Journal

The Japanese journal of neuropsychology

[Vol.28 No.4 contents]
Japanese/English

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ArticleTitle Annual rate of change in the Mini-Mental State Examination (MMSE) in Alzheimer's disease: Factors affecting the rate for the 2nd and 3rd years
Language J
AuthorList Yuka Adachi1), Chikako Asai2), Fumika Isobe3), Chie Usuki4), Takuya Sato5), Toru Imamura1)6)
Affiliation 1)Department of Speech Therapy, School of Health Sciences, Niigata University of Health and Welfare
2)Department of Rehabilitation, Toyama City Hospital
3)Department of Rehabilitation, Saiseikai Kanazawa Hospital
4)Department of Rehabilitation, Hot Spring of Rehabilitation Nakaizu Hospital
5)Division of Speech Therapy, Department of Rehabilitation, Niigata Rehabilitation Hospital
6)Department of Neurology, Niigata Rehabilitation Hospital
Publication Japanese Journal of Neuropsychology: 28 (4), 240-247, 2012
Received Mar 28, 2011
Accepted Sep 16, 2011
Abstract Objective: To find factors affecting the rate of cognitive change for the 2nd and 3rd years after the first visit in patients with Alzheimer's disease (AD). Subjects: 76 AD patients who presented to our memory clinic and underwent the Mini-Mental State examination (MMSE) both one year and three years after the first visit. The mean age was 79.6±5.9 years and the mean MMSE score was 20.7±3.5 at the point of one year after the first visit. Methods: We conducted repeated analyses of multiple regression. The statistical model consisted of the rate of MMSE change for the 2nd and 3rd years as repeated measure, the MMSE scores at one year after the first visit as covariate and one of the items in the following categories as independent variable; patient characteristics, disease characteristics, neuropsychiatric symptoms, therapeutic interventions and care support services at one year after the first visit. Results: Partial regression coefficients were significant between the rate of MMSE change for the 2nd and 3rd years and the scores of Following Commands and Orientation in the Alzheimer's Disease Assessment Scale (ADAS) at one year after the first visit. That is, patients with worse score in Following Commands and those with worse score in Orientation at one year after the first visit showed significantly worse rates of MMSE change for the 2nd and 3rd years. Conclusions: AD patients with language symptom were reported to have a trend of rapid progression for cognitive dysfunction. The results in this study suggested that the trend exists also in elder AD patients with the impairment of verbal comprehension. Several literatures reported that AD progresses rapidly in the middle stage of the disease while it does slowly in the early and late stages. The significant relation between the orientation task and the rate of MMSE change for the 2nd and 3rd years may be because the occurrence of disorientation most sensitively reflected the progression from the early stage to the middle stage of AD.
Keywords cognitive dysfunction, dropout bias, annual rate of change, impairment of verbal comprehension, disorientation

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