{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:43:19Z","timestamp":1788493399965,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp; Dementia"],"published-print":{"date-parts":[[2025,6]]},"abstract":"Abstract<\/jats:title>\n \n INTRODUCTION<\/jats:title>\n We aimed to develop and externally validate a mapping to translate Mini\u2010Mental State Examination (MMSE) scores to Clinical Dementia Rating scale Sum of Boxes (CDR\u2010SB) scores in patients with Alzheimer's disease (AD).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n We extended a previously published CDR\u2010SB to MMSE mapping to include later stages of AD and validated it using the US National Alzheimer's Coordinating Centers (NACC) database. Calibration and discrimination metrics were evaluated, and the mapping was validated in clinically relevant subgroups of the AD population.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A linear MMSE to CDR\u2010SB mapping ( demonstrated high goodness of fit and satisfied all validation metrics. The extended mapping performed well across subgroups, though calibration was less accurate for severe dementia patients.<\/jats:p>\n <\/jats:sec>\n \n DISCUSSION<\/jats:title>\n This MMSE to CDR\u2010SB MMSE mapping performed generally well though caution is needed when applying this mapping to people with severe AD dementia. It could be used to help contextualize outcomes in AD clinical trials and real\u2010world health research studies.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n \n \n \n We developed a mapping between the CDR\u2010SB and MMSE instruments, by obtaining the optimal functional form of a mapping previously published using data from the Alzheimer's Disease Neuroimaging Initiative dataset and extending it to the full range of clinical severities for Alzheimer's disease.<\/jats:p>\n <\/jats:list-item>\n \n The resulting mapping was externally validated using 26,729 MMSE and CDR\u2010SB pairs from participants recruited to the US National Alzheimer's Coordinating Centers database.<\/jats:p>\n <\/jats:list-item>\n \n The selected model satisfied the pre\u2010specified selection criteria and the extended mapping demonstrated good performance, especially in the earlier clinical stages. However, caution is advised when inferring mapped scores in more severe dementia.<\/jats:p>\n <\/jats:list-item>\n \n The extension and subsequent validation of the mapping can support the translation of AD severity assessments between datasets using CDR\u2010SB and MMSE, bridging a common information gap between clinical trials, real\u2010world evidence studies, and clinical practice.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/alz.70163","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T01:14:36Z","timestamp":1750382076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Extension and external validation of mapping between the Mini\u2010Mental State Examination and the Clinical Dementia Rating scale in patients with Alzheimer's disease"],"prefix":"10.1002","volume":"21","author":[{"given":"Niels Juul","family":"Brogaard","sequence":"first","affiliation":[{"name":"Novo Nordisk A\/S S\u00f8borg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie Hviid","family":"Hahn\u2010Pedersen","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S S\u00f8borg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Gundgaard","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S S\u00f8borg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pepa","family":"Polavieja","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S S\u00f8borg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Bray","sequence":"additional","affiliation":[{"name":"Health Analytics, Lane Clark & Peacock LLP London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei Sum","family":"Chan","sequence":"additional","affiliation":[{"name":"Health Analytics, Lane Clark & Peacock LLP London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Men","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry School of Medicine Trinity College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1421-2966","authenticated-orcid":false,"given":"Dominic","family":"Trepel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry School of Medicine Trinity College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Alzheimer's Disease International: World Alzheimer report","author":"Prince M","year":"2015"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.11.2412-a"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.6.1508"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.65.8.1091"},{"issue":"1","key":"e_1_2_10_6_1","first-page":"S45","article-title":"Rationale for use of the clinical dementia rating sum of boxes as a primary outcome measure for Alzheimer's disease clinical trials","volume":"9","author":"Cedarbaum JM","year":"2013","journal-title":"Alzheimer's & Dementia"},{"key":"e_1_2_10_7_1","first-page":"1","volume-title":"Clinical Dementia Rating Scale. Encyclopedia of Quality of Life and Well\u2010Being Research","author":"Schmidt K","year":"2021"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2015.1119312"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JGP.0000192478.82189.a8"},{"issue":"1","key":"e_1_2_10_10_1","first-page":"354","article-title":"Disease severity and minimal clinically important differences in clinical outcome assessments for Alzheimer's disease clinical trials","volume":"5","author":"Andrews JS","year":"2019","journal-title":"Alzheimers & Dementia"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200817"},{"issue":"2","key":"e_1_2_10_12_1","article-title":"The association of Mini\u2010Mental State Examination (MMSE) with Clinical Dementia Rating (CDR)","volume":"3","author":"Srishyla D","year":"2020","journal-title":"Public Health Rev"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-022-00326-y"},{"issue":"1","key":"e_1_2_10_14_1","article-title":"Integrated Alzheimer's disease rating scale: clinically meaningful change estimates","volume":"8","author":"Wessels AM","year":"2022","journal-title":"Alzheimers Dementia"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014508"},{"key":"e_1_2_10_16_1","first-page":"249","volume-title":"The National Alzheimer's Coordinating Center (NACC) Database: The Uniform Data Set","author":"Beekly DL","year":"2007"},{"key":"e_1_2_10_17_1","article-title":"How do humans understand explanations from machine learning systems? an evaluation of the human\u2010interpretability of explanation","author":"Narayanan M","year":"2018","journal-title":"arXiv preprint arXiv:180200682"},{"key":"e_1_2_10_18_1","article-title":"An evaluation of the human\u2010interpretability of explanation","author":"Lage I","year":"2019","journal-title":"arXiv preprint arXiv:190200006"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7797"},{"key":"e_1_2_10_20_1","volume-title":"A guide to the cognitive measures in five British birth cohort studies","author":"Moulton V","year":"2020"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxac011"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-statistics-042522-103837"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.39874"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n857"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.05.001"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.04.005"}],"container-title":["Alzheimer's & Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.70163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T11:20:13Z","timestamp":1760008813000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/alz.70163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/alz.70163"],"URL":"https:\/\/doi.org\/10.1002\/alz.70163","archive":["Portico"],"relation":{},"ISSN":["1552-5260","1552-5279"],"issn-type":[{"value":"1552-5260","type":"print"},{"value":"1552-5279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2024-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70163"}}