Abstract
Introduction: In Vietnam, Alzheimer's disease (AD) and other dementias have become increasingly important public health concerns among older adults. Developing a diagnostic instrument with high reliability and validity is therefore essential. The Clinical Dementia Rating (CDR) is a global clinical assessment scale widely used for diagnosing dementia and classifying its severity, and it has been extensively applied in epidemiological studies worldwide. Objective: To develop the Vietnamese version of the Clinical Dementia Rating (V-CDR) and evaluate its feasibility, reliability, and validity for diagnosing and classifying cognitive function in older adults. Methods: A total of 153 older outpatients at Cho Ray Hospital were screened for cognitive impairment using the Mini-Mental State Examination (MMSE). Participants with MMSE scores ≤26 were enrolled in the study and subsequently assessed using the Vietnamese version of the CDR (V-CDR) and standard clinical diagnostic criteria for dementia. Reliability was evaluated by internal consistency (Cronbach’s α), intrarater reliability, and interrater reliability (weighted κ). Concurrent validity and discriminative validity of the V-CDR were also assessed. Results: The V-CDR demonstrated excellent internal consistency for both raters (Cronbach’s α = 0.90 and 0.96) and excellent intrarater and interrater reliability (weighted κ = 0.84 [95% CI: 0.74–0.94] and 0.82 [95% CI: 0.72–0.93], respectively). The sensitivity and specificity for detecting dementia were 93.6% and 100%, respectively. The positive and negative predictive values were 100% and 96.4%, respectively. Agreement between the V-CDR and the clinical diagnosis was excellent (weighted κ = 0.94; 95% CI: 0.88–0.99). The V-CDR significantly outperformed the MMSE in discriminating mild cognitive impairment from normal cognitive function (AUC = 0.957, 95% CI: 0.893–1.000 vs. AUC = 0.594, 95% CI: 0.441–0.746). Conclusions: The Vietnamese version of the Clinical Dementia Rating is a feasible, reliable, and valid instrument. It should be incorporated into routine clinical practice for diagnosing dementia and classifying its severity among older adults.
