VALIDATION OF THE CLINICAL DEMENTIA RATING SCALE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Mild cognitive impairment (MCI) has been recognized as a risk factor for progression to Alzheimer's disease (AD). Presently, MCI is usually identified by clinical examination and with several instruments in English that integrate information from a reliable collateral source. No such validated culturally adapted instrument is available for the screening of MCI in the Puerto Rican population. The aims of this study are to culturally adapt and validate the Clinical Dementia Rating (CDR) scale, an informant-based examination for the assessment of patient's cognitive status in the Puerto Rican population. For the cultural adaptation, a translator will revise the Argentinean Spanish version of the CDR in terms of conceptual and linguistic equivalence, cultural context, and colloquialisms. Spanish speaking Puerto Ricans will evaluate the revised CDR for clarity, appropriateness, and cultural relevance of the language used in the instrument. To validate the scale, a Certified CDR evaluator will apply the scale to 60 individuals divided into three groups: normal subjects, subjects with memory complaints without a diagnosis, and subjects diagnosed with dementia and their respective informants. A psychologist will measure the subject's performance in several cognitive domains. Validation of the CDR scale will be established by the sensitivity and specificity and the positive and negative predictive values of the test, with respect to the relative standing of patients with memory complaints and with AD from normal controls, determined through z-scores. In this study we define MCI as subjects with an objective memory impairment of at least 1.5 standard deviation (SD) below normal controls in one of more cognitive domain and AD patients with 2.0 SD or more in two or more cognitive domains.Graphic representation will be through receiver operator characteristic (ROC) curves for discrimination between MCI subjects, demented, and normal controls.