Bridging the gap: A conversion framework for CDR-SB and MoCA scores in Alzheimer's disease and related dementia.

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The Journal of Prevention of Alzheimer's Disease Pub Date : 2025-06-07 DOI:10.1016/j.tjpad.2025.100226

Babak Haji, Quanwu Zhang, Amir Abbas Tahami Monfared

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引用次数: 0

Abstract

Background: Accurate assessment of cognitive impairment is essential to effective Alzheimer's disease (AD) management and research. However, the absence of validated methods to translate scores between widely used instruments-such as the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) in trials and the Montreal Cognitive Assessment (MoCA) in clinical practice-poses a significant barrier. This limits data harmonization, impedes cross-study comparability, and complicates the integration of clinical and research evidence. Bridging this gap is critical for consistent staging, longitudinal monitoring, and data-driven decision-making in AD and related dementias.

Objectives: To develop and validate bidirectional score conversion tables between CDR-SB and MoCA using a large, diverse cohort spanning the full spectrum of cognitive function.

Design: Retrospective, cross-sectional analysis using equipercentile equating with log-linear smoothing. Optimal smoothing parameters were selected by minimizing mean squared error, Akaike Information Criterion, and Bayesian Information Criterion. Concordance was assessed using Spearman's rank correlation and Bland-Altman plots.

Setting: National Alzheimer's Coordinating Center (NACC), aggregating standardized assessments from 35 U.S.-based Alzheimer's Disease Research Centers.

Participants: 23,717 individuals (59,871 visits) with same-day CDR-SB and MoCA assessments from January 2015 to September 2024, spanning normal cognition, mild cognitive impairment (MCI), and dementia.

Intervention: None; this was a secondary analysis of existing data.

Measurements: Primary measures included CDR-SB (0-18; higher = greater impairment) and MoCA (0-30; higher = better cognition). Bidirectional crosswalk tables were derived using equipercentile equating.

Results: CDR-SB and MoCA scores showed strong inverse correlation (Spearman's ρ = -0.68; p < 0.001). Crosswalk tables demonstrated good agreement across the cognitive spectrum and performed consistently in the full cohort and an AD-specific subgroup.

Conclusions: This study provides the first validated, bidirectional CDR-SB-MoCA crosswalk, supporting data harmonization and consistent interpretation of cognitive severity across research and clinical settings.

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弥合差距：阿尔茨海默病和相关痴呆的CDR-SB和MoCA评分转换框架

背景：认知功能障碍的准确评估对阿尔茨海默病（AD）的有效管理和研究至关重要。然而，缺乏有效的方法来翻译广泛使用的工具之间的分数，例如临床痴呆评定量表（CDR-SB）和临床实践中的蒙特利尔认知评估（MoCA），这构成了一个重大障碍。这限制了数据的协调，阻碍了交叉研究的可比性，并使临床和研究证据的整合复杂化。弥合这一差距对于阿尔茨海默病和相关痴呆的一致分期、纵向监测和数据驱动决策至关重要。目的：建立和验证CDR-SB和MoCA之间的双向评分转换表，使用跨越全谱认知功能的大型多样化队列。设计：采用对数线性平滑等百分位数进行回顾性横断面分析。采用均方误差最小化、赤池信息准则和贝叶斯信息准则选择最优平滑参数。采用Spearman等级相关图和Bland-Altman图评估一致性。背景：国家阿尔茨海默病协调中心（NACC），汇总了美国35个阿尔茨海默病研究中心的标准化评估。参与者：23,717人（59,871次就诊），于2015年1月至2024年9月进行当日CDR-SB和MoCA评估，涵盖正常认知，轻度认知障碍（MCI）和痴呆。干预:没有;这是对现有数据的二次分析。测量方法：主要测量方法包括CDR-SB (0-18；越高=损伤越大)和MoCA (0-30；更高=更好的认知)。双向人行横道表采用等分位方程推导。结果：CDR-SB与MoCA评分呈强负相关(Spearman’s ρ = -0.68；P < 0.001)。人行横道表在认知谱上表现出良好的一致性，在整个队列和ad特定亚组中表现一致。结论：本研究提供了第一个经过验证的双向CDR-SB-MoCA人行横道，支持研究和临床环境中认知严重程度的数据协调和一致解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health

CiteScore

9.20

自引率

0.00%

发文量

期刊介绍： The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.