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NEUROLOGY 1990;40:1225
© 1990 American Academy of Neurology

Longitudinal evaluation of dementia of the Alzheimer type

A comparison of 3 standardized mental status examinations

David P. Salmon, PhD, Leon J. Thal, MD, Nelson Butters, PhD and William C. Heindel, PhD

From the Departments of Neurosciences (Drs. Salmon, Thal, and Heindel) and Psychiatry (Dr. Butters), University of California School of Medicine at San Diego; and the Neurology (Dr. Thal) and Psychology Services (Drs. Salmon, Butters, and Heindel), San Diego Veterans Administration Medical Center, San Diego, CA.

We administered 3 commonly employed tests of mental status (the Information-Memory-Concentration test [IMC], the Mini-Mental State Examination [MMSE], and the Dementia Rating Scale [DRS]) to 92 patients with probable dementia of the Alzheimer type. The 3 tests were readministered to 55 of the patients (2-year subgroup) approximately 1 year later, and administered a 3rd time to 20 of the patients (3-year subgroup) approximately 2 years after their initial assessment. In all cases, scores on the 3 tests were highly correlated with each other. Examination of the annual rate of change (ARC) in score for the 2-year subgroup revealed an average decline of—3.24 error points on the IMC, 2.81 points on the MMSE, and 11.38 points on the DRS. Of the 3 tests, only the DRS evidenced greater sensitivity to change with increasing dementia severity. In the 3-year subgroup, the ARC between years 1 and 2 was not correlated with ARC between years 2 and 3 for any of the 3 tests. This finding suggests that a patient's rate of progression in 1 year may bear little relationship to future rate of decline.

Address correspondence and reprint requests to Dr. David P. Salmon, Riford Clinic (H-204), UCSD Medical Center, 225 Dickinson Street, San Diego, CA 92103.

Supported in part by funds from the VA Medical Research Service and by NIA grants AG-05131 and AG-08204.

Received December 7, 1989. Accepted for publication in final form January 30, 1990.




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