Affiliations: [a] Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA | [b] Department of Neurology, Chungnam University, Daejon, Korea
Correspondence:
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Correspondence to: Scott A. Lyness, Department of Neurology, Keck School of Medicine, University of Southern California, Health Sciences Campus, 1540 Alcazar Street, CHP 209-G, Los Angeles, CA 90033, USA. Tel.: +1 323 442 7793; Fax: +1 323 442 7790; E-mail: lyness@usc.edu.
Abstract: 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.
Keywords: Autopsy, consensus, dementia, memory disorders, Modified Mini-Mental State (3MS), neuropsychological tests, sensitivity and specificity
