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Errors Produced on the Mini-Mental State Examination and Neuropsychological Test Performance in Alzheimer's Disease, Ischemic Vascular Dementia, and Parkinson's Disease

Received November 27, 2000; revised March 15, 2001; accepted April 26, 2001. From the Neuropsychology Program, Drexel University, Philadelphia, Pennsylvania (S.A.C., A.L.J., D.J.L.); Neuropsychology Service (S.A.C., A.L.J., D.J.L.) and Departments of Psychiatry (S.K.B.) and Neurology (B.B., N.L.), Crozer Chester Medical Center, Upland, Pennsylvania; Department of Psychology, Suffolk University, and Departments of Neurology and Psychiatry, Boston University Medical Center, Boston, Massachusetts (E.K.); and Department of Psychiatry, MCP/ Hahnemann University, Philadelphia, Pennsylvania (D.J.L.). Address correspondence to Dr. Libon, Neuropsychology Service, Alexander Silberman Center, Crozer Chester Medical Center, Upland, PA 19013.

The authors investigated whether MMSE indices designed to measure temporal and physical orientation, declarative memory, language, working memory, and motor/constructional function could differentiate patients with different dementia diagnoses: Alzheimer's disease (AD), ischemic vascular dementia (IVD), or Parkinson's disease (PD). MMSE summary scores did not differ (AD, 21.4; IVD, 21.1; PD, 22.3). The AD group scored lower than IVD or PD on temporal orientation and declarative memory, IVD lower than AD on motor/ constructional and working memory. The IVD and PD groups made more errors in writing a sentence and copying intersecting pentagons. Significant correlations were found between the orientation indices and neuropsychological tests of naming and memory, and between the working memory and motor/constructional indices and tests of executive control. Such analyses of MMSE performance could assist in formulating referral questions for cognitive assessment and in tracking the course of dementing illnesses.

Key Words: Mini-Mental State Examination • Diagnosis • Dementia

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