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Mattis Dementia Rating Scale (MDRS)
Please visit this website for more information about the instrument: Mattis Dementia Rating Scale
Supplemental: Parkinson's Disease (PD)
Short Description of Instrument
Purpose: The Mattis Dementia Rating Scale (MDRS) was developed as a screen for cognitive impairment in the general population. It differentiates general population from mild cognitive impairment and dementia in Alzheimer disease and in Parkinson's disease.
Overview: It is a generic instrument that is administered by a trained examiner to the patient. The scale covers the domains of attention, initiation-preservation, construction, conceptualization and memory. There is an alternative form that has a strong between-form reliability and equivalency.  It has been translated to other languages. Administration time is 20-30 minutes.
Comments/Special Instructions
There is software that automatically generates age-corrected subscale scores, and age- and education-corrected Dementia Rating Scale-2 (DRS-2) Total Score, and percentile subscale score. The Interpretive Report describes the overall performance and subtest performance.
Scoring and Psychometric Properties
Scoring: There are 144 maximum points and 5 subscales/subtests: Attention (8 items, 37 points); Initiation-Perseveration (11 items, 37 points); Construction (6 items, 6 points); Conceptualization (6 items, 39 points); and Memory (5 items, 25 points). Each item or subsection may have multiple questions. Higher scores are better.
Numerous cutoffs for Parkinson's disease-mild cognitive impairment (PD-MCI) and Parkinson's disease dementia (PDD) have been proposed using the DRS-2:
Matteau et al. (2012): PDD = 132/144 (1.00 sensitivity, 1.00 specificity); PD-MCI =140/144 (0.86, 0.54) (vs. healthy)
Pirogovsky et al. (2014): =137 (0.77, 0.65) (vs. healthy)
Bezdicek et al. (2015): =139 (0.78, 0.88 vs. healthy; 0.78, 0.76 vs. PD normal cognition)
Psychometric Properties: Performance is largely influenced by both age and educational level and there is global and subscale age-and educated corrected normative data.  Ways to convert the MDRS to the Montreal Cognitive Assessment which is another commonly used scale (van Steenoven et al., 2014) have been developed.
In persons with PD, the DRS-2 has utility in screening overall level of cognitive functioning but the subtest scores may lack construct validity and may not correlate well with scores from established neuropsychological tests of similar cognitive domains (Lopez et al., 2021). However, other studies suggest good divergent and convergent validity of DRS-2 with other screening tests, memory tests, fluency tests, and intelligence tests (Skorvanek et al., 2018).
Internal consistency is very good (Cronbach alpha 0.82) as is test-retest reliability (0.97) (Katsarou et al., 2010).
DRS-2 is sensitive to change with time (Siderowf et al., 2010) and treatment with rivastigmine (Dujardin et al., 2006).
Strengths: The MDRS is a standardized instrument that has been widely used in Alzheimer's disease (AD) and PD (Brown et al., 1999; Foley et al., 2018; Kim et al., 2019), providing a global as well as subscale age-and education-corrected data.  It is used to screen for PD-MCI and PDD (Villeneuve et al., 2011; Pirogovsky et al., 2014).
Weaknesses: Its time of administration is longer than usual scales used in practice, requiring trained rater. Some studies show that it is no better than the Montreal Cognitive Assessment scale that is shorter and free (Kim et al., 2019).
Key References:
Mattis, S. (1988) Dementia rating scale. Professional manual. Psychological Assessment Resources, Odessa.
Schmidt R, Freidl W, Fazekas F, Reinhart B, Grieshofer P, Koch M, Eber B, Schumacher M, Polmin K, Lechner H. The Mattis Dementia Rating Scale: normative data from 1,001 healthy volunteers. Neurology. 1994 May;44(5):964-6.
Parkinson's Disease-Specific References:
Brown GG, Rahill AA, Gorell JM, McDonald C, Brown SJ, Sillanpaa M, Shults C. Validity of the Dementia Rating Scale in assessing cognitive function in Parkinson's disease. J Geriatr Psychiatry Neurol. 1999 Winter;12(4):180-8.
Bezdicek O, Michalec J, Nikolai T, Havrankova P, Roth J, Jech R, Ruzicka E. Clinical validity of the Mattis Dementia Rating Scale in differentiating mild cognitive impairment in Parkinson's disease and normative data. Dement Geriatr Cogn Disord. 2015;39(5-6):303-11.
Dujardin K, Devos D, Duhem S, DestÉe A, MariÉ RM, Durif F, Lacomblez L, Touchon J, Pollak P, PÉrÉ JJ. Utility of the Mattis dementia rating scale to assess the efficacy of rivastigmine in dementia associated with Parkinson's disease. J Neurol. 2006 Sep;253(9):1154-9.
Foley T, McKinlay A, Warren N, Stolwyk RJ. Assessing the sensitivity and specificity of cognitive screening measures for people with Parkinson's disease. NeuroRehabilitation. 2018;43(4):491-500.
Katsarou Z, Bostantjopoulou S, Zikouli A, Kazazi E, Kafantari A, Tsipropoulou V, Kourtesi G, Peitsidou E. Performance of Greek demented and nondemented subjects on the Greek version of the Mattis Dementia Rating Scale. A validation study. Int J Neurosci. 2010 Nov;120(11):724-30.
Kim HM, Nazor C, Zabetian CP, Quinn JF, Chung KA, Hiller AL, Hu SC, Leverenz JB, Montine TJ, Edwards KL, Cholerton B. Prediction of cognitive progression in Parkinson's disease using three cognitive screening measures. Clin Park Relat Disord. 2019;1:91-97.
Lopez FV, Kenney LE, Ratajska A, Jacobson CE, Bowers D. What does the Dementia Rating Scale-2 measure? The relationship of neuropsychological measures to DRS-2 total and subscale scores in non-demented individuals with Parkinson's disease. Clin Neuropsychol. 2021 Nov 15:1-20.
Matteau E, DuprÉ N, Langlois M, Provencher P, Simard M. Clinical validity of the Mattis Dementia Rating Scale-2 in Parkinson disease with MCI and dementia. J Geriatr Psychiatry Neurol. 2012 Jun;25(2):100-6.
Pirogovsky E, Schiehser DM, Litvan I, Obtera KM, Burke MM, Lessig SL, Song DD, Liu L, Filoteo JV. The utility of the Mattis Dementia Rating Scale in Parkinson's disease mild cognitive impairment. Parkinsonism Relat Disord. 2014 Jun;20(6):627-31.
Skorvanek M, Goldman JG, Jahanshahi M, Marras C, Rektorova I, Schmand B, van Duijn E, Goetz CG, Weintraub D, Stebbins GT, Martinez-Martin P; members of the MDS Rating Scales Review Committee. Global scales for cognitive screening in Parkinson's disease: Critique and recommendations. Mov Disord. 2018 Feb;33(2):208-218.
van Steenoven I, Aarsland D, Hurtig H, Chen-Plotkin A, Duda JE, Rick J, Chahine LM, Dahodwala N, Trojanowski JQ, Roalf DR, Moberg PJ, Weintraub D. Conversion between mini-mental state examination, montreal cognitive assessment, and dementia rating scale-2 scores in Parkinson's disease. Mov Disord. 2014 Dec;29(14):1809-15.
Villeneuve S, Rodrigues-Brazète J, Joncas S, Postuma RB, Latreille V, Gagnon JF. Validity of the Mattis Dementia Rating Scale to detect mild cognitive impairment in Parkinson's disease and REM sleep behavior disorder. Dement Geriatr Cogn Disord. 2011;31(3):210-7.
Document was last updated on August 2022