TOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6c. TRACKING COGNITIVE DECLINE IN ALZHEIMER'S DISEASE USING THE MINI-MENTAL STATE EXAMINATION: A META-ANALYSIS (“MINI” IS NOT NECESSARILY TRIVIAL!)

It was well beyond my expectations when I heard from Professor Ames that our meta-analysis paper (Han et al., 2000) was among the top-cited papers in International Psychogeriatrics. As an expression of my gratitude to the editor for the invitation and to the audience of this paper, I would like to offer this informal discussion on the background of the paper and extend a few ideas that were not conveyed fully at the time, due either to insufficient knowledge or unavailability of relevant data or methodologies.

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Exploring Time of Day Effects on Mini-Mental State Examination Performance in Alzheimer's Disease and Age-Associated Cognitive Decline

Brain Impairment ◽

10.1375/brim.2005.6.3.212 ◽

2005 ◽

Vol 6 (3) ◽

pp. 212-218 ◽

Cited By ~ 1

Author(s):

Michelle A. Brown ◽

Margaret Newson ◽

Judy Haworth ◽

Gordon K. Wilcock

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Decline ◽

Mental State ◽

Mini Mental State Examination ◽

Neuropsychological Test ◽

Time Of Day ◽

Future Research ◽

Cognitive Screening ◽

State Examination

AbstractNeuropsychological assessment plays a prominent role in the diagnosis of Alzheimer's disease (AD) and other cognitive impairments. Increasingly, neuropsychological test results are also used to guide clinicians in the prescription of anti-dementia medication. There is evidence to suggest that the cognitive ability of an individual with AD may vary over the course of a day. If time of day can influence an individual's performance on cognitive tests, then it could potentially affect his or her diagnosis and eligibility for treatment. This study set out to explore the effect of time of day on Mini-Mental State Examination (MMSE) performance in individuals with AD and Age-Associated Cognitive Decline (AACD). No significant effect of time of day (TOD) on Folstein MMSE performance was found. However, some interesting results were highlighted and future research suggested. Overall, the study does not provide evidence that time of day needs to be considered when interpreting the result of a short cognitive screening test.

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Describing Cognitive Decline of Patients at the Mild or Moderate Stages of Alzheimer's Disease Using the Standardized MMSE

International Psychogeriatrics ◽

10.1017/s1041610202008451 ◽

2002 ◽

Vol 14 (3) ◽

pp. 249-258 ◽

Cited By ~ 12

Author(s):

Alexandra Ward ◽

J. Jaime Caro ◽

Heather Kelley ◽

Andrew Eggleston ◽

William Molloy

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Decline ◽

Mental State ◽

Mini Mental State Examination ◽

Proportional Hazards ◽

Rapid Decline ◽

Severe Stage ◽

Rate Of Decline ◽

State Examination

Objective: To describe the progression of patients with mild or moderate Alzheimer's disease (AD) to a severe stage using the Standardized Mini-Mental State Examination (SMMSE). Methods: A cohort of 206 patients was stratified according to their baseline SMMSE scores: mild (19–24) and moderate (10–18). Proportional hazards analyses were used to determine the hazard of switching into a severe stage, defined as SMMSE score < 10. Results: Among patients at the mild stage, 25% reached the severe stage within 2.6 years, and in the moderate group within 1.5 years. Patients with hallucinations at the mild stage experienced more rapid decline. The previous rate of decline was also found to be an important predictor. At the moderate stage, key predictors were lower SMMSE score and longer time since onset. Conclusions: Current SMMSE scores with other clinical details can be used to advise patients and caregivers about the expected progression of AD.

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Validation of the Hungarian version of Alzheimer’s Disease Assessment Scale – Cognitive Subscale

Orvosi Hetilap ◽

10.1556/oh.2012.29332 ◽

2012 ◽

Vol 153 (12) ◽

pp. 461-466 ◽

Cited By ~ 5

Author(s):

Magdolna Pákáski ◽

Gergely Drótos ◽

Zoltán Janka ◽

János Kálmán

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Mental State ◽

Mini Mental State Examination ◽

Assessment Scale ◽

Disease Assessment ◽

Control Subjects ◽

Cognitive Subscale ◽

State Examination ◽

Hungarian Version

The cognitive subscale of the Alzheimer’s Disease Assessment Scale is the most widely used test in the diagnostic and research work of Alzheimer’s disease. Aims: The aim of this study was to validate and investigate reliability of the Hungarian version of the Alzheimer’s Disease Assessment Scale in patients with Alzheimer’s disease and healthy control subjects. Methods: syxty-six patients with mild and moderate Alzheimer’s disease and 47 non-demented control subjects were recruited for the study. The cognitive status was established by the Hungarian version of the Alzheimer’s Disease Assessment Scale and Mini Mental State Examination. Discriminative validity, the relation between age and education and Alzheimer’s Disease Assessment Scale, and the sensitivity and specificity of the test were determined. Results: Both the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale had significant potential in differentiating between patients with mild and moderate stages of Alzheimer’s disease and control subjects. A very strong negative correlation was established between the scores of the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale in the Alzheimer’s disease group. The Alzheimer’s Disease Assessment Scale showed slightly negative relationship between education and cognitive performance, whereas a positive correlation between age and Alzheimer’s Disease Assessment Scale scores was detected only in the control group. According to the analysis of the ROC curve, the values of sensitivity and specificity of the Alzheimer’s Disease Assessment Scale were high. Conclusions: The Hungarian version of the Alzheimer’s Disease Assessment Scale was found to be highly reliable and valid and, therefore, the application of this scale can be recommended for the establishment of the clinical stage and follow-up of patients with Alzheimer’s disease. However, the current Hungarian version of the Alzheimer’s Disease Assessment Scale is not sufficient; the list of words and linguistic elements should be selected according to the Hungarian standard in the future. Orv. Hetil., 2012, 153, 461–466.

