ABSTRACT
OBJECTIVE: The validity of supplementing the three-item recall portion of the Mini-Mental State Examination (MMSE) with a cued recall procedure to help specify the nature of patients' memory problems was examined. METHOD: Subjects were 247 individuals representing three diagnostic groups: Alzheimer's disease (AD), subcortical vascular ischemic dementia (SVaD), and normal controls. Individuals were administered a battery of neuropsychological tests, including the MMSE, as part of a comprehensive evaluation for the presence of dementia or other neurologic disorder. RESULTS: MMSE performance differed among groups. The three-item free recall performance also differed among groups, with post hoc analyses revealing the AD and SVaD groups were more impaired than controls but did not differ significantly from each other. Following a cued recall procedure of the MMSE three-items, groups differed, with post hoc analyses showing that AD patients failed to benefit from cues, whereas SVaD patients performed significantly better and comparable to control subjects. Significant correlations between the MMSE three-item cued recall performance and other memory measures demonstrated concurrent validity. CONCLUSIONS: Consistent with previous research indicating that SVaD is associated with memory encoding and retrieval deficits, whereas AD is associated with consolidation and storage problems, the present study supported the validity of the cued recall procedure of the three items on the MMSE in helping to distinguish between patients with AD and those with a vascular dementia with primarily subcortical pathology; however, despite these findings, a more extensive battery of neuropsychological measures is still recommended to consistently assess subtle diagnostic differences in these memory processes.
Subject(s)
Alzheimer Disease/psychology , Dementia, Vascular/psychology , Mental Recall , Mental Status Schedule/standards , Aged , Aged, 80 and over , Alzheimer Disease/classification , Alzheimer Disease/diagnosis , Dementia, Vascular/classification , Dementia, Vascular/diagnosis , Diagnosis, Differential , Female , Humans , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Estimating a person's premorbid cognitive abilities is common practice as part of a dementia assessment. Vocabulary has traditionally served as a "hold" measure because of its relative resilience to neurologic impairment and aging and its high correlation with overall intellectual functioning. Normative data for the Vocabulary subtest of the Shipley Institute of Living Scale (SILS) only go to age 64. This study describes the relations among age, gender, education, and SILS Vocabulary subtest performance. Normative data and Wechsler Adult Intelligence Scale-Revised equivalent Full-Scale IQ scores are reported for SILS Vocabulary subtest performance for a sample of 383 nonimpaired community-dwelling older adults, ranging in age from 60 to 94. Results expand the utility of the Vocabulary subtest of the SILS in providing an estimated level of premorbid cognitive ability.
