[Multi-functional dementia rating scale: reliability and clinical validity].

A new rating method was designed to evaluate five symptoms of dementia; disorders of memory, cognition, language, visuospatial functions, and personality, which are defined as recent neuropsychological criteria for dementias by Cummings and Benson. Thirty-two items were made from the items of the Hasegawa dementia scale and neuropsychological tests. Scales for the five symptoms of dementia were then constituted of the items. In semi-structured interview, 113 demented patients and 16 normal elderly volunteers were rated. Interrater reliability of the five symptom scales were tested by ANOVA ICC and all the symptoms had a significant reliability. The scores of the five symptoms were correlated with each other and with the scores of the Hasegawa dementia scale. A Principal Component Analysis was applied to the scores of the five symptoms. The largest principal component had correlations with the scores of the Hasegawa dementia scale and the scores of the all five symptoms and was interpreted as a factor for severity of dementia. This component explains about 70% of total variance of the data. The other 30% of the variance were explained by four principal components which were interpreted as factors of the differences of the scores of the symptom scales. Relations between the scores of the symptoms and regional cerebral blood flow (rCBF) measured using SPECT were investigated in 25 moderately demented patients which met the criteria of probable Alzheimer's disease of NINCDS-ADRDA. rCBF was calculated as a ratio of 123I-IMP uptake of the areas to the mean uptake of right and left cerebellum. Significant correlations were found between the scores of memory symptom and the rCBF of the left temporal lobe (r = 0.59: p < 0.01) and between the scores of personality changes and the rCBF of the both frontal lobes (r = 0.58, 0.54: p < 0.01). Results suggest the possibility that the distribution of brain damage reflects symptoms in dementia and also supports the validity of analytic evaluation of dementia symptoms by this scale.