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Challenges in the clinical diagnosis of Alzheimer's disease: Influence of "family coach ng" on the Mini-Mental State Examination
Teneille Gofton, MSc, MD
Department of Medicine (Neurology), Dalhousie University, HaliJax, Nova Scotia, Canada
Donald F. Weaver, MD, PhD, FRCP(C)
Departments of Medicine (Neurology), Chemistry, and Biomedical Engineering, Dalhousie University, HaliJax, Nova Scotia, Canada
The Mini-Mental State Examination (MMSE) is a commonly used clinical toolfor evaluating the cognitive aspects of mental function. In this study, 40 consecutive patients presenting to a memory disorder clinic and their caregivers were evaluated for coaching of the patient with respect to MMSE content over the 24 hours prior to clinical evaluation. Caregivers completed a questionnaire concerning MMSE practice sessions with the patient prior to the physician encounter; then, the patients were asked to spell the word "WORM" backwards instead of "WORLD" during the MMSE test. Some or all of the MMSE content was reviewed with the patient prior to the interview by 42.5 percent of the caregivers, 17.5 percent ofpatients spelled or attempted to spell "WORLD" backwards instead of "WORM" These results demonstrate that coaching of patients prior to administration of the MMSE is not uncommon, and that this needs to be taken into consideration when forming therapeutic decisions based on MMSE results.
Key Words: Mini-Mental State Examination patient coaching caregivers therapeutic decisions
References
- 1. Folstein MF, Folstein SE, McHugh PR: XEN=“Mini-Mental State": A practical method for grading the cognitive state of patients for the clinician. J Psichiatr Res. 1975; 12: 189-198.
- 2. Crum RM, Anthony JC, Bassett SS, et al.: Population-based norms for the Mini-Mental Status Examination by age and educational level. JAMA. 1993; 269: 2386-2391.[Abstract/Free Full Text]
- 3. Tierney MC, Szalai JP, Dunn E, et al.: Prediction of probable Alzheimer disease in patients with symptoms suggestive of memory impairment. Value of the Mini-Mental State Examination. Arch Fan Med. 2000; 9: 527-532.[CrossRef]
- 4. Dellasega C, Morris D. The MMSE to assess the cognitive state of elders. Mini-Mental State Examination. J Neurosci Nurs. 1993; 25: 147-152.[Medline]
[Order article via Infotrieve]
- 5. Kukull WA, Larson EB, Teri L, et al.: The Mini-Mental State Examination score and the clinical diagnosis of dementia. J Clin Epidemiol. 1994; 47: 1061-1067.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- 6. Feher EP, Mahurin RK, Doody RS. Establishing the limits of the Minimental State: Examination of subtests. Arch Neurol. 1992; 49: 87-97.[Abstract/Free Full Text]
- 7. Kilada S, Gamaldo A, Grant EA, et al.: Brief screening tests for the diagnosis of dementia: Comparison with the Mini-Mental State Exam. Alzheimer Dis Assoc Disord. 2005; 19: 8-16.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- 8. Wind AW, Schellevis FG, Van Staveren QG et al.: Limitations of the Mini-Mental State Examination in diagnosing dementia in general practice. Int J Geriatr Psychiatry. 1997; 12: 101-108.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- 9. Murali Doraiswamy P, Kaiser L. Variability of the Mini-Mental State Examination in dementia. Neurology. 2000; 54: 1538-1539.[Free Full Text]
- 10. Van Belle G, Arnold A. Reliability of cognitive tests used in Alzheimer's disease. Stat Med. 2000; 19: 1411-1420.[CrossRef][Medline]
[Order article via Infotrieve]
- 11. Salmon DP, Thai LJ, Butters N, et al.: Longitudinal evaluation of dementia of the Alzheimer's type: a comparison of three standardized mental status examinations. Neurology. 1990; 40: 1225-1230.[Abstract/Free Full Text]
- 12. Fillenbaum GG, Heyman A. Wilkinson WE, et al.: The correlation and reliability of the Mini-Mental Status Examination and the modified Blessed test. Arch Neurol. 1987; 44: 924-927.[Abstract/Free Full Text]
- 13. Thai LJ, Grundman M. Golden R. Alzheimer's disease: A correlational analysis of the Blessed Information-Memory-Concentration Test and the Mini-Mental Status Examination. Neurology. 1986; 36: 262-264.[Abstract/Free Full Text]
- 14. Alzheimer's Society. The Mini-Mental State Examination A guide for people with dementia and their carers. Information Sheet #436. Available at: www.alzheimers.org.uk. Accessed April 28, 2005.
- 15. Galasko D, Abramson I, Corey-Bloom J, et al.: Repeated exposure to the Mini-Mental State Examination and the Informationmemory-Concentration Test results in a practice effect in Alzheimer's disease. Neurology. 1993; 43: 1559-1563.[Abstract/Free Full Text]
- 16. Helkala EL, Kivipelto M, Hallikainen M, et al.: Usefulness of repeated presentation of Mini-Mental State Examination as a diagnostic procedure: A population-based study. Acta Neurol Scand. 2002; 106: 341-346.[CrossRef][Medline]
[Order article via Infotrieve]
- 17. Keating HJ. Studying for the Mini-Mental Status Exam. JAm Geriatr Soc. 1987; 35: 594-595.
- 18. Hux MJ, O'Brien BJ, Iskedjian M, et al.: Relation between severity of Alzheimer's disease and costs of caring. Can MedAssoc J. 1999; 161: 1390-1392.
- 19. Robinson-Whelen S, Storandt M. Immediate and delayed prose recall among normal and demented adults. Arch Neurol. 1992; 49: 32-34.[Abstract/Free Full Text]
American Journal of Alzheimer's Disease and Other Dementias®, Vol. 21, No. 2,
109-112 (2006)
DOI: 10.1177/153331750602100210

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