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Educational bias in the assessment of severe dementia: Brazilian cutoffs for severe Mini-Mental State Examination

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20140002 ◽

2014 ◽

Vol 72 (4) ◽

pp. 273-277 ◽

Cited By ~ 13

Author(s):

José Roberto Wajman ◽

Fabricio Ferreira de Oliveira ◽

Rodrigo Rizek Schultz ◽

Sheilla de Medeiros Correia Marin ◽

Paulo Henrique Ferreira Bertolucci

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Mental State ◽

Cognitive Assessment ◽

Mini Mental State Examination ◽

Cognitive Responses ◽

Clinical Dementia Rating ◽

Severe Dementia ◽

Advanced Stages ◽

State Examination

Cognitive assessment in advanced stages of Alzheimer’s disease (AD) is limited by the imprecision of most instruments. Objective: To determine objective cognitive responses in moderate and severe AD patients by way of the Severe Mini-Mental State Examination (SMMSE), and to correlate performances with Mini-Mental State Examination (MMSE) scores. Method: Consecutive outpatients in moderate and severe stages of AD (Clinical Dementia Rating 2.0 or 3.0) were evaluated and compared according to MMSE and SMMSE scores. Results: Overall 400 patients were included, 67.5% females, mean age 76.6±6.7 years-old. There was no significant impact of age or gender over MMSE or SMMSE scores. Mean schooling was 4.4±2.5 years, impacting SMMSE scores (p=0.008). Scores on MMSE and SMMSE were significantly correlated (F-ratio=690.6325, p<0.0001). Conclusion: The SMMSE is influenced by schooling, but not by age or gender, and is an accurate test for assessment of moderate and severe AD.

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The Mini-Mental State Examination in the Early Diagnosis of Alzheimer's Disease

Archives of Neurology ◽

10.1001/archneur.1990.00530010061020 ◽

1990 ◽

Vol 47 (1) ◽

pp. 49-52 ◽

Cited By ~ 203

Author(s):

D. Galasko ◽

M. R. Klauber ◽

C. R. Hofstetter ◽

D. P. Salmon ◽

B. Lasker ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Early Diagnosis ◽

Mental State ◽

Mini Mental State Examination ◽

State Examination

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Kihito, a Traditional Japanese Kampo Medicine, Improves Cognitive Function in Alzheimer’s Disease Patients

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/4086749 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Hidetoshi Watari ◽

Yutaka Shimada ◽

Mie Matsui ◽

Chihiro Tohda

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trial ◽

Cognitive Function ◽

Mental State ◽

Mini Mental State Examination ◽

Mmse Score ◽

Photon Emission ◽

Emission Computed Tomography ◽

State Examination

Background and Aims. We previously reported that the administration of traditional Japanese medicines, kihito (Gui-Pi-Tang in Chinese) and kamikihito (Jia-Wei-Gui-Pi-Tang in Chinese), to Alzheimer’s disease (AD) model mice improved memory impairment. There are a few reports that show kihito and kamikihito have a beneficial effect on the cognitive function of AD patients in clinical studies. However, these studies are not comparative and are retrospective studies; thus, more evidence is needed. Therefore, we conducted an open-label, crossover designed clinical trial to investigate the effect of kihito on cognitive function of AD patients. Methods. The inclusion criteria for eligible patients were as follows: (1) imaging diagnosis (magnetic resonance imaging and single-photon emission computed tomography) of AD, (2) a treatment regimen including acetylcholinesterase inhibitors (ChEIs), and (3) a Mini-Mental State Examination (MMSE) score ≥15. The exclusion criteria were as follows: (1) change in ChEI dosage, (2) memantine usage, and (3) MMSE score < 15. To prevent bias in age and baseline cognitive function, patients were divided into two groups: the first group received 2.5 g of kihito extract 3 times/day during the first half of the study (weeks 0-16) and the second group received the same dose of kihito during the second half of the study (weeks 17-32). ChEI dosage did not change during the study period. Patients underwent a cognitive function test during weeks 0, 16, and 32. Cognitive function was evaluated by Japanese versions of the Mini-Mental State Examination (MMSE-J) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS-J) test. Results. Ten patients completed the clinical trial (4 males, 6 females, average age 71.7 years). MMSE-J scores significantly increased during the kihito intake period. RBANS-J test scores had a slight improvement during the kihito intake period compared with the ChEI alone treatment period, but no significant changes were observed. Conclusion. Kihito improves cognitive function in AD patients.

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