Journal of the Korean neurological association (대한신경과학회지)

Korean Neurological Association (대한신경과학회)
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Differentiation of Alzheimer's Disease from Vascular Dementia Using the Modified Mini- Mental State Examination

Modified Minimental Status (3MS) 검사를 이용한 알쯔하이머병과 혈관성치매의 감별

Lee, Ae-Young;Sohn, Eun-Hee;Park, Hyun-Ju
이애영;손은희;박현주

  • Published : 20020000
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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 educationmatched 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, & +LR=3.38) and 1 (SN=0.81, SP=0.71, & +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.

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References

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