Clinical Dementia Rating (CDR), Chinese Version · tion to Mini-Mental Status Examination (MMSE)...

Acta Neurologica Taiwanica Vol 12 No 3 September 2003

From the Neurological Institute, Taipei Veterans GeneralHospital and National Yang-Ming University School ofMedicine, Taipei, Taiwan.Received May 28, 2003. Revised and Accepted June 12, 2003.

Reprint requests and correspondence to: Ker-Neng Lin, PhD.The Neurological Institute, Taipei Veterans General Hospital,Taipei, Taiwan.E-mail: [email protected]

Clinical Dementia Rating (CDR), Chinese Version

Ker-Neng Lin and Hsiu-Chih Liu

Summary

Due to the continuing increase in elder population in Taiwan, aging has become one of the majorpublic health and socioeconomic problems nowadays. Dementia is a disease commonly seen in theelderly and Alzheimer’s disease (AD) comprises almost 60% of the elderly demented patients. In addi-tion to Mini-Mental Status Examination (MMSE) and Cognitive Abilities Screening Instrument(CASI), Clinical Dementia Rating (CDR) is a global rating scale in assessing the severity of AD. TheCDR-Chinese version has been frequently used in the routine cognitive assessment of the suspectedAD patients to assess the severity of AD. The results from several research projects demonstrate sub-stantial reliability and validity of the CDR-Chinese version.

Key Words: Alzheimer’s disease, CDR, CASI

Continuing Medical Education 154

155


2003 5 28 2003 612

201E-mail: [email protected]

30

( ) (Alzheimer’s Disease)

65 85 5% 15%

(MMSE) (CASI)

(CDR)

CDR

CDR

CDR

CDR = 1

CDR

Acta Neurol Taiwan 2003;12:155-165

(Clinical Dementia Rating;

CDR) Hughes (1)

(Alzheimer’s disease)

156


(2-5)

(Memory) (M)

(Orientation) (O)

(Judgment - problem solving)

(JPS)

(Community affairs) (CA)

(Home hobbies) (HH)

(Personal care) (PC)

0 ~ 3

0 (Health)

0.5 (Questionable impair-

ment)

1 (Mild impairment)

2 (Moderate impairment)

3 (Severe impairment)

(

(CDR = 0.5))

( )

CDR

CDR = 0

CDR = 0.5

CDR = 1

CDR = 2

CDR = 3

CDR = 4

(

)

CDR = 5

(

)

CDR

24

CDR = 1

CDR = 2

CDR

( ~ )

157


1

?

2

? ?

?

? ? ?

3

?

?

4

7 50

?

5

6

7

8

(MMSE)(6-9) (CASI)(10-12)

(MMSE: 0~30;

CASI: 0~100)

(1)

(2)

? ? ?

? ? ?

( , ) ? ?

? ?

? ?

? ?

158


? ?

?

?

? ?

?

?

?

?

? 265

?

( )

(Health)

(Questionable) (Mild) (Moderate)

(Severe)

( )

(0.5) (M)

9 ( * )

0.5

( ) 0

( )

CDR=4 CDR=5

? ?

CDR

CDR

(1,13)

72%(14)

159


70 (15)

0,0.5,1,2, 3

CDR

CDR CDR

71% (50 ) CDR

CDR kappa 0.63

kappa 0.62 ( )

(5)

(CASI)

CASI

CASI 100 (LTM)

(STM) (ATTEN)

(MENMA) (ORIEN) (ABSTR)

(LANG) (DRAW)

(ANML)

CDR 709

405 304 56 96

0 25

67 (CDR = 0) 149

(CDR = 0.5) 493 (CDR ≥ 1)

(t - tests, p < 0.05)

CASI CASI MMSE

(t - tests, p < 0.01)

( 0 1

5 6 )

(t - tests, p < 0.05)

475 ( 2 )

( 1 )

(CASI)(16)

