Differentiation of Alzheimer's Disease from Vascular Dementia Using the Modified Mini-Mental State Examination.
- Author:
Ae Young LEE
1
;
Eun Hee SOHN
;
Hyun Ju PARK
Author Information
1. Department of Neurology, College of Medicine, Chungnam National University, Korea. aelee@cnu.ac.kr
- Publication Type:Original Article
- Keywords:
Alzheimer's disease;
Vascular dementia;
3MS
- MeSH:
Alzheimer Disease*;
Consensus;
Dementia;
Dementia, Vascular*;
Diagnosis;
Humans;
Mass Screening;
Neurology;
ROC Curve;
Sensitivity and Specificity
- From:Journal of the Korean Neurological Association
2002;20(6):624-629
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Alzheimer's disease (AD) and vascular dementia (VaD) are the most frequently occurring dementia. Although accurate differentiation of dementia subtype is important in treatment perspective, it is not easy even using expensive and time-consuming devices. To evaluate diagnostic value of the Modified Mini-Mental State (3MS) examination as a dementia screening and whether the first recall (FR) and delayed recall(DR) of 3MS are helpful in differentiating AD from VaD. METHODS: Patients comprised of 64 cases diagnosed for dementia at the Neurology department. Diagnosis of probable AD (n=34) and VaD (n=30) were made according to consensus criteria. Cognitive status was measured by the Mini-Mental State Examination (MMSE) and 3MS. Receiver operating characteristic (ROC) curves were used to identify the optimal FR and DR for differentiating AD from VaD. Ninety-three age- and education-matched controls were evaluated. The neuropsychologist was blind to clinical diagnosis. RESULTS: Sensitivity (SN), specificity (SP), diagnostic accuracy (DA), and positive likelihood ratio (+LR) of 3MS (cutoff score=76) were 0.75, 0.68, 0.70 and 2.34. The optimal score of FR and DR to differentiate AD from VaD were 2 (SN=0.81, SP=0.76, and +LR=3.38) and 1 (SN=0.81, SP=0.71, and +LR=2.79), respectively. CONCLUSIONS: The diagnostic value of 3MS is comparable to that of MMSE as well as covers broader cognitive functions and has wider difficulty levels. Among dementia patients, a low FR and DR scores on the 3MS produce small to moderate increases the post-test probability of AD.
