10-minute delayed recall from the modified mini-mental state test predicts Alzheimer's disease pathology.
We compared the sensitivity and specificity of two delayed recall scores from the Modified Mini-Mental State (3MS) test with consensus clinical diagnosis to differentiate cognitive impairment due to Alzheimer's disease (AD) versus non-AD pathologies. At a memory disorders clinic, 117 cognitively impaired patients were administered a baseline 3MS test and received a contemporaneous consensus clinical diagnosis. Their brains were examined after death about 5 years later. Using logistic regression with forward selection to predict pathologically defined AD versus non-AD, 10-min delayed recall entered first (p = 0.001), followed by clinical diagnosis (p = 0.02); 1-min delayed recall did not enter. 10-min delayed recall scores ≤4 (score range = 0-9) were 87% sensitive and 47% specific in predicting AD pathology; consensus clinical diagnosis was 82% sensitive and 45% specific. For the 57 patients whose initial Mini-Mental State Examination scores were ≥19 (the median), 3MS 10-min delayed recall scores ≤4 showed some loss of sensitivity (80%) but a substantial gain in specificity (77%). In conclusion, 10-min delayed recall score on the brief 3MS test distinguished between AD versus non-AD pathology about 5 years before death at least as well as consensus clinical diagnosis that requires much more comprehensive information and complex deliberation.
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Scott A
SA
Lyness
Department of Neurology, Chungnam University, Daejon, Korea.
Ae Young
AY
Lee
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Chris
C
Zarow
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Evelyn L
EL
Teng
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Helena C
HC
Chui
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000473:pathology*; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D011939:Mental Recall / Q000502:physiology*; D008609:Mental Status Schedule; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D011930:Reaction Time / Q000502:physiology*; D012189:Retrospective Studies
Autopsy; Modified Mini-Mental State (3MS); consensus; dementia; memory disorders; neuropsychological tests; sensitivity and specificity