The Dementia Rating Scale (DRS) in the diagnosis of vascular dementia.

Cláudia Sellitto Porto,Paulo Caramelli,Ricardo Nitrini

doi:10.1590/s1980-57642008dn10300010

Cláudia Sellitto Porto, Paulo Caramelli + Show 1 more

Open Access

https://doi.org/10.1590/s1980-57642008dn10300010

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Abstract

The Dementia Rating Scale (DRS) is considered a very useful instrument to assess patients with dementia. The tasks are grouped into five subscales, each one evaluating different cognitive areas, namely: Attention, Initiation/Perseveration (I/P), Construction, Conceptualization and Memory.ObjectiveTo verify the ability of the DRS in discriminating vascular dementia (VaD) patients from healthy controls and VaD from Alzheimer disease (AD) patients.MethodsThe DRS was applied to 68 patients with mild dementia (12 with VaD and 56 with AD) and 60 healthy controls. The clinical diagnosis was made by two neurologists based on the patients´ history, laboratory and neuroimaging results and neuropsychological tests.ResultsIn the comparison between VaD patients and controls, the subscales I/P, Memory, Conceptualization and Attention were those displaying best discrimination between the two groups. The cutoff <124 yielded 93.3% of sensitivity and 91.7% of specificity for the diagnosis of VaD. Only the I/P subscale differentiated VaD from AD patients.ConclusionsThe DRS was found to be a useful instrument to discriminate VaD patients from controls. VaD patients showed worse performance in tasks of executive functions than AD patients. Executive dysfunction, evaluated through the I/P subscale of the DRS, might be useful in differentiating between VaD and AD patients.

Highlights

The Dementia Rating Scale (DRS) is considered a very useful instrument to assess patients with dementia
Previous investigators have reported that the DRS is able to differentiate patients with Alzheimer disease (AD) from cognitively healthy controls,[3,4] as well as AD from dementia associated with Parkinsons disease,[5] Huntingtons disease from AD,[6] and patients with vascular dementia (VaD) from patients with AD.[7,8]
The main objective of this work is to verify the ability of the DRS to discriminate VaD patients from controls, and VaD from AD patients

Summary

Introduction

The Dementia Rating Scale (DRS) is considered a very useful instrument to assess patients with dementia. Results: In the comparison between VaD patients and controls, the subscales I/P, Memory, Conceptualization and Attention were those displaying best discrimination between the two groups. Resultados: Na comparação de pacientes com DV e controles, as subescalas I/P, Memória, Conceituação e Atenção foram as que melhor diferenciaram os dois grupos. The scale includes 36 tasks which are grouped into five subscales assessing different cognitive domains, namely: Attention, Initiation/Perseveration (I/P), Construction, Conceptualization and Memory. Previous investigators have reported that the DRS is able to differentiate patients with AD from cognitively healthy controls,[3,4] as well as AD from dementia associated with Parkinsons disease,[5] Huntingtons disease from AD,[6] and patients with vascular dementia (VaD) from patients with AD.[7,8]

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