New, rapid dementia screening tool rivals ‘gold standard’ clinical evaluations

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Aug 13, 2015

Determining whether or not an individual has dementia and to what degree is a long and laborious process that can take an experienced professional about 4 to 5 hours to administer, interpret, and score the test results. A leading neuroscientist at Florida Atlantic University has developed a way for a layperson to do this in 3 to 5 minutes with results that are comparable to the "gold standard" dementia tests used by clinicians today.

The "Quick Dementia Rating System" (QDRS), which uses an evidence-based methodology, validly and reliably differentiates individuals with and without dementia. When dementia is present, it accurately stages the condition to determine if it is very mild, mild, moderate, or severe. QDRS has applications for use in clinical practice, to prequalify patients in clinical trials, prevention studies, community surveys, and biomarker research.

The QDRS is the brainchild of James E Galvin MD MPH, a professor of clinical biomedical science in the Charles E Schmidt College of Medicine and a professor in the Christine E Lynn College of Nursing at Florida Atlantic University. Galvin recently published an article on his findings in Alzheimer's & Dementia. He has developed a number of dementia screening tools including the AD8, a brief informant interview to translate research findings to community settings that is used worldwide to detect dementia in diverse populations.

"After extensive testing and evaluation of the Quick Dementia Rating System, we have found it to be as effective as the gold standard used today to screen for the five stages of dementia," said Galvin. "This new tool gives you a lot of power to see the same results as a full screening in a fraction of the time it takes for a complete screening."

The QDRS is a 10-item questionnaire that can be completed by a caregiver, friend, or family member, and is brief enough to be printed on 1 page or viewed as a single screenshot, maximizing its clinical utility. Scores range from 0 to 30 with higher scores representing greater cognitive impairment. The questionnaire covers: (1) memory and recall, (2) orientation, (3) decision-making and problem-solving abilities, (4) activities outside the home, (5) function at home and hobbies, (6) toileting and personal hygiene, (7) behavior and personality changes, (8) language and communication abilities, (9) mood, and (10) attention and concentration.

The total score is derived by summing up the 10 fields and each area has 5 possible answers increasing in severity of symptoms. The 10 areas capture the prominent symptoms of mild cognitive impairment, Alzheimer disease, and non-Alzheimer neurocognitive disorders including Lewy body dementia, frontotemporal degeneration, vascular dementia, chronic traumatic encephalopathy, and depression.

A total of 267 individuals with various forms of dementia from Alzheimer disease to Lewy body dementia participated in the study, which included 32 healthy controls. Study participants also included their spouses/significant others, adult children, relatives, friends, and paid caregivers who completed the QDRS.

"Most patients never receive an evaluation by a neurologist, geriatric psychiatrist, or geriatrician skilled in dementia diagnoses and staging. Early detection will be important to enable future interventions at the earliest stages when they are likely to be most effective," said Galvin. "The QDRS has the potential to provide a clearer, more accurate staging for those patients who are unable to see these more specialized clinicians and get them the treatment, referrals, and community services they so desperately need."

The Quick Dementia Rating System is copyrighted and permission to use this tool is required. QDRS is available at no cost to clinicians, researchers, and not-for-profit organizations.

Galvin is working to improve clinical detection by combining biomarkers including high density EEG, functional and structural MRI, PET scans, and CSF biomarkers to characterize and differentiate Lewy body dementia from healthy aging and other neurodegenerative diseases.

Source: News Release
Florida Atlantic University
August 12, 2015

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