The Validity of the Korean Version of Global Deterioration Scale

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1 The Validity of the Korean Version of Global Deterioration Scale Seong Hye Choi, MD, Duk L Na, MD *, Byung Hwa Lee, MA *, Dong-Seog Hahm, MD, J ee Hyang Jeong, MD *, Young Jeong, MD *, Eun-Jung Koo, MD, Choong-Kun Ha, MD, Sung Shin Ahn, MD, Korean Dementia Research Group Department of Neurology, College of Medicine, Inha University Department of Neurology*, Sungkyunkwan University School of Medicine, Department of Neurology, Yongin Hyoja Geriatric Hospital Department of Neurology, College of Medicine, Ewha Womens University Department of Neurology, College of Medicine, Seoul National University Background : Clinicians broadly accept the Global Deterioration Scale (GDS) as a staging measure for dementia The aim of this study is to test the inter-rater reliability and concurrent validity of the Korean version of GDS Methods : Participants included 34 subjects without dementia and 41 patients with Alzheimer s disease, in addition to 37 patients with vascular dementia A rater, using a semi-structured clinical interview, interviewed the participants and their informed collateral sources To obtain the concurrent validity, all participants received the Korean Mini-Mental State Examination (K-MMSE), the Korean version of Syndrome Kurz Test (K-SKT) and a 15-items abbreviated Korean- Boston Naming Test (K-BNT) on the same day We also tested the inter-rater reliability among the four raters using a videotape design Results : The agreements of the overall GDS ratings by the four raters were high (κ, ) GDS correlated significantly with K-MMSE, K-SKT, and the abbreviated K-BNT and Clinical Dementia Rating scale Conclusion : The Korean version of GDS may be a reliable and valid tool to be used as a staging measure for Korean patients with Alzheimer s disease as well as vascular dementia J Korean Neurol Assoc 20(6):612~617, 2002 Key Words : GDS, Dementia, Validity, Alzheimer s disease, Vascular dementia Seong Hye Choi, MD 612 Copyright 2002 by the Korean Neurological Association

2 Table 1 Global Deterioration Scale (GDS)? 1 = 2 = :(1) ;(2) 3 = :(1) ;(2) ;(3) (; 100-7, 93-7) ;(4) 4 = :(1) ;(2) ;(3) (,, ) (,,, ) = 20 2 ( ),, ( ) 6 = :(1) (, );(2) ( );(3),, ;(4), 7 = ( ) J Korean Neurol Assoc / Volume 20 / November,

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4 Table 2 Kappa values measuring the inter-rater agreement on GDS 1 vs 2 1 vs 3 1 vs 4 2 vs 3 2 vs 4 3 vs 4 GDS , 2, 3, and 4 represents examiner 1 (Lee), examiner 2 (Jeong), examiner 3 (Hahm) and examiner 4 (Choi), respectively GDS; global deterioration scale Table 3 Means and standard deviations (SD) of K-MMSE, K-SKT and 15-items abbreviated K-BNT for each GDS group K-MMSE K-SKT abbreviated K-BNT Mean±SD (range) Mean±SD (range) Mean±SD (range) GDS 1 (N=15) 283±12 (26-30) 13±10 (0-4) 109±24 (6-14) GDS 2 (N=12) 266±18 (22-29) 34±28 (0-9) 103±26 (5-15) GDS 3 (N=17) 240±28 (20-28) 65±35 (1-11) 96±27 (5-14) AD (N=3) 213±06 (21-22) 90±10 (8-10) 97±29 (8-13) VaD (N=7) 251±26 (20-28) 71±31 (3-11) 113±19 (8-14) GDS 4 (N=16) 202±37 (16-27) 115±44 (3-18) 79±31 (2-14) AD (N=7) 200±35 (17-26) 103±29 (5-12) 87±13 (7-10) VaD (N=9) 203±41 (16-27) 128±58 (3-18) 72±40 (2-14) GDS 5 (N=22) 165±3 5 (11-24) 178±56 (8-26) 61±34 (1-11) AD (N=12) 164±31 (11-23) 185±49 (9-26) 65±33 (2-11) VaD (N=10) 166±41 (12-24) 167±71 (8-24) 57±36 (1-10) GDS 6 (N=15) 76±31 (2-13) 243±31 (21-27) 2 3±21 (0-7) AD (N=10) 70±34 (2-13) 243±31 (21-27) 29±22 (1-7) VaD (N=5) 88±22 (6-11) NA 12±13 (0-3) GDS 7 (N=15) 0 3±07 (0-2) NA 01±05 (0-2) AD (N=9) 04±09 (0-2) NA 02±07 (0-2) VaD (N=6) 02±04 (0-1) NA 0±0 (0) AD; Alzheimer s disease, VaD; vascular dementia, K-MMSE: Korean Mini-Mental State Examination, K-SKT; Korean version of Syndrom Kurz Test, K-BNT; Korean-Boston Naming Test, NA; Not appilcable κ J Korean Neurol Assoc / Volume 20 / November,

5 Figure 1 The relationship of Global Deterioration Scale and Clinical Dementia Rating (CDR) scale is showed 616 J Korean Neurol Assoc / Volume 20 / November, 2002

6 01 Hughes CP, Berg L, Danziger WL, Coben LA Martin RL A new clinical scale for the staging of dementia Br J Psychiatry 1982;140: Morris JC The Clinical Dementia Rating (CDR): current version and scoring rules Neurology 1993;43: Choi SH, Na DL, Lee BH, Hahm D, Jeong JH, Yoon SJ, et al Estimating the validity of the Korean version of expanded Clinical Dementia Rating (CDR) Scale J Korean Neurol Assoc 2001;19: Reisberg B, Ferris SH, De Leon MJ, Crook T The global deterioration scale for assessment of primary degenerative dementia Am J Psychiatry 1982;139: McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM Clinical diagnosis of Alzheimer s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer s Disease N e u r o l o g y ; 3 4 : Chui HC, Victoroff JI, Margolin D, Jagust W, Shankle R, Katzman R Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer s Disease Diagnostic and Treatment Centers N e u r o l o g y 1992;42: Choi SH, Na DL, Oh K, Park BJ A Short form of Samsung Dementia Questionnaire(S-SDQ): development ( ) ( ) and cross-validation J Korean Neurol Assoc 1999;17: Kang SJ, Choi SH, Lee BH, Kwon JC, Na DL, Han SH, et al The reliability and validity of the Korean Instrumental Activities of Daily Living(K-IADL) J Korean Neurol Assoc 2002;20: Kang Y, Na DL, Hahn S A validity study on the Korean Mini-Mental State Examination(K-MMSE) in dementia patients J Korean Neurol Assoc 1997;15: Kang Y, Kim H, Na DL Parallel Short form of the Korean-Boston Naming Test(K-BNT) J Korean Neurol Assoc 2000;18: Feinstein AR Clinical epidemiology Philadelphia: Saunders, 1985; Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K, et al Research criteria for subcortical vascular dementia in clinical trials J Neural Transm ; 59: Vetter PH, Krauss S, Steiner O, Kropp P, Moller WD, Moises HW, et al Vascular dementia versus dementia of Alzheimer s type: do they have differential effects on caregivers burden? J Gerontol B Psychol Sci Soc Sci 1999;54:S Fernandez-Novoa L,Corzo L, Zas R, Alvarez XA, Cacabelos R Global Deterioration Scale-related brain hemodynamics and histamine levels in Alzheimer s disease and vascular dementia Ann N Y Acad Sci 1997;826: ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) J Korean Neurol Assoc / Volume 20 / November,

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