Cerebral metabolic rate of glucose and Alzheimer's disease

The clinical validity of the Mattis Dementia Rating Scale in staging Alzheimer's dementia

Considerable heterogeneity exists in the criteria used for the establishment of stages of impairment for patients with dementia. The valid distinction of stages is important both for clinical interpretation and the study of dementia. This study reports on the use of the Mattis Dementia Rating Scale (DRS) in staging dementia. Using a sample of 42 patients diagnosed with Alzheimer-type dementia, DRS performance and a rating of Instrumental Activities of Daily Living (IADL) were compared with clinical ratings of dementia severity. Total DRS score provides a clinically valid measure of stage of impairment and appeared to provide a better distinction among stages than IADL score. However, use of the IADL score in conjunction with total DRS may improve correspondence with clinical staging over use of the total DRS score alone. Normative data for the DRS are also provided.

Computerized history and self-assessment questionnaire for diagnostic screening among patients with dementia

In order to standardize and quantify diagnostic information derived from medical histories and case reports given by demented patients, their families or care-providers, a questionnaire has been developed containing 94 questions. The output is categorized by computer into graphic clinical scales which correlate and weigh information relating to seven of the most common causes of dementia. The present investigation assesses the validity of predictive diagnostic classifications derived from the clinical scales tested on admission by correlating them later with final diagnoses determined independently by thorough clinical evaluation including standard diagnostic tests, computed tomography and nuclear magnetic resonance scans. Results of 101 healthy, neurologically normal, age-matched volunteers and 140 patients representative of the more common forms of dementia indicate that correct diagnostic identification was: 75% for dementia secondary to Parkinson's disease, 100% for Huntington's disease, 90.2% for Alzheimer's disease, 82.4% for multi-infarct dementia, 90.0% for posttraumatic dementia, 77.8% for normal-pressure hydrocephalus and 85.7% for Wernicke-Korsakoff dementia. Correct diagnostic assignment was highly significant (P less than .0005). The screening questionnaire may prove to be a useful and standard diagnostic tool for clinicians and investigators concerned with epidemiology, prevention and treatment of dementia.