. CDR Kendell tau-b Cohen kapp

Kendall tau-b p Cohen kappa p

CDR 0.85 <0.01 0.63 <0.010.89 <0.01 0.74 <0.010.92 <0.01 0.77 <0.010.79 <0.01 0.62 <0.010.91 <0.01 0.78 <0.010.87 <0.01 0.71 <0.010.86 <0.01 0.79 <0.01

. CDR CDR CDR

0 0.5 1 2 30 10 3 130.5 5 11 6 221 18 2 20

CDR 2 1 9 2 123 1 2 3

15 14 25 12 4 70

160


475 238

(CDR = 1) 155 (CDR = 2)

82 (CDR = 3)

(t - tests,

p > 0.05) CASI

CASI

Z

CASI

(CDR=0) (CDR=0.5)

(CDR=1) (CDR=2) (CDR=3)

(CDR=4) (CDR=5)

CDR

Hughes (1)

(1,17)

V313

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CDR

(Memory) (M)

(Orientation) (O) (Judgment - problem solving) (JPS)

(Community affairs) (CA)(Home hobbies) (HH)

(Personal care) (PC)

3 ( ) (M)

(No)

3 M 2

(No)

CDR= M

M=0 2 0 CDR=0.5M=0.5 3 1 CDR=1M>0 0 CDR=M

M; M; M CDR=M

(Yes)

CDR=M

(Yes)

CDR=M

161


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162


Standardized Semi-Structured Interview for Dementia --

according to CDR and DSM-IV

Subject

I. Recent memory1. recall

*2. 29683 3. 4. 5.

II. Orientation

III. Similarity & Difference

IV. Judgement7 50

V. Apraxia

1. 2. 3.

VI. Aphasia1. 2. 3. 4. 5. 6.

VII. Agnosia1. Visual agnosia 2. Tactile agnosia

VIII. Executive function1. Verbal fluency: 2. 3.

163


Family

I. Memory

1. 1. 2.

*2. 1. 2.

*3. 1. 2.

*4. 1. 2.

*5. 1. 2.

*6. 1. 2.

*7. 1. 2.

8. 1. 2.

9. 1. 2.

10. 1. 2.

11. 1. 2.

12. 1. 2.

13. 1. 2.

14. 1. 2.

II. Orientation

1. 1. 2.

*2. 1. 2.

3. 1. 2.

4. 1. 2.

5. 1. 2.

6. 1. 2.

III. Judgement

1. 1. 2.

2. 1. 2.

3. 1. 2.

IV. Community affairs

1.

*2.

3.

1. 2.

4. 1. 2.

5. 1. 2.

1. 2.

164


V. Home hobbies1.

VI. Personal care1. 1. 2. 3. 4. 2.

1. 2. 3. 4. 3. 1. 2. 3. 4. 4.

1. 2. 3. 4. 5. 1. 2. 3.

VII. Personality & Behavioral Problem1. 1. 2. 2. 1. 2. 3. 1. 2. 4. 1. 2. 5. 1. 2. 6. 1. 2. 7. 1. 2. 8. 1. 2. 9. 1. 2.

VIII. Language1. 1. 2. 2. 1. 2. 3. 1. 2. 4. 1. 2. 5. 1. 2. 6. 1. 2.

I-VIII1.

(1) 6 (2) 6 12 (3) 1 2 (4) 2

2. (1) (2) 1 3 (3) 1 (4)

3. (1) (2) (3) (4)

165


Clinical Dementia Rating (CDR)

Health Questionable Mild Moderate Severe CDR 0 CDR 0.5 CDR 1 CDR 2 CDR 3

Memory * * * * ** * * *

* **

Orientation * * * ** *

*Judgment * * * * *& Problemsolving * *

*Community * * * *affairs

Home & * * * * *hobbies

* *

Personal * * * *care

CDR 4Profound

CDR 5Terminal

0 0.5 1 2 3

M

O

JPS

CA

HH

PC

Clinical Dementia Rating (CDR), Chinese Version · tion to Mini-Mental Status Examination (MMSE)...

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