Use of clinical dementia rating in detecting early cognitive deficits in a community-based sample of Chinese older persons in Hong Kong.Alzheimer Dis Assoc Disord 2008 Apr-Jun; 22(2):153-7AD
With increasing demand for dementia care in the Chinese community, there is a pressing need to identify practical and valid assessment tool for early detection of dementia. In a sample of 473 randomly recruited community-dwelling Chinese older persons aged 60 or above, we evaluated the cognitive characteristics of subjects with Clinical Dementia Rating (CDR) of 0.5. The cognitive profiles of CDR 0.5 subjects were compared with standard clinical criteria for mild cognitive impairment. The Alzheimer's disease assessment scale-cognitive subscale and list learning delay recall test scores were between -1 and -2 SD below the cutoff for clinically not-demented subjects (CDR 0). Concordance between CDR 0.5 and mild cognitive impairment classifications were related to educational level of the subjects. A higher agreement was found in subjects having >6 years of education than subjects having <or=2 years of education (85.2% vs. 53.8%) (chi2=35.41, df=2, P<0.0001). The results suggested that CDR is able to identify mild but significant cognitive impairment in the Chinese community. The use of CDR suggested that attention should be paid to local cultural characteristics. With the use of cognitive evaluation, special adjustments are required to fit the performance of the respondents with different educational background.