3 (3)    MH REPORT (601.93)

.|.|Global Deterioration Scale||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB: 
<.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>||Dementia Stage: <-Stage->||   1 = No cognitive decline |   2 = Very mild cognitive decline---Forgetful |   3 = Mild cognitive 
decline---Early confusional |   4 = Moderate cognitive decline---Late confusional |   5 = Moderately severe cognitive decline---Early dementia |   6 = Severe cognitive decline---Middle dementia |   7 
= Very severe cognitive decline---Late dementia ||Copyright (c) 1983 by Barry Reisberg, M.D. Reproduced with permission.||Information contained in this note is based on a self-report assessment and 
is not sufficient to use alone for diagnostic purposes.  Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities and procedures.|     $~