Abstract:

Although the Global Deterioration Scale (GDS) describes seven nominal stages of cognitive decline in persons with age-related cognitive impairment as well as primary degenerative dementia, the discriminating power of the GDS to stage cognitive changes associated with aging as well as the disease process of dementia remains untested. A randomly stratified statewide sample of 491 older persons applying for community-based services because they were at high risk for institutionalization were staged using mental status score to approximate the GDS. Frequency distribution comparisons and logistic regression analysis showed that many deficits in function and behavioral problems were present in earlier cognitive stages than predicted by the present form of the GDS. The incongruity of our observed frequency of functional and behavioral problems with the seven cognitive GDS stages suggests the importance of further research to develop a measure of course of illness based upon psychometric scaling of the frequency distributions of observed cognitive and behavioral changes in different populations.