Diagnostic Concordance between Clinical Dementia Rating, Hindi Mental State Examination and Clinical Evaluation

Data from 85 participants enrolled in the project were used for this study. The participants were clinically evaluated and diagnosed by expert psychiatrists; while CDR and HMSE were administered by trained and certified research fellows. The classification based on CE [ HE (n = 47), MCI (n = 24), and AD (n = 14)] by expert psychiatrists was considered as the 'gold standard'. The overall agreement among CDR, HMSE, and CE was assessed using Fleiss' multi-rater kappa, while Cohen's weighted kappa was used to evaluate agreement within individual categories RESULT: Clinical ratings of 85 participants using CA, CDR and HMSE showed "moderate" agreement (Fleiss kappa = 0.556; Z=11.885; p <0.001) with each other. The agreement between CA and CDR was "very good" weighted kappa=0.954; Z=10.994; p <0.001), and agreement with HMSE was "moderate" (weighted kappa=0.483; Z=6.041; p <0.001). The agreement between HMSE and CDR was "moderate" (weighted kappa=0.482; Z=5.99, p <0.001). Between all the three methods, the agreement on Healthy Elders was "very good" (weighted kappa=0.848; Z=9.311; p <0.001), agreement within the MCI category was "moderate" (weighted kappa=0.518; Z=6.171; p <0.001) and agreement within AD category was "good" (weighted kappa=0.784; Z=12.088; p <0.001) CONCLUSION: The results of the study highlight the excellent concordance between CDR-derived diagnoses with CE-based diagnoses, the gold standard, in this project that aims to examine the various factors contributing to the 'brain age gap' in AD and MCI in India.