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Received July 20, 1998; revised November 9, 1998; accepted December 7, 1998. From the Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, and the Memory Disorders Clinic, Department of Biological Psychiatry, New York State Psychiatric Institute, New York, NY. Address correspondence to Dr. Albert, Gertrude H. Sergievsky Center, Columbia University, College of Physicians and Surgeons, Box 16, 630 W. 168th St., New York, NY 10032; e-mail: sma10{at}columbia edu
The authors investigated differences in functional ability among three groups of subjects who were not diagnosed with dementia: normal control (NC) subjects (n=35); Clinical Dementia Rating Scale (CDRS) score of 0 (minimal impairment; n=26); and CDRS 0. 5 (questionable dementia; n=42). CDRS 0 and 0. 5 patients reported significantly poorer functioning than NCs in household and other activities, but CDRS 0 and CDRS 0. 5 groups did not differ in self-reported functioning. It is likely that CDRS 0. 5 patients overestimated their functional abilities. Correlations between self- and informant reports of functional status were significantly lower in the CDRS 0. 5 group than in the CDRS 0 group, an important finding for clinical management because patients with questionable dementia may actually be more impaired than they admit. Informants' reports or standardized performance-based assessment should be considered in the clinical evaluation of such patients.
Key Words: Alzheimer's Disease • Cognition • Functional Impairment
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