Reliability of clinical nurse specialists in the staging of dementia.

We studied the reliability of master's-prepared clinical nurse specialists for the identification and staging of dementia, using videotapes of physician assessments of both healthy older persons and those with senile dementia of the Alzheimer type. The Washington University (St Louis, Mo) Clinical Dementia Rating system was the staging instrument. The results from three nurses, each reviewing 25 videotaped assessments, indicate that agreement is high between clinical nurse specialists and physicians for the presence and severity of dementia (kappa = .75). This study suggests that clinical nurse specialists can use the Clinical Dementia Rating scale effectively, and thus reliably identify and stage dementia.