Document Detail


Language and behavior domains enhance the value of the clinical dementia rating scale.
MedLine Citation:
PMID:  21575870     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The six domain standard Clinical Dementia Rating Scale (CDRstd) has been successful for staging patients with the clinical syndrome of probable Alzheimer's disease (AD). The CDRstd does not specifically address language dysfunction or alteration in personality and social behaviors which are prominent in behavioral variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA).
OBJECTIVE: To determine the value of adding domains of Language (LANG), and Behavior, Comportment, and Personality (BEHAV) to the CDRstd for the evaluation of patients with bvFTD and PPA.
METHODS: Two new domains, LANG and BEHAV, were constructed to parallel the six domains sampled in the CDRstd. Clinical and neuropsychological test data were obtained from the National Alzheimer's Coordinating Center. The dataset contained information on 2550 probable AD, 88 vascular dementia, 281 dementia with Lewy body, 234 bvFTD, and 137 PPA patients.
RESULTS: There were 76.5% of bvFTD and 99.3% of PPA patients with abnormal ratings (>0) on the LANG domain; 90.2% of bvFTD and 63.5% of PPA had abnormal ratings on the BEHAV domain. In patients with a CDRstd sum of boxes score of <4, 53.7% of bvFTD had BEHAV domain and 78.6% of PPA patients had LANG domain scores>1. Among probable AD patients, 3.7% had LANG ratings that were ≥1 and 3.8% had BEHAV ratings that were ≥1. Logistic regression analyses showed that adding either the LANG or BEHAV domains to the CDRstd sum of boxes score significantly improved the discrimination between probable AD, bvFTD, and PPA.
CONCLUSIONS: The new LANG and BEHAV domains add value to the CDRstd for the characterization of the nonamnestic symptoms that are prominent in patients with bvFTD and PPA but that also occur in those with probable AD.
Authors:
David S Knopman; Sandra Weintraub; Vernon S Pankratz
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Validation Studies    
Journal Detail:
Title:  Alzheimer's & dementia : the journal of the Alzheimer's Association     Volume:  7     ISSN:  1552-5279     ISO Abbreviation:  Alzheimers Dement     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-17     Completed Date:  2012-04-09     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  101231978     Medline TA:  Alzheimers Dement     Country:  United States    
Other Details:
Languages:  eng     Pagination:  293-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cross-Sectional Studies
Dementia / complications*,  diagnosis*,  psychology
Diagnosis, Differential
Female
Humans
Language Disorders / diagnosis*,  etiology,  psychology
Language Tests / standards*
Male
Mental Disorders / diagnosis*,  etiology,  psychology
Neuropsychological Tests / standards*
Predictive Value of Tests
Grant Support
ID/Acronym/Agency:
P30 AG013854/AG/NIA NIH HHS; P30 AG013854-09/AG/NIA NIH HHS; P30-AG013854/AG/NIA NIH HHS; P50 AG016574/AG/NIA NIH HHS; P50 AG016574-13/AG/NIA NIH HHS; P50-AG016574/AG/NIA NIH HHS; R01 AG023195-01/AG/NIA NIH HHS; R01-AG023195/AG/NIA NIH HHS; U01 AG016976/AG/NIA NIH HHS; U01 AG016976/AG/NIA NIH HHS; U01 AG016976-13/AG/NIA NIH HHS
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