Quick Dementia Rating System (QDRS)

By Guest Contributor March 15, 2016 18:49

The QDRS survey below appeared in Joan Jackson’s story, “Could it Be Dementia? 10 Quick Questions” in the Spring 2016 issue of FAN.

QUICK DEMENTIA RATING SYSTEM (QDRS)

Reprinted with permission. ©2013 The Quick Dementia Rating System: A Rapid Dementia Staging Tool is a copyrighted instrument of James E. Galvin and New York University Langone Medical Center.
All Rights Reserved.

The following descriptions characterize changes in the patient’s cognitive and functional abilities.  You are asked to compare the patient now to how they used to be — the key feature is change.  Choose one answer for each category that best fits the patient — NOTE, not all descriptions need to be present to choose an answer

  1. MEMORY AND RECALL

0              No obvious memory loss or inconsistent forgetfulness that does not interfere with function in everyday activities

0.5          Consistent mild forgetfulness or partial recollection of events that may interfere with performing everyday activities; repeats questions/statements, misplaces items, forgets appointments

1              Mild to moderate memory loss; more noticeable for recent events; interferes with performing everyday activities

2              Moderate to severe memory loss; only highly-learned information remembered; new information rapidly forgotten

3              Severe memory loss, almost impossible to recall new information; long-term memory may be affected

  1. ORIENTATION

0              Fully oriented to person, place, and time nearly all the time

0.5          Slight difficulty keeping track of time; may forget day or date more frequently than in the past

1              Mild to moderate difficulty keeping track of time and sequence of events; forgets month or year; oriented to familiar places but gets confused outside of familiar areas; gets lost or wanders

2              Moderate to severe difficulty, usually disoriented to time and place (familiar and unfamiliar); frequently dwells in past

3              Only oriented to their name, although may recognize family members

  1. DECISION MAKING AND PROBLEM SOLVING ABILITIES

0              Solves everyday problems without difficulty; handles personal business and financial matters well; decision-making abilities consistent with past performance

0.5          Slight impairment or takes longer to solve problems; trouble with abstract concepts; decisions still sound

1              Moderate difficulty with handling problems and making decisions; defers many decisions to others; social judgment and behavior may be slightly impaired; loss of insight

2              Severely impaired in handling problems, making only simple personal decisions; social judgment and behavior often impaired; lacks insight

3              Unable to make decisions or solve problems; others make nearly all decisions for patient

  1. ACTIVITIES OUTSIDE THE HOME

0              Independent in function at usual level of performance in profession, shopping, community and religious activities, volunteering, or social groups

0.5          Slight impairment in these activities compared to previous performance; slight change in driving skills; still able to handle emergency situations

             Unable to function independently but still may attend and be engaged; appears “normal” to others; notable changes in driving skills; concern about ability to handle emergency situations

2              No pretense of independent function outside the home; appears well enough to be taken to activities outside the family home but generally needs to be accompanied

             No independent function or activities; appears too ill to be taken to activities outside the home

  1. FUNCTION AT HOME AND HOBBY ACTIVITIES

             Chores at home, hobbies and personal interests are well maintained compared to past performance

0.5          Slight impairment or less interest in these activities; trouble operating appliances (particularly new purchases)

1              Mild but definite impairment in home and hobby function; more difficult chores or tasks abandoned; more complicated hobbies and interests given up

2              Only simple chores preserved, very restricted interest in hobbies which are poorly maintained

3              No meaningful function in household chores or with prior hobbies

  1. TOILETING AND PERSONAL HYGIENE

0              Fully capable of self-care (dressing, grooming, washing, bathing, toileting)

0.5          Slight changes in abilities and attention to these activities

             Needs prompting to complete these activities but may still complete independently

2              Requires some assistance in dressing, hygiene, keeping of personal items; occasionally incontinent

3              Requires significant help with personal care and hygiene; frequent incontinence

  1. BEHAVIOR AND PERSONALITY CHANGES

0              Socially-appropriate behavior in public and private; no changes in personality

0.5          Questionable or very mild changes in behavior, personality, emotional control, appropriateness of choices

             Mild changes in behavior or personality

2              Moderate behavior or personality changes, affects interactions with others; may be avoided by friends, neighbors, or distant relatives

3              Severe behavior or personality changes; making interactions with others often unpleasant or avoided

  1. LANGUAGE AND COMMUNICATION ABILITIES

0              No language difficulty or occasional word searching; reads and writes as well as in past

0.5          Consistent mild word-finding difficulties, using descriptive terms or takes longer to get point across, mild problems with comprehension, decreased conversation; may affect reading and writing

             Moderate word-finding difficulty in speech, cannot name objects, marked reduction in word production; reduced comprehension, conversation, writing and/or reading

2              Moderate to severe impairments in speech production or comprehension; has difficulty communicating thoughts to others; limited ability to read or write

3              Severe deficits in language and communication; little to no understandable speech is produced

  1. MOOD

0              No changes in mood, interest or motivation level

0.5          Occasional sadness, depression, anxiety, nervousness or loss of interest/motivation

             Daily mild issues with sadness, depression, anxiety, nervousness or loss of interest/motivation

2              Moderate issues with sadness, depression, anxiety, nervousness or loss of interest/motivation

3              Severe issues with sadness, depression, anxiety, nervousness or loss of interest/motivation

  1. ATTENTION AND CONCENTRATION

0              Normal attention, concentration and interaction with his/her environment and surroundings

0.5          Mild problems with attention, concentration, and interaction with environment and surroundings, may appear drowsy during day

1              Moderate problems with attention and concentration, may have staring spells or spend time with eyes closed, increased daytime sleepiness

             Significant portion of the day is spent sleeping, not paying attention to environment, when having a conversation may say things that are illogical or not consistent with topic

3              Limited to no ability to pay attention to external environment or surroundings

_____   COGNITIVE SUBTOTAL (QUESTIONS 1, 2, 3, 8)

_____  BEHAVIORAL SUBTOTAL (QUESTIONS 4, 5, 6, 7, 9, 10)

_____  TOTAL QDRS SCORE

What does your score mean?

The Quick Dementia Rating System has a scoring range from zero to 30. After filling out the survey, add up the numbers. Higher scores suggest more impairment. Here is how the scores are rated:

0-1  Normal
2-5 
Mild cognitive impairment
6-12 
Mild dementia
13-20 
Moderate dementia
21-30 
Severe dementia

Scores in the impaired range indicate a need for further assessment to establish a formal diagnosis. Scores in the “normal” range suggest that a dementia is unlikely, but a very early disease stage cannot be ruled out. More advanced assessment may be warranted when other evidence of impairment exists.

Reprinted with permission. ©2013 The Quick Dementia Rating System: A Rapid Dementia Staging Tool is a copyrighted instrument of James E. Galvin and New York University Langone Medical Center. All Rights Reserved.

 

 

 

By Guest Contributor March 15, 2016 18:49
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