Clinical Dementia Rating (CDR) Scale

CDR is scored based on 6 categories where memory (M) is the primary category and orientation (O), judgment and problem solving (JPS), community affairs (CA), home and hobbies (HH), and personal care (PC) are secondary categories defined in the table below. a When M ≥1, CDR cannot be 0; in this circumstance, CDR = 0.5 when the majority of secondary categories are 0. b X = score of majority of secondary categories on the side of M that has the greater number of secondary categories. With ties in the secondary categories on one side of M, CDR = tied score closest to M (e.g. if M and another secondary category = 3, two secondary categories = 2, and two secondary categories = 1, then CDR = 2). c When 1-2 secondary categories have the same score as M, CDR = M as long as ≤2 secondary categories are on either side of M. Categories: Category Points Memory (M) No memory loss or slight inconsistent forgetfulness 0 Mild consistent forgetfulness; partial recollection of events; "benign" forgetfulness 0.5 Moderate memory loss; more marked for recent events; interferes with everyday activities 1 Severe memory loss; only highly learned material retained; new material rapidly lost 2 Severe memory loss; only fragments remain 3 Orientation (O) Fully oriented 0 Fully oriented except for slight difficulty with time relationships 0.5 Moderate difficulty with time relationships; oriented for place and person at examination but may have geographic disorientation 1 Severe difficulty with time relationships; usually disoriented to time, often to place 2 Oriented to person only 3 Judgment and problem solving (JPS) Solves everyday problems well; judgment good in relation to past performance 0 Slight impairment in solving problems, similarities, and differences 0.5 Moderate difficulty in handling complex problems; social judgment usually maintained 1 Severely impaired in handling problems, similarities, and differences; social judgment usually impaired 2 Unable to make judgments or solve problems 3 Community affairs (CA) Independent function at usual level in job, shopping, business, and financial affairs, volunteer and social groups 0 Slight impairment in these activities 0.5 Unable to function independently at these activities although may still be engaged in some; appears normal to casual inspection 1 No pretense of independent function outside home; appears well enough to be taken to functions outside a family home 2 No pretense of independent function outside home; appears too ill to be taken to functions outside a family home 3 Home and hobbies (HH) Life at home, hobbies, and intellectual interests well maintained 0 Life at home, hobbies, and intellectual interests slightly impaired 0.5 Mild but definite impairment of function at home; more difficult chores abandoned; more complicated hobbies and interests abandoned 1 Only simple chores preserved; very restricted interests, poorly maintained 2 No significant function in home 3 Personal care (PC) Fully capable of self-care 0 Needs prompting 1 Requires assistance in dressing, hygiene, keeping of personal effects 2 Requires much help with personal care; frequent incontinence 3 From Morris et al (1993) .