The Clinical Dementia Rating (CDR) is the gold standard for staging the clinical severity of Alzheimer's disease in both academic research and clinical drug trials.
The Problem with Questionnaires
Written tests like the MoCA are subject to performance anxiety, language barriers, and visual impairments (e.g., cataracts). The CDR bypasses these issues. It relies on the clinician's expert judgment after conducting structured interviews with the patient and their family. It assesses the patient's actual real-world functioning, rather than their ability to draw a clock on a piece of paper.
The Six Domains
The clinician assigns a score of 0 (Normal) to 3 (Severe) in six categories:
- Memory: The anchor category. Severe memory loss automatically drives the global score up.
- Orientation: Awareness of time and place.
- Judgment: Ability to handle complex financial or social problems.
- Community Affairs: Ability to work, shop, and engage in social groups.
- Home & Hobbies: Ability to do chores and pursue interests.
- Personal Care: Ability to bathe, dress, and use the toilet.
Complex algorithm synthesizing scores (0, 0.5, 1, 2, 3) across 6 domains. Memory is the primary anchor.