COSMIN database

Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review

Olde Rikkert, M. G., Tona, K. D., Janssen, L., Burns, A., Lobo, A., Robert, P., Sartorius, N., Stoppe, G., and Waldemar, G.
New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles describing 12 staging instruments were identified (N = 6109 participants, age 65-87). Reliability was studied in most (91%) of the articles and was judged moderate to good. Approximately 78% of the articles evaluated concurrent validity, which was good to very good, while discriminant validity was assessed in only 25%. The scales can be applied in +/-15 minutes. Clinical Dementia Rating (CDR), Global Deterioration scale (GDS), and Functional Assessment Staging (FAST) have been monitored on reliability and validity, and the CDR currently is the best-evidenced scale, also studied in international perspective, and is available in 14 languages. Taking into account the increasing differentiation of Alzheimer's disease in preclinical and predementia stages, there is an urgent need for global rating scales to be refined as well
Am J Alzheimers.Dis.Other Demen.
Publication year:
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Physical state
Functional status:
Physical functioning
Adults (18-65)
Seniors (65+)
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
6 - Clinical rating scales
BANS-S - Bedford Alzheimer Nursing Severity Scale
CDR - Clinical Dementia Rating scale
CDR-SB - Clinical Dementia Rating Sum of Boxes Scores
CGI-S - Clinical Global Impression-Scale
DAFS - Direct Assessment of Functional Status
DSRS - Dementia Severity Rating scale
DSS - Dementia Severity scale
FAST - Functional Assessment Staging
FRS - Functional Rating scale
GAD - Global Assessment of Dementia
GBS Scale - Gottfries-Brane-Steen Scale
GDS - Global Deterioration scale
HDS - Hierarchic Dementia scale
Machine Learning (ML) analysis of CDR (Clinical Dementia Rating)