Modified Clinical Dementia Rating Scale

Impairment None (0) Questionable (0.5) Mild (1) Moderate (2) Severe (3)
Memory No memory loss or slight, Consistent, slight Moderate memory loss, Severe memory loss only Severe memory loss, only
inconstant, forgetfulness forgetfulness, partial more marked for recent highly learned material fragments remain
recollection of events events, defect interferes retained, new material
with every day activities rapidly lost
Orientation Fully oriented Fully oriented or slight Moderate difficulty with Severe difficulty with Oriented to person only
difficulty with time time relationships, oriented time relationship; usually
relationship for place at examination, disoriented in time, often
may have geographic to place
disorientation elsewhere
Judgment and Solves everyday problems Slight impairment to Moderate difficulty in Severely impaired in Unable to make judgment or
problem and handles business and solving problems, handling problems, handling problems, solve problems
financial affairs well, similarities, differences similarities, differences. similarities, differences.
judgment good in relation to Social judgment usually Social judgment usually
past performance maintained impaired
Community Independent function at Slight impairment in these Unable to function No pretense of No pretense of independent
affairs usual level in job, shopping, activities independently at these independent function function outside of the home,
volunteer and social groups activities though may stilloutside of the home, appears too ill to be taken to
be engaged in some appears appears well enough to be functions outside of family
normal to casual inspectiontaken to functions outside home
of family home
Home and office Life at home, office, Life at home, office, Mild but definite Only simple chores No significant function in
intellectual interests well intellectual interests impairment of function at preserved, very restricted home
maintained slightly impaired home, more difficult chores interests poorly
abandoned, more maintained
complicated hobbies and
interests abandoned
Personal care Fully capable of self care Fully capable of self care Needs prompting Requires assistance in Requires much help with
dressing, hygiene keeping personal care, personal
of personal effects incontinency
Note: CDR rating of 4 &5 are based on overall status, stage 4 indicates profound dementia and in stage 5 indicated terminal dementia

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 AYURVEDIC METHODOLOGY OF CLINICAL EXAMINATION (MENTAL DISORDERS)
1. Sila (habits, etc.) 2. Chesta (Psychomotor activity)
i. Habits i. General motor activity
ii. Temperature ii. Speech
iii. Physiological functions iii. Facial expression
iv. Leisure time activity iv. Posture
3. Achara (conduct) 4. Manah (mind)
i. Personal standards i. Indriyabhigraha (perception and motor
control)
ii. Social standards ii. Manonigrahaha (mental control)
iii. Ooha (guess)
iv. Vicharana (tought)
5. Budhi (decision) 6. Smriti (Memory)
i. Ability to take quick decisions i. Ability to recall what is seen
ii. Ability to decide complex issues ii. Ability to recall what is heard
iii. Ability to recall what is experienced
7. Sanjnajnanam(orientation and responsiveness) 8. Bhakti (desire) Desire in relation to:
i. Orientation to i. Ahara (food)
(a) Desha (place) ii. Vyavaya (sex)
(b) kala (time) iii. Vesma (dress)
(c) Atmajnana (person) iv.Ranjanam
ii. Responsiveness to external stimuli v. Anya (others)

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“Unmadam punarmanobuddhi sanjnajnana smriti bhakti sheela chesta achara vibhramsam vidyat” – Ch.Nid.7 ch.

3
 AYURVEDIC RESEAERCH UNIT AND ADVANCED CENTRE FOR AYURVEDA,
NIMHANS, BANGALORE

MANAH PARIKSHA PATRAKAM (PROFORMA FOR MENTAL EXAMINATION)

VI. Seela (habits, etc.)

Intact (0)/Moderately changed (3)/Grossly changed (6)

(i) Habits (0) (3) (6)

1. Vinidra (insomnia)

2. Svapnanityata (desirous of seclusiveness)

3. Rahaskamata (desirous of seclusiveness)

4. Abhikshnam asthane Hasanam (excessive and

/or inappropriate laught/smiling)
5. Abhikshnam asthane Rodanam (excessive and
/or inappropriate Weeping/crying)
6. Arochakam (tastelessness)

