Re: Fw: MMSE, Cheryl, Book

[Guest guest]

Cheryl, and Kind Friends,

Yes, these tests measure dementia; they are very useful, but have limitations.

The point brought out in the neurology book was that these brief tests (MMSE,

DRS) are convenient tools. The second test, the Dementia Rating Scale,

touches on more specific aspects of dementia and permits finer discrimination

of scores which is why the authors preferred the DRS with Parkinson patients.

Again, the chapter (please see sources below) was written in 1992. I would

imagine the MMSE may be more convenient and serve the purposes of the

physicians well, hence its popularity. This section on " Global Cognitive

Function, " at the end of the chapter, is only a few paragraphs long.

Most of the chapter (pp.32-45) is a technical discussion of a comprehensive

neuropsychological examination, with detailed information on specific

symptoms and measurements. Headings include: memory, visuospatial skills,

language, executive functions, attention and concentration, bradyphrenia, and

depression.

From an earlier e-mail :

I chanced upon an interesting chapter in Parkinson's Disease, Neurological

Aspects, edited by J. Huber, Ph.D. and L. Cummings, M.D. New

York: Oxford University Press, 1992. Although the book is concerned with

Parkinson's Disease, the third chapter relates to our discussion regarding

the assessment of dementia. The chapter is: Neuropsychological Evaluation of

Parkinson's Disease, by J. Huber and A. Bornstein (pp. 32-45).

Included in the chapter's extensive bibliography are the sources for the

MMSE, " the most widely used global assessment procedure " and another test,

the DRS, which is described on p.42 as " having a wider range of measurements

(144 vs 30 points) " and " broader areas of cognitive function are examined. "

Please note this commentary is from a book printed in 1992.

MMSE: Mini Mental State Exam

Folstein MF, Folstein SE, McHugh PR. Mini mental state: a practical guide for

grading the mental state of patients for the clinician. Journal Psychiatric

Res. 1975; 12;189-198.

DRS: Dementia Rating Scale

Mattis S. Mental status examination for organic mental syndrome in the

elderly patient. In: Belack L, Karasu TB, Eds. Geriatric Psychiatry. New

York: Grune and Stratton; 1976;77-121.

Bertha

[Guest guest]

Bertha, what you are suggesting sounds SO intriguing. I am assuming you do

not have the capacity to reproduce the sections you are talking about, as I

do not. But it would we wonderful if we could all read the input. I must

tell you that it is SO frustrating . . . Thanks for trying. Cheryl

[Guest guest]

Cheryl,

You are right. I have no scanner. But the main idea, and I'm sure this can be

found in more recent neurology books, is that there are many different mental

abilities that change as dementia sets in, and that these brief assessment

exams give the global picture. I believe they are therefore general as

compared to the criteria mentioned in the extensive material on the

" comprehensive " exam. But even lacking detail, these quick assessment

questions examine different kinds of thinking and serve a purpose, as

Mai-Liis and others who are more familiar with the test itself have emphasized

Bertha