The Japanese journal of neuropsychology

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ArticleTitle	Addition of the cued recall and recognition tasks to Mini Mental State Examination: Floor effect in Alzheimer's disease with moderate cognitive impairment
Language	J
AuthorList	Chihiro Suzuki¹⁾, Tomoko Honda²⁾, Takuya Sato³⁾, Toru Imamura¹⁾⁴⁾
Affiliation	¹⁾Department of Speech Therapy, School of Health Sciences, Niigata University of Health and Welfare ²⁾Department of Rehabilitation, Kaetsu Hospital ³⁾Division of Speech Therapy, Department of Rehabilitation, Niigata Rehabilitation Hospital ⁴⁾Department of Neurology, Niigata Rehabilitation Hospital
Publication	Japanese Journal of Neuropsychology: 29 (1), 71-77, 2013
Received	Jun 21, 2012
Accepted	Sep 12, 2012
Abstract	Objective: To evaluate floor effect in the combined task of delayed free recall, cued recall and recognition of 3 words in patients with Alzheimer's disease (AD) who had moderate cognitive impairment. Subjects: 447 patients with AD who scored 10 or more in the Mini-Mental State Examination (MMSE) and who underwent the Alzheimer's Disease Assessment Scale (ADAS) . Methods: We added the cued recall and recognition tasks to the delayed free recall of the 3 words in MMSE. We obtained the score of each patient using the 3-2-1 scoring (9-point scale) : 3 points for each word that is recalled freely, 2 points for each word that is recalled after a categorical cue is given, and 1 point for each word that is recognized in forced-choice recognition with one target and two distractor words. We examined the relations between the 3-2-1 score and the MMSE score, and between the 3-2-1 score and the result of the 10-word recall task in the ADAS. Results: The 3-2-1 scores did not show floor effect in the patients with 21 or more of the MMSE score and the patients with 4.3 or more of the mean recalled words in the 10-word recall task. Floor effect in the 3-2-1 scores appereared in the patients with a worse performance in those tasks. Conclusion: When we use the 3-2-1 scoring for combined task of free recall, cued recall and recognition of three words in AD patients with moderate or severe cognitive impairment, we should consider floor effect to assess the severity of resent memory deficit.
Keywords	3-word recall test, floor effect, recent memory deficit, severity, Alzheimer's disease