Development of Clinical Dementia Rating Scale Cut‐off Scores for Patients With Parkinson's Disease

Abstract

Background The purpose of this study was to explore validity of the Clinical Dementia Rating Scale in measuring cognitive impairment among individuals with Parkinson's disease. The scale was created for use in patients with Alzheimer's disease and, to date, there have been no published studies examining if this tool is appropriate for patients with Parkinson's disease. Methods The data were obtained from the National Alzheimer's Coordinating Center database and included 490 subjects diagnosed with Parkinson's disease, further categorized as having Parkinson's disease dementia (n= 151), mild cognitive impairment (n= 186), or normal cognition (n = 153) by a treating physician. Sensitivity, specificity, positive predictive value and negative predictive values were calculated for the Clinical Dementia Rating Scale Global Score as well as the Sum of Boxes Score using existing cutoff scores. Finally, new cutoff scores were calculated using sensitivity and specificity values derived using Receiver Operating Characteristic curves. Results Sensitivity and specificity of the published Global Score cutoff scores for patients with dementia were .34 and .10, respectively. The newly calculated cutoff scores for patients with dementia yielded a sensitivity of .79 and a specificity of .96. The area under the curve was 0.92 (95% CI = 0.90-0.95). Conclusion The CDR is a useful tool in identifying dementia in patients with Parkinson's disease when the cutoff scores are adjusted.

Predicting Cognitive Decline in Parkinson’s Disease with Mild Cognitive Impairment: A One-Year Observational Study

“…After a one-year follow-up, four participants (2 AD-MCI and 2 PD-MCI) developed dementia, which was confirmed by the clinical criteria of final CDR ≥ 1 or CDR-SB ≥ 4.5 [ 13 , 14 ]. Thirteen (17.6%) participants with MCI had a cognitive decline.…”

“…To avoid fatigue, the time limit for each interview was 90 minutes. The diagnosis of MCI was based on the global clinical dementia rating (CDR) of 0.5 and the CDR Sum of Boxes (CDR-SB) of 0.5–4.0 [ 13 , 14 ].…”

Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms

“…C l i n i c a l D e m e n t i a R at i n g ( C D R ) A CDR score of 0.5 is considered appropriate to define PD-MCI (Goldman et al, 2011;Wyman-Chick and Scott, 2015). Therefore, participants were classified as MCI if they had a CDR (subject) and CCDR (informant) (Morris, 1993) score of 0.5, integrating our independent interviews of the patient and informant.…”

Trinta anos da escala Clinical Dementia Rating: o que sabemos sobre o CDR?

“…14 Mais recentemente, em 2013, Cedarbaum e colaboradores avaliaram o uso do CDR-SOB como medida de desfecho primário em ensaios clínicos, mostrando que as propriedades psicométricas do instrumento parecem adequadas para as pesquisas realizadas nas fases mais precoces da DA. 15 Até a conclusão deste levantamento bibliográfico, os artigos relevantes estavam relacionados ao uso CDR-SOB como parte de um possível instrumento para avaliação no CCL e nos estágios iniciais da DA, 16 ao desenvolvimento de pontos de cortes diferenciado do CDR global e CDR-SOB para pacientes com doença de Parkinson, 17 ao uso do CDR global no CCL 18 e na avaliação da performance de grupos em ensaios clínicos com o uso do CDR-SOB. 19 O CDR no Brasil Apesar de o CDR ser conhecido mundialmente como um instrumento com alta confiabilidade no estagiamento da demência, no Brasil ainda dispomos de poucas publicações referentes ao tema.…”