Functional status in MCI, AD, and healthy older adults: A cross-sectional analysis using the Dementia Severity Rating Scale.

摘要

Researchers and clinicians have reported a need for well-validated, brief screening measures of activities of daily living. This study investigated the utility of the Dementia Severity Rating Scale (DSRS) with groups of cognitively impaired and non-impaired community dwelling older adults. Of the 320 participants included in this study, 85 (26.6%) were normal controls, 96 (30%) had either Amnestic Mild Cognitive Impairment (n = 50) or Amnestic Mild Cognitive Impairment-multiple domains (n = 46), and the remaining 139 (43.4%) had possible (n = 28) or probable (n = 111) Alzheimer's disease (AD). Each participant was given a thorough examination consisting of a comprehensive standardized neuropsychological battery, assessment of functional status, neurological evaluation, general medical evaluation, imaging, and laboratory analyses. All diagnoses were made based on a consensus of a board-certified neurologist and licensed clinical neuropsychologist.; Results from this study indicated that (a) the DSRS was highly correlated to cognitive and functional status as measured by a battery of widely-used neuropsychological and functional measures, and (b) the control, Mild Cognitive Impairment (MCI), and AD groups differed significantly in terms of daily functioning as measured by the DSRS. Additional discriminant analyses revealed that the DSRS was moderately accurate at classifying diagnostic groups. That is, the DSRS accurately identified 81% of the control group, 60% of the MCI group and 78% of the AD group. Post-hoc analyses showed improved efficacy when used in combination with a brief cognitive measure. That is, the DS RS combined with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List 5-minute delay recall test accurately identified 98% of the control group, 76% of the MCI group, and 82% of the AD group. Implications for clinical practice and proposed areas of future research are discussed.