Study of Clinical Association between Frontal Assessment Battery and Clinical Dementia Rating Scores in Patients with Dementia

Due to the increase in the number of the elderly and the increasing incidence of dementia, early diagnosis of this cognitive disorder has become particularly important, because with timely diagnosis and treatment, the course of the disease can be slowed down and the quality of life of the patient and those around them can be improved. The aim of the present study was to compare the consistency and diagnostic ability of CDR (Clinical Dementia Rating) and FAB (Frontal Assessment Battery) tests with clinical symptoms contained in the Neuropsychiatric Inventory (NPI).

A cross-sectional study was performed in a hospital clinic in Tehran. Using available sampling, 60 individuals over 65 years of age were selected. First, CDR test was performed on the participants and based on the severity of dementia (mild, moderate, and severe), they were scored one to three, respectively. In this population, the test was performed based on the FAB questionnaire and, as for the score, the lower the score, the more severe the cognitive impairment. Then, 12 components of NPI were evaluated based on a questionnaire. The CDR and FAB scores were compared and the scores of each were compared with the NPI scores to determine which of the two cognitive tests was more consistent with clinical signs. The calculated reliability scales were 81% for CDR, 88% for FAB, and 86% for NPI. Data were analyzed using SPSS, version 22, and using statistical methods running chi-square test and spearman correlation coefficient.

This study included 60 patients with dementia with the mean age and standard deviation of 75.39 ± 7.25 years. Totally, 36 patients (0.60%) were female, 39 (0.65%) were literate, and 46 (76.7%) had underlying diseases. The agreement between NPI and FAB was -0.64 and the agreement between NPI and CDR was 0.68 (P <0.001), which indicates a relatively strong relationship between NPI with both tests and whatever score as the NPI increases, so does the severity of the cognitive impairment. This indicates clinical association and no significant difference between the two tests. There was a significant relationship between CDR score and education level (P = 0.004), but there was no significant relationship between CDR and FAB with gender (P = 0.284).

Both CDR and FAB tests have the same utility.