7. Chardhi (vomiting)

8. Alpaharam (undereating)

9. Bahubhuki (overeating)

10. Bhunkte Balam (post pandral aggravation)

11. Firne balam (post digestion aggravation)

12. Ratrau Bhrisham bhavati (nocturnal aggravation)

13. Gridhirabhyvahareshu (excessive desire for food articles)

14. Anya (others)_________________________________
(ii) Temperament
1. Krodhaha (anger)
2. Santarjanam (threatening)
3. Anya (others)_________________________________

4
(iii) Physiological Functions
1. Swedabahulya (excessive perspiration)
2. Trishnabahulya (excessive thirst)
3. Swasaturaha (dyspnoea)
4. Kasa (cough)
5. Naripriyata (desirous of women/sex)
6. Sadanam (weakness)
7. Ananane swayathu (oedema on the face)
8. Anya (others)____________________________________
(iv) Personal care
Preserved (0)/ not preserved (3) (0) (3)
1. Malopadigdhakshitva (eyes covered with mucosal discharge)

2. Lalasrava (dribbling of saliva)

3. Asyat Phenagamanam (frothing from mouth)

4. Singhanaka Sravaha (excessive flow of nasal discharge)

5. Analankairalankaranam(adorning person with un

ornamental things)
6. Anya (others)_________________________________________
(v) Leisure time activity:
Normal (0)/ moderate abnormality (3)/gross abnormality (6)

VII. Chesta (psychomotor activity)

(i) General motor activity
Intact (0)/moderately changed (3)/grossly-changed (6)
1. Abhikshanam Asthane nartanam (excessive and/or
inappropriate dancing)
2. Abhikshanam Asthane Vandanam (excessive and/or
inappropriate playing of musical instrument)
3. Abhikshanam Asthane Gayanam (excessive and/or
inappropriate singing)
4. Ajasram Parisaranam (constant rambling)
5. Akasmat anga vikshepanam (sudden jerking of body parts)

5
 6. Abhidravanam (escaing)

7. Asthane Samrambhaha (inopportune excitement)

8. Asthane Akroshaha (inopportune shouting)

9. Pareshan Abhihananam (assaulting)

10. Nabda Chesta (reduced motor activity)

11. Venu geetadi shabdhanukaranam (imitating the

tunes of various musical instruments)
12. Anya (others)____________________________________

(ii) Speech
Intact (0)/moderately changed (3)/grossly-changed (6) (0) (3) (6)
1. Satatam Giramutsargaha (continuous/excessive talk)

2. Aniyatam Giramutsargaha (irregular/incoherent/

indefinite talk)

3. Parushavak (harsh/rude talk)

4. Vakmanda (slowness of speech)

5. Anya (others)___________________________________

(iii) Facial expression and postures

Intact (0)/abnormal (3) (0) (3)
1. Svayatuscanane (puffiness of face)

2. Sthimitakshata (fixed eyes)

3. Utpindikakshata (protruded eyes)

4. Samrabdhakshata (furious eyes)

5. Aruna/Tamra/Haridra/Haritakshata (reddish/coppery/
yellowish/greenish eyes)
6. Nakhadi Shouklyam (pallor of nails, etc.)

7. Pitikhabha (yellowish aura)

8. Rukshachhavi (dry skin)

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 9. Dhamanitataha (having prominent veins)

10. Karshyam (emaciation)

11. Sphurita sandhi (throbbing of joints)

12. Sthanamekadeshe (confining to one place)

13. Anya (others)________________________________________

III. Acharah (conduct)

Intact(0)/abnormal(3)

(i) Personal standards

1. Soucha Dveshaha/Bhibhatsatvam (hating cleanliness and
remaining very dirty and shabby without caring for personal hygiene)
(ii) Social standards
1. vinagnabhavah (nudity)
2. Anya (others)_______________________________________
IX. Manah (mind)

Intact/Moderately changed/Grossly changed/ cannot be tested

(i) Indriyabhigrahah (perception and motor control)

(a) Cannot be tested because of non co-operation
(b) Disturbed because of peripheral factors
(c) Disturbed: Mild/Moderate/Severe
Description:
(d) Indriyasapekshayatharthajnanam (hallucination):
Absent (0)/Present (3) (0) (3)
1. Asatya Jvaladi Darshanam (hallucination of flame, star, etc.)
2. Anya (others)_____________________________________
(ii) Manonigrahah (mental control)
Intact (0)/ Loose occasionally (3)/ Loose frequently (6)

