Global Deterioration Scale

Original Editor - Carina Therese Magtibay

Top Contributors - Carina Therese Magtibay  

Objective[edit | edit source]

The Global Deterioration Scale (GDS), also known as Reisberg Scale, is an outcome measure used to determine the stages of cognitive function among patients diagnosed with primary degenerative dementia. It helps caregivers/ healthcare professionals assess the progression and prognosis of the disease.[1]

Intended Population[edit | edit source]

This screening tool is intended for patients with primary degenerative dementia such as Alzheimer’s disease.

Method of Use[edit | edit source]

A set of specific clinical characteristics in accordance with GDS guides caregivers/healthcare practitioners in detecting the patient's level of cognitive function. GDS is classified into 7 stages:[1]

  • Pre-dementia Stages
    • Stage 1- No cognitive decline
    • Stage 2- Very mild cognitive decline (Age-Associated Memory Impairment)
    • Stage 3- Mild cognitive decline (Mild Cognitive Impairment)
  • Dementia Stages
    • Stage 4- Moderate cognitive decline (Mild Dementia)
    • Stage 5- Moderately severe cognitive decline (Moderate Dementia)
    • Stage 6- Severe cognitive decline (Moderately Severe Dementia)
    • Stage 7- Very severe cognitive decline (Severe Dementia)


Evidence[edit | edit source]

Reliability[edit | edit source]

According to several studies, the Global Deterioration Scale has good interrater reliability, ranging from0.82 to 0.92.[3][4] [5]

Validity[edit | edit source]

Researches done by Ferris et al (1980) and Schmidt et al (2010) indicate that GDS correlated significantly with CT scan rankings of ventricular dilation (r = .62) and CT scan-based assessments of sulcus enlargement (r = .53).[6][7]

Links[edit | edit source]

Global Deterioration Scale - for full definition of clinical characteristics

References[edit | edit source]

  1. 1.0 1.1 Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. The American journal of psychiatry. 1982 Sep.
  2. The OT Minute. Reisbergs 7 stages of dementia (aka the Global Deterioration Scale). Available from: [last accessed 26/3/2023]
  3. Gottlieb GL, Gur RE, Gur RC: Reliability of psychiatric scales in patients with dementia of the Alzheimer type. Am J Psychiatry 1988; 145:857-860
  4. Foster JR, Sclan S, Welkowitz J, Boksay I, Seeland I. Psychiatric assessment in medical long‐term care facilities: Reliability of commonly used rating scales. International Journal of Geriatric Psychiatry. 1988 Jul;3(3):229-33.
  5. Reisberg B, Ferris SH, Steinberg G, Schulman E, Dc Leon MJ, Sinaiko E: Longitudinal study of dementia patients and aged controls, in Special Research Methods for Gerontology. Edited by Lawton MP, Herzog AR. Amityville, NY, Baywood, 1989
  6. Schmidt C, Redyk K, Meissner B, Krack L, Von Ahsen N, Roeber S, Kretzschmar H, Zerr I. Clinical features of rapidly progressive Alzheimer’s disease. Dementia and geriatric cognitive disorders. 2010;29(4):371-8.
  7. Ferris SH, de Leon MJ, Wolf AP, Farkas T, Christman DR, Reisberg B, Fowler JS, MacGregor R, Goldman A, George AE, Rampal S. Positron emission tomography in the study of aging and senile dementia. Neurobiology of Aging. 1980 Dec 1;1(2):127-31.