Dementia Rating Scale


Purpose:
Designed to measure and track mental status in adults with cognitive impairment.

Population:  ages 56 to 105

Score: Attention, Initiation-Perseveration, Construction, Conceptualization, Memory, Total. 

Time:.  15 – 30 minutes

Author: L  Steven Mattis, Paul, J. Jurica, and Christopher L. Leitten

Publisher:  Psychological Assessment Resources

Description: The Dementia Rating Scale (DRS-2), is a 36- task and 32-stimulus card individually administered instrument designed to assess level of cognitive functioning for individuals with brain dysfunction. The DRS-2 is sensitive at the lower ends of functioning and differentiating levels of deficits. Conversely, the instrument generally will not discriminate individual functioning in the average or higher range of intelligence due to the design to minimize floor effects of clinically impaired individuals. The DRS-2 consists of a professional manual, scoring booklets, and 32-stimulus cards. (DRS-2) is an enhanced version of the original DRS designed to provide standardized, quantitative cognitive functioning assessment in neurologically impaired populations. The initial pool of items was revised for comprehensive and brief administration, however, allowing for a low floor so that even severely impaired individuals could be evaluated.  The DRS-2 has a wider age range than the original DSR, and the age corrected scaled and percentile ranks are more sensitive to change in cognitive status.  The task and stimulus card have not been changed from the original. In the hands of an experienced neuropsychologist-clinical psychologist, this is an excellent instrument but it is highly dependent upon qualifications and skill of each individual test user.

Scoring: The DRS-2 assesses cognitive functioning on five subscales: Attention (ATT, 8 items); Initiation-Perseveration (I-P, 11 items); Construction (CONST, 6 items); Conceptualization (CONCEPT, 6 items); and Memory (MEM, 5 items).

Reliability: The reliability and validity properties of the DRS-2 are excellent. The DRS-2 uses the previously established reliability and validity scores. A test-retest reliability correlation coefficient was .97 with subscale correlation coefficients ranging from .61 to .94. The DRS was administered twice with a 1-week interval between administrations to a group of 30 patients diagnosed with dementia of the Alzheimer's type. A split-half reliability coefficient was .90, utilizing a sample of 25 patients ages 65 to 94 years who received diagnoses of either organic brain syndrome or senile dementia. A t test indicated no significant differences between scores on the two halves. The alpha coefficients were calculated for four DRS subscales using a combined dementia sample. The alpha coefficients were Attention (.95), Initiation-Perseveration (.87), Conceptualization (.95), and Memory (.75). Five factors were found; however, there is a confound of scoring dependence as patients who score positive on the initial items are given credit for the remaining items on the subtest, which results in an artificial correlation.

Validity: The DRS-2 was compared with the Mini-Mental State Examination (MMSE), which displayed a significant correlation (r = .82) with the DRS-2 showing a greater sensitivity to change than the MMSE in patients with severe dementia. In addition, correlations with the Wechsler Adult Intelligence Scale indicated a correlation of .75 between the WAIS full scale and the DRS-2 total score.

Norms: The normative data for the DRS-2 is provided by the Mayo Older American’s Normative Study (MOANS) taken from 623 healthy adults living in community settings from ages 56-105 (199 men and 424 women). The normative data-base are not representative of U.S. population, as they consisted of predominately Caucasian adults with higher than average educational levels..

Suggested use: The DRS-2 is very useful in the assessment and progression of dementia of Alzheimer's type, vascular dementia, Parkinson's disease, Huntington's disease, and age-related dementia in mental retardation and Down's syndrome.