Clinical staging of dementia in a population survey: comparison of DSM‐III‐R and the Washington University Clinical Dementia Rating Scale

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Abstract
In a population survey in Stockholm, 224 dementia cases were staged using two scales: the Washington University Clinical Dementia Rating Scale and DSM III‐R. Both scales had to be modified by adding additional specifications and, in the case of DSM III‐R, a new category of questionable dementia. After modification, the comparison of the two scales showed good agreement when all stages were analyzed (k = 0.60), but moderate agreement on the questionable and mild stages (k = 0.47). These results confirm the staging of mild dementia as the most problematic issue. Finally, the scales both showed moderate agreement with the categorized Mini‐Mental State Examination (MMSE) (0–17 for severe and moderate forms; 18–23 for mild cases). Our data suggest new cut‐off points for the MMSE when used as a staging scale.