P1‐074: The Dementia Severity Rating Scale for dementia: Relationships with the CDR sum of boxes, clinical diagnosis and CSF biomarkers

Le résumé fourni par la source

The Dementia Severity Rating Scale (DSRS) is a brief, informant-rated questionnaire to quantify functional impairment in Alzheimer's disease (AD). Items are comparable to the Clinical Dementia Rating Scale (CDR), but incorporate a broader range of scores to detect finer increments of change across time. Here, we examined the ability of the DSRS to predict CDR sum of boxes (CDR-SB), clinical diagnosis, and cerebrospinal fluid (CSF) biomarkers of AD. Pearson correlations and linear regression were performed with DSRS and CDR-SB scores from subjects at the Penn Memory Center (n = 952). This sample was split in half to create test and validation samples. We also performed receiver operating characteristic (ROC) curve analyses in a varied clinical sub-sample (n = 199), comparing DSRS and CDR-SB in discriminating dementia versus no-dementia and probable AD versus mild cognitive impairment (MCI). We also compared DSRS and CDR-SB ROC curves in the detection of abnormal or normal CSF amyloid-b 1–42, total-tau, phospho-tau, and two CSF biomarker ratios. A regression model was obtained from the test sample with an R-squared value of 0.8: Predicted CDR-SB = -0.068 + 0.39DSRS_TOTAL. The correlation between the DSRS-predicted CDR-SB and the observed CDR-SB was 0 .9 for the test sample and validation sample. In the sub-sample, the ROC curve analyses showed that: 1) for distinguishing individuals diagnosed with dementia (AD and PDD) from those without dementia (controls, MCI, PD), the DSRS had an AUC = .79, while CDR-SB AUC = .91; 2) for discriminating individuals diagnosed with MCI from those diagnosed with AD, DSRS AUC = .73, while CDR-SB AUC = .88; 3) for distinguishing individuals with abnormal amyloid-b 1–42 from those with normal amyloid-b 1–42, DSRS AUC = .70, while the CDR-SB AUC = .74. AUCs for identifying abnormality among other CSF proteins varied between .51 and .69. DSRS total score is a strong predictor of CDR-SB and is comparable in its ability to distinguish dementia from no-dementia, MCI from AD, and abnormal from normal amyloid-b 1–42. The DSRS is advantageous relative to the CDR in that it is brief and requires minimal staff or clinical expertise to administer.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.