The LM subtest of the WMS-R is a standardized assessment of narrative episodic memory [5]. A short story is orally presented, and the examinee is asked to recall the story verbatim (immediate recall). Approximately 20 or 30 min later, free recall of the story is again elicited (delayed recall). Of the NACC sample, 11,569 subjects were administered the UDS cognitive battery version 1 and 11,869 were given version 2. Between 2005 and 2007, two version 1 examinations were administered (1.1 and 1.2), with version 1.1 having a delayed story recall of 30 min and version 1.2 being 20 min. The UDS version 2 retained the 20-min recall. For all UDS versions, LM Story A delayed recall was used and the only difference from version 1.1 to versions 1.2 and 2 was the delay interval. Of note, we were unable to distinguish between subjects who received versions 1.1 and 1.2, but the differences in the delay intervals have been shown not to be associated with number of units recalled [14].
Mini Mental Test De Folstein Pdf Download
The use of MMSE and LM-II scores to determine eligibility for AD clinical trials and diagnostic studies may lead to inappropriate inclusion or exclusion of subjects. Such biases in sample selection could translate to misleading results from trials testing the efficacy of new AD treatments, or diagnostic studies examining methods and biomarkers for the detection of AD.
Our results demonstrated that the practice effect could be minimized when alternate forms of the MMSE-2 were used. The MMSE-2 had good to excellent test-retest reliability, except for three subtests (i.e., visual-constructional ability, registration, and recall). Caution should be taken when interpreting the results of visual-constructional ability, registration, and recall subtests of the MMSE-2.
Four commonly-used cognitive screening tools have been used for the early detection of dementia including the Mini-Mental State Examination (MMSE), the Short Portable Mental Status Questionnaire, the Montreal Cognitive Assessment, and the Saint Louis University Status Examination [6]. Each of abovementioned screening tools has its own merits and among these four, the MMSE has been the most extensively used in clinical and research settings due to its practicality. The MMSE is easy to administer and requires no specialized equipment or training [6,7,8]. It has been reported that overall, the four screening tools are similar in test-retest reliability; however, the MMSE has demonstrated higher test-retest reliability with acceptable random measurement error and small practice effect [6]. Although the MMSE has its own weaknesses, such as less sensitive to change with increasing age, having a ceiling effect, and vulnerability to practice effect [9, 10], the new version of MMSE, the Mini-Mental State Examination-Second Edition (MMSE-2) was developed to overcome these issues [7].
An assessment would be considered useful if it could produce stable and consistent results with repeated administration [15]. The practice effect refers to improvements in test results in repeated assessments, given that previous experience might carry over to the next assessment in the absence of any interventions [16]. The practice effect might obscure the true cognitive decline of people with dementia. One of the methods to reduce practice effects is by using alternate forms [17, 18], Test-retest reliability concerns the extent of agreement between repeated assessments under similar assessments conditions [19]. A measure with acceptable test-retest reliability allows users to consistently identify those at risk for cognitive function decline [6]. The abovementioned psychometric properties are essential for a measure to ensure its utility for repeated assessments in people with dementia. Therefore, the purpose of this study was to examine the practice effect and test-retest reliability of the MMSE-2 in people with dementia.
The visual-constructional ability subtest in both the SF and AF groups showed small effects. A possible reason for the slightly higher practice effect might be that the same question was used both in the red and blue form of the MMSE-2, with participants being asked to draw two intersecting pentagons in which the interconnected area should be shaped like a rhombus [9, 30]. Our participants might have become familiar with the drawing upon repeated administrations. To reduce the impact of practice effects, there is a need to develop a new question design for the alternate form of the visual-constructional ability subtest.
The two subtests (i.e., registration and recall) in the AF group showed moderate test-retest reliability, indicating that these two subtests may not consistently assess specific subtest functions over repeated assessments. One possible reason might be that alternate forms (blue and red forms) were used in the AF group, which may have resulted in more variation compared to using the same form as the SF group. Although the alternate forms used diminished the carryover effect, they increased the variation due to random errors in measurement. Thus, caution is needed when using the alternate forms of registration and recall subtests in people with dementia.
Overall, the practice effect of the MMSE-2 diminished when the alternate forms were performed. In addition, the MMSE-2 had good to excellent test-retest reliability with an acceptable random measurement error, which supports the use of this measure in both clinical and research settings. However, the visual-constructional ability subtest showed small practice effects, and both the registration and recall subtests were found to have moderate test-retest reliability. Thus, caution should be exercised when interpreting the results of the visual-constructional ability, registration, and recall subtests of the MMSE-2.
