Clinical staging of dementia in a population survey: comparison of DSM-III-R and the Washington University Clinical Dementia Rating Scale

Acta Psychiatr Scand. 1992 Jul;86(1):49-54. doi: 10.1111/j.1600-0447.1992.tb03225.x.

Abstract

In a population survey in Stockholm, 224 dementia cases were staged using two scales: the Washington University Clinical Dementia Rating Scale and DSM III-R. Both scales had to be modified by adding additional specifications and, in the case of DSM III-R, a new category of questionable dementia. After modification, the comparison of the two scales showed good agreement when all stages were analyzed (kappa = 0.60), but moderate agreement on the questionable and mild stages (kappa = 0.47). These results confirm the staging of mild dementia as the most problematic issue. Finally, the scales both showed moderate agreement with the categorized Mini-Mental State Examination (MMSE) (0-17 for severe and moderate forms; 18-23 for mild cases). Our data suggest new cut-off points for the MMSE when used as a staging scale.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Dementia / classification
  • Dementia / diagnosis*
  • Dementia / epidemiology
  • Female
  • Humans
  • Male
  • Population Surveillance
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Sweden / epidemiology