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Description:
(iii) Vicharah (thought)
Intact (0)/Mildly impaired (3)/Grossly-impaired (6) (0) (3) (6)
(a) Discriminative ability
Intact (0)/Mildly impaired (3)/Grossly-impaired (6) (0) (3) (6)
1. Ativelam Santapa (continuous causeless
mental distress)
2. Ayanairyanam (raiding on things which are neither
movable nor mounts)
3. Anya (others)___________________________________
(b) Indriyanirapekshayatharthajnanam (delusion)
Absent (0)/Present (3) (0) (3)
1. Himambunicayepicha Vahnishanki (doubting fire/
hotness in cool surroundings)
2. Aushnyam (feeling of hotness)

3. Anya (others)____________________________________
X. Budhi (decision)

Intact (0)/Partly impaired (3)/Grossly impaired (6)

(0) (3) (6)

1. Vividhashabdanukaranam (imitation of different

sounds)

2. Sveshambhihananam (beating oneself)

3. Alpamati (feeling of hotness mentally dull)

4. Anya (others)____________________________________

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XI. Smriti (memory)

Intact (0)/Mild impairment (3)/Moderate impairment (6)/Gross

impairment (9)

(0) (3) (6) (9)

XII. Sanjnajnanam (orientation and responsiveness)

Intact (0)/Mild impairment (3)/Moderate impairment (6)/Gross

impairment (9)

(0) (3) (6) (9)

(a) Orientation to place:

(b) Orientation to time:

(c) Orientation to person:

Description:
(d) Responsiveness:

Description
XIII. Bhakti (desire)

Intact (0)/Mild impairment (3)/Moderate impairment (6)/Gross impairment

(9)

(0) (3) (6) (9)

(i) Physiological desires

(ii) Desires in relation to attire
(iii) Desires in relation to entertainment
(iv) Others____________________________________

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 Absent (0) Present(3)
1. Ushnasevi (desirous of hot things)

2. Sheetabhilashi (desirous of cool things)

3. Alabdheshu Abhyavaharyesu Tivra Lobha

(craving for securing unobtainable things)
4. Labdheshu Abhyavaharyesu Tivramatsaryam

(hitting things craved for, when they are available)

5. Anya (others)_____________________________________________

XIV. (I) Prakriti (constitution)

(a) Shareera (physical) V P K VK VP PK VPK

(b) Manasika (psychological) SATWA RAJO TAMO

Pravara Madhyama Awara

XV. Satvam (mental stamina):

ASSESSMENT OF RESULTS AFTER THE MANAH PAREEKSHA

SCORE
MANAH PAREEKSHA BEFORE TREATMENT AFTER TREATMENT
SEELA (habits,etc.)

(i) Habits
(ii) Temperament
(iii) Physiological functions
(iv) Personal care
(v) Leisure time activity
CHESTA (psychomotor activity)

(i) General motor activity

(ii) Speech
(iii) Facial expression and postures
ACHARA (conduct)

(i) Personal standards

(ii) Social standards
MANAH (mind)

(i) Indriabhigraha (perception&motor

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control)
(ii) Manonigraha (mental control)
(iii) Vichara (thought)
BUDHI (decision)
SMRITI (memory)
SANJNAJNANAM (orientation
&responsiveness)
BHAKTI (desire)
TOTAL

APPENDIX
AYURVEDIC METHODOLOGY OF CLINICAL EXAMINATION (MENTAL DISORDERS)
1. Sila (habits, etc.)
i. Habits
ii. Temperature
iii. Physiological functions
iv. Leisure time activity personal cure
v. Leisure time activity
2. Chesta (Psychomotor activity)
i. General motor activity
ii. Speech
iii. Facial expression and posture
3. Achara (conduct)
i. Personal standards
ii. Social standards
4. Manah (mind)
i. Indriyabhigraha (perception and motor control0
ii. Manonigrahaha (mental control)
iii. Ooha (guess)
iv. Vicharana (tought)
5. Budhi (decision)
6. Smriti (Memory)
7. Sanjnajanana (orientation and responsiveness)
i. Orientation to
(a) Desha (place)

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 (b) kala (time)
(c) Atmajnana (person)
ii. Responsiveness to external stimuli
8. Bhakti (desire)
Desire in relation to:
i. Ahara (food)
ii. Vyavaya (sex)
iii. Vesma (dress)
iv. Ranjanam (entertainment)
v. Anya (others)

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