Abstract
The Dementia Rating Scale (DRS) comprises a series of five subtests which assess attention, memory, initiation/perseveration, construction, and conceptualisation. It can be delivered in full in approximately 30 min, making it a useful test for the detection and estimation of the overall level of dementia. We analysed the pattern of subscale test scores in patients with cortical and subcortical dementias, who were matched for their overall level of dementia on this scale. Patients with dementia of Alzheimer's type were more impaired than patients with Huntington's disease (HD) and progressive supranuclear palsy (PSP) on the memory subtest, whereas patients with HD and PSP were more impaired on the initiation/perseveration subtest. This is evidence in favour of the concept of cortical and subcortical dementias as separate, although overlapping, entities. Qualitative differences in the pattern of cognitive impairment in these disorders can be detected with a brief cognitive status examination.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Albert ML, Feldman RG, Willis AL (1974) The “subcortical dementia” of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 37:121–130
Benson DF, Kuhl DE, Hawkins RA, et al (1983) The fluorodeoxyglucose 18F scan in Alzheimer's disease and multiinfarct dementia. Arch Neurol 40:711–714
Brown RG, Marsden CD (1988) “Subcortical dementia”, the neuropsychological evidence. J Neurosci 25:363–387
Butters N, Wolfe J, Martone M, Granholm E, Cermak LS (1985) Memory disorders associated with Huntington's disease: verbal recall, verbal recognition and procedural memory. Neuropsychologia 23:729–744
Butters N, Wolfe J, Martone M, Granholm E (1986) An assessment of verbal recall, recognition and fluency abilities in patients with Huntington's disease. Cortex 22:11–32
Butters N, Granholm E, Salmon DP, Grant I, Wolfe J (1987) Episodic and semantic memory: a comparison of amnesic and demented patients. J Clin Exp Neuropsychol 9:479–497
Cummings JL (1990) Subcortical dementia. Oxford University Press, Oxford
Damasio AR, Van Hoesen GW, Hyman BT (1990) Reflections on the selectivity of neuropathological changes in Alzheimer's disease. In: Schwartz MF (ed) Modular deficits in Alzheimer's-type dementia. MIT Press, Cambridge, Mass., pp 83–101
Folstein JF, Folstein SE, McHugh PR (1975) “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Hasselbalch SG, Oberg G, Sorensen SA, et al (1992) Reduced region cerebral blood flow in Huntington's diseae studied by SPECT. J Neurol Neurosurg Psychiatry 55:1018–1023
Hedreen JC, Peyser CE, Folstein SE, Ross CA (1991) Neuronal loss in layers v and vi of the cerebral cortex in Huntington's disease. Neurosci Lett 133:257–263
Heindel WC, Salmon DP, Butters N (1993) Cognitive approaches to the memory disorders of demented patients. In: Sutker PD, Adams HE (eds) Comprehensive textbook of psychopathology, 2nd edn. Plenum Press, New York, pp 735–761
Hodges JR (1993) Subcortical dementia. Alzheimer's Rev 2:41–45
Hodges JR, Salmon DP, Butters N (1990) Differential impairment of semantic and episodic memory in Alzheimer's and Huntington's diseases: a controlled prospective study. J Neurol Neurosurg Psychiatry 53:1089–1095
Hodges JR, Salmon DP, Butters N (1992) Semantic memory impairment in Alzheimer's disease: failure of access or degraded knowledge? Neuropsychologia 30:301–314
Lees AJ (1987) The Steele-RichardsonOlszewski syndrome. In: Marsden CD, Fahn S (eds) Movement disorders 2. Butterworths, London, pp 272–287
Lehericy S, Hirsch E, Cervera P, et al (1989) Selective loss of cholinergic neurons in the ventral striatum of patients with Alzheimer's disease. Proc Natl Acad Sci USA 86:329–335
Mattis S (1992) Dementia Rating scale. NFER-Nelson, Windsor
McKhann G, Drachman D, Folstein M, et al (1984) Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimers Disease. Neurology 34:939–944
Moss MB, Albert MS, Butters N, Payne M (1986) Differential patterns of memory loss among patients with Alzheimer's disease, Huntington's disease and alcholoic Korsakoff's syndrome. Arch Neurol 43:239–246
Pillon B, Dubois B, Lhermitte F, Agid Y (1986) Heterogeneity of cognitive impairment in progressive supranuclear palsy, Parkinson's disease, and Alzheimer's disease. Neurology 36:1179–1185
Pillon B, Bruno D, Ploska A, Agid Y (1991) Severity and specificity of cognitive impairment in Alzheimer's, Huntington's, and Parkinson's diseases and progressive supranuclear palsy. Neurology 41:634–643
Salmon DP, Kwo-on-Yuen PF, Heindel WC, Butters N, Thal LJ (1989) Differentiation of Alzheimer's disease and Huntington's disease with the Dementia Rating Scale. Arch Neurol 46:1204–1208
Simmons JT, Pastakia B, Chase TN, et al (1986) Magnetic resonance imaging in Huntington's disease. AJNR 7:25–28
Starkstein SE, Folstein SE, Brandt JS et al (1989) Brain atrophy in Huntington's disease. A CT-scan study. Neuroradiology 31:156–159
Tomlinson BE (1992) Ageing and the dementias. In: Adams JH, Duchen LW (eds) Greenfield's neuropathology, 4th edn. Wiley. New York, pp 1284–1441
Weinberger DR, Berman KF, Iadarola M (1988) Prefrontal cortical blood flow and cognitive function in Huntington's disease. J Neurol Neurosurg Psychiatry 51:94–104
Whitehouse PJ (1986) The concept of subcortical dementia: another look. Ann Neurol 19:1–6
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rosser, A.E., Hodges, J.R. The Dementia Rating Scale in Alzheimer's disease, Huntington's disease and progressive supranuclear palsy. J Neurol 241, 531–536 (1994). https://doi.org/10.1007/BF00873515
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00873515