Reliability of the Washington University Clinical Dementia Rating

Burke, William J.; Miller, J. Philip; Rubin, Eugene H.; Morris, John C.; Coben, Lawrence A.; Duchek, Janet M.; Wittels, Ilene; Berg, L.

doi:10.1001/archneur.1988.00520250037015

Cited by 304 publications

(184 citation statements)

References 9 publications

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“…The CDR classifies subjects without dementia (0), with questionable (0.5), mild (1), moderate (2) and severe (3) dementia. We also included the overall CDR (0 -18) which derives from scores in six individual categories of cognitive function, ie memory, orientation, judgement and problem solving, involvement in community affairs, involvement at home and in hobbies, and personal care (Burke et al, 1988). High overall CDR indicates severe dementia.…”

Section: Functional Status and Cognitive Statusmentioning

confidence: 99%

The effect of nutritional intervention in elderly subjects residing in group-living for the demented

Faxén‐Irving¹,

Andrén-Olsson²,

Geijerstam³

et al. 2002

Eur J Clin Nutr

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Objectives: We studied the nutritional status and the effects of nutritional intervention on body weight, cognition and activities of daily life (ADL)-function in demented individuals. Design: Controlled non-randomised study. Setting: Group-living for demented elderly (GLD), ie community assisted housing. Subjects and interventions: Twenty-two residents living in one of two units (GLD-I), received oral liquid supplements (1720 kJ=410 kcal=day) and the personnel of the GLD-I were given nutritional education. Fourteen residents in the other unit (GLD-C) served as controls. After 6 months 21 (83 (4) y, 81% women) and 12 (85 (4) y, 100% women) of the participants, respectively, were re-examined according to body mass index (BMI, kg=m 2 ), cognitive function (Mini Mental State Examination (MMSE, 0 -30 p) and Clinical Dementia Rating Scale (CDR) and the Katz' ADL index. Results: Body mass index (BMI) 20 was found in 19% of the participants and 44% had BMI 23. BMI correlated with MMSE (r ¼ 0.43, P < 0.01). The weight of the residents in the intervention group increased by 3.4 (3) kg (P ¼ 0.001) at follow-up, whereas the weight remained unchanged in the control group. The cognitive function was low at the start in both groups, ie MMSE 9 and no apparent positive effect of the nutritional intervention was seen. In addition, the ADL functions appeared to deteriorate in both groups. Conclusions: Being underweight was common among demented elderly in group-living and was related to low cognitive capacity. Five months of oral supplementation, along with education of personnel, was followed by a weight gain. In this study the nutritional treatment did not affect the rate of decline in cognitive function or Katz' ADL index. Sponsorship: Supported by grants from the Swedish National Board of Health and Social Welfare. Semper Foods AB provided the liquid supplements.

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Section: Functional Status and Cognitive Statusmentioning

confidence: 99%

The effect of nutritional intervention in elderly subjects residing in group-living for the demented

Faxén‐Irving¹,

Andrén-Olsson²,

Geijerstam³

et al. 2002

Eur J Clin Nutr

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“…The CDR is reliable. 13 The clinician's judgment about the presence of dementia is based on the principle of intraindividual change where the individual is used as his or her own control. The CDR is derived in accordance with a standard scoring algorithm: 0 5 no dementia, 0.5 5 very mild, 1 5 mild, 2 5 moderate, and 3 5 severe dementia.…”

mentioning

confidence: 99%

P4–059: Amyloid imaging and CSF biomarkers in predicting cognitive impairment up to 7.5 years later

Roe

Grant

Hassenstab

et al. 2013

Alzheimer's & Dementia

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Objectives: We compared the ability of molecular biomarkers for Alzheimer disease (AD), including amyloid imaging and CSF biomarkers (Ab 42 , tau, ptau 181 , tau/Ab 42 , ptau 181 /Ab 42 ), to predict time to incident cognitive impairment among cognitively normal adults aged 45 to 88 years and followed for up to 7.5 years.Methods: Longitudinal data from Knight Alzheimer's Disease Research Center participants (N 5 201) followed for a mean of 3.70 years (SD 5 1.46 years) were used. Participants with amyloid imaging and CSF collection within 1 year of a clinical assessment indicating normal cognition were eligible. Cox proportional hazards models tested whether the individual biomarkers were related to time to incident cognitive impairment. "Expanded" models were developed using the biomarkers and participant demographic variables. The predictive values of the models were compared.Results: Abnormal levels of all biomarkers were associated with faster time to cognitive impairment, and some participants with abnormal biomarker levels remained cognitively normal for up to 6.6 years. No differences in predictive value were found between the individual biomarkers (p . 0.074), nor did we find differences between the expanded biomarker models (p . 0.312). Each expanded model better predicted incident cognitive impairment than the model containing the biomarker alone (p , 0.005). Conclusions:Our results indicate that all AD biomarkers studied here predicted incident cognitive impairment, and support the hypothesis that biomarkers signal underlying AD pathology at least several years before the appearance of dementia symptoms. Biomarkers may signal underlying Alzheimer disease (AD) pathology a decade or more before the appearance of dementia symptoms.1,2 Therefore, understanding the temporal relationships between biomarker levels in cognitively normal adults, symptomatic AD (i.e., incident AD), and factors that modify those relationships is imperative.3 The National Institute on Aging/ Alzheimer's Association workgroup urges that the factors that best predict progression from normal cognition to cognitive impairment and dementia due to AD need to be determined. 3The most well-studied and promising molecular biomarkers of AD are those that reflect the presence of the signature lesions of AD: plaques, which comprise the amyloid-b (Ab) protein, and tangles, which comprise the tau protein. Both amyloid imaging, 4 used to identify fibrillar Ab plaques, and CSF biomarkers, 5 which reflect soluble Ab, tau, and phosphorylated tau (ptau), predict incident AD.6-8 However, until now, directly comparing the predictive ability of amyloid imaging with CSF biomarkers was difficult, given the recent development of amyloid imaging 4 and attendant short follow-up times, the lengthy hypothesized time between the appearance of AD

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“…The CDR sum of boxes provides a quantitative expansion of the global CDR score, ranging from 0 (no impairment) to 18 (maximal impairment). 7 The CDR has high interrater reliability, 8 is sensitive to clinical progression, and is highly predictive (93%) of autopsyconfirmed AD. 6,9 The clinical diagnostic criteria for probable AD were according to the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer Disease and Related Disorders Association.…”

mentioning

confidence: 99%

Effect of cognitive fluctuation on neuropsychological performance in aging and dementia

Escandon

Al-Hammadi²,

Galvin³

2010

Neurology

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Reliability of the Washington University Clinical Dementia Rating

Cited by 304 publications

References 9 publications

The effect of nutritional intervention in elderly subjects residing in group-living for the demented

The effect of nutritional intervention in elderly subjects residing in group-living for the demented

P4–059: Amyloid imaging and CSF biomarkers in predicting cognitive impairment up to 7.5 years later

Effect of cognitive fluctuation on neuropsychological performance in aging and dementia

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