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      Improvement of Screening Accuracy of Mini-Mental State Examination for Mild Cognitive Impairment and Non-Alzheimer's Disease Dementia by Supplementation of Verbal Fluency Performance

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          Abstract

          Objective

          This study aimed to investigate whether the supplementation of Verbal Fluency: Animal category test (VF) performance can improve the screening ability of Mini-Mental State Examination (MMSE) for mild cognitive impairment (MCI), dementia and their major subtypes.

          Methods

          Six hundred fifty-five cognitively normal (CN), 366 MCI [282 amnestic MCI (aMCI); 84 non-amnestic MCI (naMCI)] and 494 dementia [346 Alzheimer's disease (AD); and 148 non-Alzheimer's disease dementia (NAD)] individuals living in the community were included (all aged 50 years and older) in the study.

          Results

          The VF-supplemented MMSE (MMSE+VF) score had a significantly better screening ability for MCI, dementia and overall cognitive impairment (MCI plus dementia) than the MMSE raw score alone. MMSE+VF showed a significantly better ability than MMSE for both MCI subtypes, i.e., aMCI and naMCI. In the case of dementia subtypes, MMSE+VF was better than the MMSE alone for NAD screening, but not for AD screening.

          Conclusion

          The results support the usefulness of VF-supplementation to improve the screening performance of MMSE for MCI and NAD.

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          Most cited references18

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          Diagnostic and statistical manual of mental disorders.

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            Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop.

            Criteria for the diagnosis of vascular dementia (VaD) that are reliable, valid, and readily applicable in a variety of settings are urgently needed for both clinical and research purposes. To address this need, the Neuroepidemiology Branch of the National Institute of Neurological Disorders and Stroke (NINDS) convened an International Workshop with support from the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN), resulting in research criteria for the diagnosis of VaD. Compared with other current criteria, these guidelines emphasize (1) the heterogeneity of vascular dementia syndromes and pathologic subtypes including ischemic and hemorrhagic strokes, cerebral hypoxic-ischemic events, and senile leukoencephalopathic lesions; (2) the variability in clinical course, which may be static, remitting, or progressive; (3) specific clinical findings early in the course (eg, gait disorder, incontinence, or mood and personality changes) that support a vascular rather than a degenerative cause; (4) the need to establish a temporal relationship between stroke and dementia onset for a secure diagnosis; (5) the importance of brain imaging to support clinical findings; (6) the value of neuropsychological testing to document impairments in multiple cognitive domains; and (7) a protocol for neuropathologic evaluations and correlative studies of clinical, radiologic, and neuropsychological features. These criteria are intended as a guide for case definition in neuroepidemiologic studies, stratified by levels of certainty (definite, probable, and possible). They await testing and validation and will be revised as more information becomes available.
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              Diagnostic and statistical manual for mental disorders

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                Author and article information

                Journal
                Psychiatry Investig
                Psychiatry Investig
                PI
                Psychiatry Investigation
                Korean Neuropsychiatric Association
                1738-3684
                1976-3026
                January 2014
                21 January 2014
                : 11
                : 1
                : 44-51
                Affiliations
                [1 ]Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.
                [2 ]Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
                [3 ]Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Republic of Korea.
                [4 ]Department of Neuropsychiatry, Soonchunhyang University Hospital, Bucheon, Republic of Korea.
                [5 ]Department of Neuropsychiatry, Daelim Saint Mary's Hospital, Seoul, Republic of Korea.
                [6 ]Department of Neuropsychiatry, Chosun University Hospital, Gwangju, Republic of Korea.
                [7 ]Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea.
                [8 ]Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, Republic of Korea.
                [9 ]Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
                Author notes
                Correspondence: Dong Young Lee, MD, PhD. Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea. Tel: +82-2-2072-2205, Fax: +82-2-744-7241, selfpsy@ 123456snu.ac.kr
                Article
                10.4306/pi.2014.11.1.44
                3942551
                2b4232fe-ec58-459f-9d68-c95556109243
                Copyright © 2014 Korean Neuropsychiatric Association

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 March 2013
                : 22 July 2013
                : 21 August 2013
                Funding
                Funded by: Ministry of Health, Welfare & Family Affairs
                Award ID: A092145
                Funded by: KIST Open Research Program
                Award ID: 2013-1520
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                mini-mental state examination,verbal fluency,screening accuracy,mild cognitive impairment,non-alzheimer's disease dementia

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