Rationale for use of the Clinical Dementia Rating Sum of Boxes as a primary outcome measure for Alzheimer’s disease clinical trials

• Published in: Alzheimer's & dementia Vol. 9; no. 1; pp. S45 - S55
• Main Authors: Cedarbaum, Jesse M, Jaros, Mark, Hernandez, Chito, Coley, Nicola, Andrieu, Sandrine, Grundman, Michael, Vellas, Bruno
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2013; The Alzheimer's Association
• Subjects: ADNI; Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - psychology; Alzheimer's disease; Clinical trials; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Mild cognitive impairment; Neurology; Neuropsychological Tests; Outcome Assessment (Health Care); Outcome measures; Psychometrics; Research Design; ADNI; Clinical trials; Outcome measures; Mild cognitive impairment; Alzheimer's disease
• ISSN: 1552-5260; 1552-5279; 1552-5279
• DOI: 10.1016/j.jalz.2011.11.002

Abstract Background We used the database of the Alzheimer's Disease Neuroimaging Initiative (ADNI) to explore the psychometric properties of the Clinical Dementia Rating Sum of Boxes (CDR-SB) to consider its utility as an outcome measure for clinical trials in early and mild, as well as later, stages of Alzheimer's disease (AD). Methods We assessed internal consistency, structural validity, convergent validity, and 2-year internal and external responsiveness of the CDR-SB using data from 382 subjects with early or mild AD at entry into the ADNI study. Results The CDR-SB assesses both cognitive and functional domains of AD disability. Mean scores declined nearly linearly; CDR-SB cognitive and functional subsums contributed equally to total scores at both very mild (early) and mild stages of the disease. Conclusions The CDR-SB has psychometric properties that make it attractive as a primary outcome measure that comprehensively assesses both cognitive and functional disability in AD patients. It may prove particularly useful for studies in early, predementia stages of AD.