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A total score for the CERAD neuropsychological battery

From the Department of Psychiatry and Psychology (Dr. Chandler), Mayo Clinic, Rochester, MN, and Department of Psychiatry (Drs. Chandler, Lacritz, Hynan, Barnard, Allen, Weiner, and Cullum), Center for Biostatistics and Clinical Science (Dr. Hynan), Department of Anesthesiology and Pain Management (Dr. Deschner), and Department of Neurology (Drs. Weiner and Cullum), University of Texas Southwestern Medical Center at Dallas.

Address correspondence and reprint requests to Dr Cullum, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75235-8846; e-mail: munro.cullum{at}utsouthwestern.edu

Objective: To develop a total or composite score for the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery.

Method: CERAD total scores were obtained by summing scores from the individual CERAD subtests (excluding the Mini-Mental State Examination [MMSE]) into a total composite (maximum score = 100). The method of tabulating the total score was constructed using normal controls (NCs; n = 424) and patients with AD (n = 835) from the CERAD registry database. The utility of the total score was further tested in independent samples of mild AD (n = 95), mild cognitive impairment (MCI; n = 60), and NC (n = 95) subjects.

Results: The CERAD total score was highly accurate in differentiating NC and AD subjects in the CERAD registry. Age, gender, and education effects were observed, and demographic correction scores were derived through multiple regression analysis. Demographically corrected CERAD total scores showed excellent test-retest reliability across samples (r = 0.95) and were highly correlated with the MMSE (r = 0.89) and Clinical Dementia Rating Scale (r = –0.83) in mixed AD and NC samples and with the Blessed Dementia Rating Scale in an AD sample (r = –0.40). The CERAD total score was highly accurate in differentiating independent samples of NC, MCI, and AD subjects.

Conclusion: Results provide support for the validity of a Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) total score that can be used along with the normative data to provide an index of overall level of cognitive functioning from the CERAD neuropsychological battery.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the July 12 issue to find the title link for this article.

Supported in part by NIH, NIA grant P30AG12300. Presented in part at the International Neuropsychological Society Meetings in Baltimore, MD (2004), and St. Louis, MO (2005).

Received August 20, 2004. Accepted in final form March 18, 2005.

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