients with mild AD and cognitively healthy elderly volunteers in the Brazilian version of the ACE-R, and to determine its cut-off score/subscores and the corresponding sensitivity, specificity, and positive and negative predictive values in this sample.…”

Habilidades linguísticas de pacientes com demência vascular: estudo comparativo com a doença de Alzheimer

“…Estudos de meta-análise procuram resolver alguns dos problemas acima mencionados, uma vez que comparam os grupos independentemente da significância estatística e do tamanho da amostra (Mathias e Burke, 2009 Alguns estudos apresentaram resultados demonstrando que a expressão linguística está mais afetada na DV do que na DA, em habilidades de nomeação (Lukatela et al 2000;Chan et al, 2008), escrita (Kertesz e Clydesdale, 1994) e outros testes verbais que envolvem função executiva, como a fluência verbal (Lukatela et al 2000;Porto et al, 2007). Ao contrário, relatos de melhor desempenho dos pacientes com DV na expressão linguística também são encontrados na literatura (Villardita, 1993;Powell et al, 1988;Barr et al, 1992;Chapman, 1997).…”

“…Vários estudos apontaram que a fluência verbal é uma medida que pode diferenciar as duas formas de demência (Tierney et al, 2001;Matioli, 2005), estando mais prejudicada na DV (Matioli, 2005;Porto et al, 2007) usada na ABCD é raramente vista em baterias de avaliação cognitiva e, talvez, seja mais restritiva com relação ao acesso lexical em populações de baixa escolaridade, como é o caso da população brasileira.…”