An empirical evaluation of the Global Deterioration Scale for staging Alzheimer's disease.
C. Eisdorfer ... [et al.]
Bok Engelsk C Eisdorfer
Flere språk: Engelsk
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| Opplysninger | OBJECTIVE: Although the Global Deterioration Scale hasbeen widely used since its publication in 1982, its stages are based onimplicit assumptions about the linearity, temporality, andinterdependence of cognitive, functional, and behavioral impairment inAlzheimer's disease. The authors evaluated the validity of theseassumptions and tested the hypothesis that psychopathology and functionalimpairment would occur in earlier stages than the Global DeteriorationScale predicts. METHOD: The analyses were based on data on 324patients with Alzheimer's disease who were selected from a registryof such patients. Data analyses included 1) descriptive statisticson the frequency of psychiatric symptoms and difficulties withactivities of daily living and 2) logistic regression, with symptoms andfunctional impairment as independent variables, to test forsignificant changes in patients' status between stages of the GlobalDeterioration Scale. RESULTS: More than 50% of the patients at stage 2 displayed psychopathology, and 32% had two or more symptoms. Thesignificant increase in psychiatric symptoms occurred between stages 3and 4, not between stages 5 and 6 as predicted by the GlobalDeterioration Scale. Impairment in functional status was observed at allstages, and significant increases occurred between stages 3 and 4as well as between stages 5 and 6. CONCLUSIONS: Psychiatric symptomsand functional impairment occur earlier than predicted by theGlobal Deterioration Scale, and the rate of change is alsodifferent from that specified in the scale. Separate scales to describecognitive, clinical, and functional status may be the best way todescribe the illness until better multidimensional instruments aredeveloped.
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