title: The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center (SIST-M): development, reliability, and cross-sectional validation of a brief structured clinical dementia rating interview.
abstract: BACKGROUND
  The Clinical Dementia Rating (CDR) and CDR Sum-of-Boxes can be used to grade mild but clinically important cognitive symptoms of Alzheimer disease. However, sensitive clinical interview formats are lengthy.
  
  
  OBJECTIVE
  To develop a brief instrument for obtaining CDR scores and to assess its reliability and cross-sectional validity.
  
  
  METHODS
  Using legacy data from expanded interviews conducted among 347 community-dwelling older adults in a longitudinal study, we identified 60 questions (from a possible 131) about cognitive functioning in daily life using clinical judgment, inter-item correlations, and principal components analysis. Items were selected in 1 cohort (n=147), and a computer algorithm for generating CDR scores was developed in this same cohort and re-run in a replication cohort (n=200) to evaluate how well the 60 items retained information from the original 131 items. Short interviews based on the 60 items were then administered to 50 consecutively recruited older individuals, with no symptoms or mild cognitive symptoms, at an Alzheimer's Disease Research Center. Clinical Dementia Rating scores based on short interviews were compared with those from independent long interviews.
  
  
  RESULTS
  In the replication cohort, agreement between short and long CDR interviews ranged from κ=0.65 to 0.79, with κ=0.76 for Memory, κ=0.77 for global CDR, and intraclass correlation coefficient for CDR Sum-of-Boxes=0.89. In the cross-sectional validation, short interview scores were slightly lower than those from long interviews, but good agreement was observed for global CDR and Memory (κ≥0.70) as well as for CDR Sum-of-Boxes (intraclass correlation coefficient=0.73).
  
  
  CONCLUSIONS
  The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center is a brief, reliable, and sensitive instrument for obtaining CDR scores in persons with symptoms along the spectrum of mild cognitive change.
authors.affiliation: Department of Psychiatry, Gerontology Research Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. ookereke@partners.org
authors.forename: Olivia I
authors.initials: OI
authors.lastname: Okereke
authors.forename: Maura
authors.initials: M
authors.lastname: Copeland
authors.forename: Bradley T
authors.initials: BT
authors.lastname: Hyman
authors.forename: Taylor
authors.initials: T
authors.lastname: Wanggaard
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Albert
authors.forename: Deborah
authors.initials: D
authors.lastname: Blacker
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000465:Algorithms; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires