Updating the Mattis Dementia Rating Scale to DSM-5-TR/ICD-11: A new item-division based on the current neurocognitive domains.

Abstract

Objective: The Mattis Dementia Rating Scale (DRS), a widely used cognitive assessment tool, has been revised to align with contemporary diagnostic criteria and cognitive domain classifications such as those outlined in Diagnostic Statistical Manual for Mental Disorders, fifth edition-text revision (DSM-5-TR) and eleventh version of the International Classification of Diseases (ICD-11). This study proposed a reorganization of DRS items into five new subscales based on cognitive domains of those classificatory manuals, aiming to enhance its construct validity and clinical utility.

Method: The DRS and other neuropsychological tests were used for the assessment of 407 older adults with low formal education and heterogeneous cognitive backgrounds. We used confirmatory factor analysis to test different arrangements of DRS items and correlated the final model with other neuropsychological tests.

Results: Our final model (following the DSM-5-TR/ICD-11 cognitive domains) showed better model fit in multiple indexes when compared with the original DRS subscales. They showed significant correlation with specific neuropsychological tests corresponding to their respective cognitive domains, supporting its validity. Group comparisons across cognitive impairment levels (cognitively unimpaired, mild neurocognitive disorder, major neurocognitive disorder) revealed progressive cognitive decline patterns consistent with clinical expectations.

Conclusions: The proposed DRS item division based in DSM-5-TR and ICD-11 cognitive domains showed more consistent evidences of validity than the original. The proposed revision can use the original DRS subtests and scoring system, just reorganizing the subscales to better fit the DSM-5-TR/ICD-11 model and can in any translation/local version of the test. Further research is needed to replicate this findings and establish normative values and cutoff scores for clinical application. (PsycInfo Database Record (c) 2025 APA, all rights reserved).