Stability of the Clinical Dementia Rating, 1979-2007.
OBJECTIVE
To examine dementia severity as determined by the Clinical Dementia Rating (CDR) over time.


METHODS
Secondary analysis of data from longitudinal studies of aging and dementia.


METHODS
Alzheimer's Disease Research Center, where a variety of clinicians contributed CDR ratings during the study.


METHODS
Adults aged 63 to 83 years with no (CDR 0), very mild (CDR 0.5), or mild (CDR 1) dementia enrolled in the Alzheimer's Disease Research Center at any time from August 13, 1979, through May 30, 2007.


METHODS
Within each CDR group, changes in scores on standardized psychometric tests with time were examined using multiple linear regression analyses. These tests included the Mini-Mental State Examination, Short Blessed Test, Logical Memory IA-Immediate from the Wechsler Memory Scale-Revised, and Blessed Dementia Scale, and a psychometric composite score.


RESULTS
A total of 1768 participants met the inclusion criteria. With time, participants were older, more educated, and more likely to be nonwhite and less likely to be men. Statistically significant change in psychometric test performance with time occurred only within the CDR 1 group for Logical Memory and the psychometric composite, but the degree of change was minimal.


CONCLUSIONS
Despite changes in participant characteristics, the CDR demonstrates general stability for assessment of dementia for almost 3 decades.
Williams
Monique M
MM
Washington University School of Medicine, Division of Geriatrics and Nutritional Science, 4488 Forest Park Blvd, Ste 201, St Louis, MO 63108, USA. MWilliam@DOM.wustl.edu
Roe
Catherine M
CM
Morris
John C
JC
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000503:physiopathology; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology; D003951:Diagnostic Errors / Q000517:prevention & control*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011594:Psychometrics; D044469:Racial Groups; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors