title: Detecting clinical change with the CDR-FTLD: differences between FTLD and AD dementia.
abstract: To investigate the psychometric properties of the Clinical Dementia Scale-frontotemporal lobar degeneration (CDR-FTLD) psychometric properties using Rasch analysis and its sensitivity distinguishing disease progression between FTLD and Alzheimer's disease (AD).
  
  
  
  Of 603 consecutive patients from the National Alzheimer Coordinating Center dataset (FTLD = 350; AD = 253), 120 FTLDs were included in a Rasch analysis to verify CDR-FTLD psychometric properties; 483 (FTLD = 230; AD = 253) were included to analyse disease progression, with 195 (FTLD = 82; AD = 113) followed-up (24 months).
  
  
  
  The CDR-FTLD demonstrated good consistency, construct and concurrent validity and correlated well with mini-mental state examination (MMSE) and disease duration (ps < 0.05). At baseline, FTLD showed greater dementia severity than AD after matched for MMSE and disease duration (p < 0.001). Independent Rasch analyses demonstrated different patterns of progression for FTLD and AD in terms of the domains initially and then subsequently affected with disease progression. At follow-up, although MMSE showed significant changes (p < 0.05), these were greater on the CDR-FTLD (p < 0.001).
  
  
  
  The CDR-FTLD satisfactorily measures dementia severity and change in FTLD, distinguishing disease progression between FTLD and AD, with clear implications for care, prognosis and future clinical trials. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.
authors.affiliation: Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
authors.forename: Eneida
authors.initials: E
authors.lastname: Mioshi
authors.affiliation: Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.|Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Flanagan
authors.affiliation: Department of Neurology, Mayo Clinic Minnesota, Rochester, MN, USA.
authors.forename: David
authors.initials: D
authors.lastname: Knopman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis; D057174:Frontotemporal Lobar Degeneration / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: CDR-FTLD; dementia severity; disease progression; frontotemporal dementia; frontotemporal lobar degeneration