Dementia Rating Scale

The Dementia Rating Test is a 36- task and 32-stimulus card individually administered instrument designed to assess level of cognitive functioning for individuals with brain dysfunction. The Dementia Rating Scale-2 is sensitive at the lower ends of functioning and differentiating levels of deficits. Conversely, the instrument generally will not discriminate individual functioning in the average or higher range of intelligence due to the design to minimize floor effects of clinically impaired individuals. The Dementia Rating Scale-2 consists of a professional manual, scoring booklets, and 32-stimulus cards. Dementia Rating Test is an enhanced version of the original Dementia Rating Scale designed to provide standardized, quantitative cognitive functioning assessment in neurologically impaired populations. The initial pool of items was revised for comprehensive and brief administration, however, allowing for a low floor so that even severely impaired individuals could be evaluated. The Dementia Rating Scale-2 has a wider age range than the original DSR, and the age corrected scaled and percentile ranks are more sensitive to change in cognitive status.The task and stimulus card have not been changed from the original. In the hands of an experienced neuropsychologist-clinical psychologist, this is an excellent instrument but it is highly dependent upon qualifications and skill of each individual test user.

Scoring: The Dementia Rating Scale-2 assesses cognitive functioning on five subscales: Attention (ATT, 8 items); Initiation-Perseveration (I-P, 11 items); Construction (CONST, 6 items); Conceptualization (CONCEPT, 6 items); and Memory (MEM, 5 items).

Reliability: The reliability and validity properties of the Dementia Rating Scale-2 are excellent. The Dementia Rating Scale-2 uses the previously established reliability and validity scores. A test-retest reliability correlation coefficient was .97 with subscale correlation coefficients ranging from .61 to .94. The Dementia Rating Scale was administered twice with a 1-week interval between administrations to a group of 30 patients diagnosed with dementia of the Alzheimer's type. A split-half reliability coefficient was .90, utilizing a sample of 25 patients ages 65 to 94 years who received diagnoses of either organic brain syndrome or senile dementia. A t test indicated no significant differences between scores on the two halves. The alpha coefficients were calculated for four Dementia Rating Scale subscales using a combined dementia sample. The alpha coefficients were Attention (.95), Initiation-Perseveration (.87), Conceptualization (.95), and Memory (.75). Five factors were found; however, there is a confound of scoring dependence as patients who score positive on the initial items are given credit for the remaining items on the subtest, which results in an artificial correlation.

Validity: The Dementia Rating Scale-2 was compared with the Mini-Mental State Examination (MMSE), which displayed a significant correlation (r = .82) with the Dementia Rating Scale-2 showing a greater sensitivity to change than the MMSE in patients with severe dementia. In addition, correlations with the Wechsler Adult Intelligence Scale indicated a correlation of .75 between the WAIS full scale and the Dementia Rating Scale-2 total score.

Norms: The normative data for the Dementia Rating Scale-2 is provided by the Mayo Older American's Normative Study (MOANS) taken from 623 healthy adults living in community settings from ages 56-105 (199 men and 424 women). The normative data-base are not representative of U.S. population, as they consisted of predominately Caucasian adults with higher than average educational levels.

Suggested use: The Dementia Rating Scale-2 is very useful in the assessment and progression of dementia of Alzheimer's type, vascular dementia, Parkinson's disease, Huntington's disease, and age-related dementia in mental retardation and Down's syndrome.

Purpose:The Dementia Rating Test is designed to measure and track mental status in adults with cognitive impairment.

Population: ages 56 to 105.

Score: Attention, Initiation-Perseveration, Construction, Conceptualization, Memory, Total.

Time: 15 - 30 minutes.

Author: Steven Mattis, Paul, J. Jurica, and Christopher L. Leitten.

Publisher:Psychological Assessment Resources.

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