Administration of the test takes between 5 and 10 minutes and examines functions including registration (repeating named prompts), attention and calculation, recall, language, ability to follow simple commands and orientation.[4] It was originally introduced by Folstein et al. in 1975, in order to differentiate organic from functional psychiatric patients[5][6] but is very similar to, or even directly incorporates, tests which were in use previous to its publication.[7][8][9] This test is not a mental status examination. The standard MMSE form which is currently published by Psychological Assessment Resources is based on its original 1975 conceptualization, with minor subsequent modifications by the authors.
Advantages to the MMSE include requiring no specialized equipment or training for administration, and has both validity and reliability for the diagnosis and longitudinal assessment of Alzheimer's disease. Due to its short administration period and ease of use, it is useful for cognitive assessment in the clinician's office space or at the bedside.[10] Disadvantages to the utilization of the MMSE is that it is affected by demographic factors; age and education exert the greatest effect. The most frequently noted disadvantage of the MMSE relates to its lack of sensitivity to mild cognitive impairment and its failure to adequately discriminate patients with mild Alzheimer's disease from normal patients. The MMSE has also received criticism regarding its insensitivity to progressive changes occurring with severe Alzheimer's disease. The content of the MMSE is highly verbal, lacking sufficient items to adequately measure visuospatial and/or constructional praxis. Hence, its utility in detecting impairment caused by focal lesions is uncertain.[11]
Other tests are also used, such as the Hodkinson[12] abbreviated mental test score (1972), Geriatric Mental State Examination (GMS),[13] or the General Practitioner Assessment of Cognition, bedside tests such as the 4AT (which also assesses for delirium), and computerised tests such as CoPs[14] and Mental Attributes Profiling System,[15] as well as longer formal tests for deeper analysis of specific deficits.
The Mini-Mental State Examination (MMSE) is a brief screening test that quantitatively assesses the cognitive status of elderly people [1, 2]. It is easy to administer and has shown good reliability. Although its validity as a screening test is acceptable for clinical samples, it has been shown to have difficulty in discriminating between demented and non-demented individuals in community-based samples [2]. The MMSE has been found to be influenced largely by pre-morbid ability and is less sensitive to focal brain dysfunction [3] or mild dementia [4].
Interviewers received a seven-day training session on administering the screening instruments and were supervised throughout by the project neurologist. Cognitive status was classified in two stages. In the first stage, interviewers carried out home-based interviews for data on cognitive function, past medical history, and demographic characteristics. All participants were contacted for cognitive screening using a formulated battery, from which the K-mMMSE and K-MMSE were extracted. And they were rated by a knowledgeable informant using the Short form of Samsung Dementia Questionnaire (S-SDQ) and Korean Instrumental Activities of Daily Living (K-IADL) [15, 16]. The S-SDQ is a Korean version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), with 15 items and scores ranging from 0 to 30 [15]. The K-IADL is composed of 11 items that grade functional abilities, with scores calculated as the sum of points over the number of applicable questions and ranging from 0.0 to 3.0 [16]. High scores on the S-SDQ and K-IADL indicate poor performance. Both tests were found to be uncontaminated by pre-morbid ability, including education or age [15, 16].
The K-mMMSE was superior to the K-MMSE for diagnosis of all levels of CIND or dementia, as well as being slightly superior at almost all cut-off points. Since dementia is usually preceded by CIND or mild cognitive impairment (MCI), the definition of both requires explication [29, 30]. Subjects with CIND or MCI have been found to be at increased risk for developing dementia or, more specifically, Alzheimer's disease and some vascular subtypes of dementia [30, 31]. The difference between the K-mMMSE and the K-MMSE in diagnosing this condition might mean that the former was more sensitive to the mild stage or pre-dementia than the latter. In this respect, the K-mMMSE seemed to partially overcome a weakness of the K-MMSE, that is, insensitivity to mild dementia [4]. The present findings suggested that the K-MMSE was actually a fairly reasonable instrument as well. Given the faster administration of the K-MMSE, it would be a choice of clinicians to use optimally, recognizing that the K-MMSE was slightly inferior in terms of its test characteristics. 2ff7e9595c
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