The behavioral symptoms seen in patients with dementia are diverse, ranging from agitation to hallucinations and paranoid delusions. Many patients with dementia have affective disturbances, including depressed mood. To provide a means of assessing the severity of depression and mood changes in demented patients, the authors and colleagues at the National Institute of Mental Health developed the Dementia Mood Assessment Scale.We modeled the Dementia Mood Assessment Scale (DMAS) after the Hamilton Depression Scale but did not include its subjective aspects, which make the scale too difficult for patients with dementia to complete. The DMAS consists of 24 items (see Table l), with items 1 to 17 used to assess the severity of depression and items 18 to 24 used to rate the overall severity of dementia. Each item is rated on a 6-point scale of severity. Ratings are made by trained interviewers based on input from nursing staff (for inpatients) or family caregivers (for outpatients). The behaviors rated typically are those that occurred within the preceding week.The DMAS has proved reliable in inpatients with mild to moderate dementia; for patients with severe dementia, depressed mood is virtually impossible to measure, no matter what the tool. The authors and colleagues have obtained high, statistically significant intraclass correlation coefficients with the DMAS in short-term drug trials. Because close supervision of patients is needed to obtain accurate data, the DMAS has primarily been used with inpatients, although there is a good correlation between caregiver ratings and staff ratings. Therefore, this scale could also be useful in outpatient trials, and evidence for such use is accumulating in the NIMH outpatient clinic and at other research centers.

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