Diagnosis and staging of mild cognitive impairment, using a modification of the clinical dementia rating scale: The mCDR

Ranjan Duara, David A. Loewenstein, Maria T. Greig-Custo, Ashok Raj, Warren Barker, Elizabeth Potter, Elizabeth Schofield, Brent Small, John Schinka, Yougui Wu, Huntington Potter

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objective: To examine the reliability and validity of the mCDR, a modified version of the clinical dementia rating (CDR) scale. Methods: The mCDR is an informant-based, technician-administered, structured interview with multiple choice responses, which does not include objective cognitive testing. Subjects (n=556) with no cognitive impairment (NCI), amnestic mild cognitive impairment (aMCI), and dementia were assessed with mCDR, CDR, and neuropsychological evaluation, while medial temporal atrophy (MTA) was measured on MRI scans. The mCDR and CDR were compared with respect to inter-rater reliability, validity, and ability to predict progression in cognitive diagnosis at 12 month follow-up. Results: The mCDR can be administered in less than one third of the time required to administer the CDR (30 min). Inter-rater reliability (Cohen's weighted κ) was 0.86 for the mCDR and 0.56 for the CDR. Ability to distinguish between NCI, aMCI, and Dementia subjects, and correlations to memory and nonmemory measures were marginally better for the CDR, in comparison to the mCDR. Correlations of mCDR and CDR scores to MTA scores did not differ. Baseline mCDR scores predicted transition from NCI to aMCI, whereas baseline CDR scores predicted transition from aMCI to Dementia. Conclusions: The mCDR, as compared to the CDR, is briefer and more reliable, and is a valid measure of functional ability among subjects with normal cognition, mild cognitive impairment, and mild dementia. The mCDR should be particularly useful as a reliable and economical instrument for assessing change in functional abilities, especially in multi-center clinical trials and population studies of MCI and mild dementia.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
JournalInternational Journal of Geriatric Psychiatry
Issue number3
StatePublished - Mar 2010


  • Clinical rating scale
  • Dementia
  • Mild cognitive impairment
  • MRI
  • Visual rating

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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