Errors Produced on the Mini-Mental State Examination and Neuropsychological Test Performance in Alzheimer's Disease, Ischemic Vascular Dementia, and Parkinson's Disease

Jefferson, Angela L.; Cosentino, Stephanie; Ball, Susan K.; Bogdanoff, Bruce; Leopold, Norman A.; Kaplan, Edith; Libon, David J.

doi:10.1176/jnp.14.3.311

Cited by 63 publications

(37 citation statements)

References 25 publications

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“…The cutoff for PD was lower to account for disease-specific (i.e., motor) errors that are not associated with dementia. 15 Participants also received the Beck Depression Inventory II (BDI-II), 16 the Geriatric Depression Scale (GDS), 17 and the Beck Anxiety Inventory (BAI). 18 For those with PD, side of symptom onset, Hoehn & Yahr motor stage, and treatment history were obtained.…”

Section: Discussionmentioning

confidence: 99%

Effects of orthostatic hypotension on cognition in Parkinson disease

et al. 2017

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Objective: To investigate the relation between orthostatic hypotension (OH) and posturemediated cognitive impairment in Parkinson disease (PD) using a cross-sectional and withingroup design.Methods: Individuals without dementia with idiopathic PD included 18 with OH (PDOH) and 19 without OH; 18 control participants were also included. Neuropsychological tests were conducted in supine and upright-tilted positions. Blood pressure was assessed in each posture. Results:The PD groups performed similarly while supine, demonstrating executive dysfunction in sustained attention and response inhibition, and reduced semantic fluency and verbal memory (encoding and retention). Upright posture exacerbated and broadened these deficits in the PDOH group to include phonemic fluency, psychomotor speed, and auditory working memory. When group-specific supine scores were used as baseline anchors, both PD groups showed cognitive changes following tilt, with the PDOH group exhibiting a wider range of deficits in executive function and memory as well as significant changes in visuospatial function. Conclusions:Cognitive deficits in PD have been widely reported with assessments performed in the supine position, as seen in both our PD groups. Here we demonstrated that those with PDOH had transient, posture-mediated changes in excess of those found in PD without OH. These observed changes suggest an acute, reversible effect. Understanding the effects of OH due to autonomic failure on cognition is desirable, particularly as neuroimaging and clinical assessments collect data only in the supine or seated positions. Identification of a distinct neuropsychological profile in PD with OH has quality of life implications, and OH presents itself as a possible target for intervention in cognitive disturbance. Orthostatic hypotension (OH) is among the most commonly reported nonmotor manifestations in persons with Parkinson disease (PD), with prevalence as high as 53%.1 Symptoms include lightheadedness, fatigue, neck pain, presyncope, and syncope.2,3 The causes can include both CNS and peripheral nervous system degeneration.4 Dopamine replacement therapies have been implicated as well. 5OH is associated with cognitive impairment. Even when controlling for systolic blood pressure (SBP), both elderly and younger individuals with OH show relative deficits in verbal memory and sustained attention, both of which are predictors of subsequent cognitive decline that is greater than would be expected in the context of normal aging. 6Idiopathic PD is itself associated with cognitive deficits. Historically, these were thought to be limited to psychomotor/information processing speeds and caused by disease-specific subcortical pathologies.7 However, deficits across executive functions are present, even in cases without

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Section: Discussionmentioning

confidence: 99%

Effects of orthostatic hypotension on cognition in Parkinson disease

et al. 2017

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“…Alternatively, error monitoring may rely on specific neuropsychological processes not adequately assessed in a gross measure of functioning. For example, there has been considerable debate regarding the ability of the MMSE to sufficiently detect executive dysfunction, with some studies showing the MMSE is sensitive to executive deficits (Axelrod et al, 1992;Jefferson et al, 2002;van Gorp et al, 1999), and others highlighting the inadequacy of the MMSE in assessing this cognitive domain (Stokholm et al, 2005). Despite this contention, the MMSE clearly does not offer a comprehensive assessment of executive functioning or other processes that might be relevant to monitoring everyday action errors, including task or script knowledge.…”

Section: Discussionmentioning

confidence: 99%

Error detection and correction patterns in dementia: A breakdown of error monitoring processes and their neuropsychological correlates

Bettcher

Giovannetti

Macmullen

et al. 2008

J. Inter. Neuropsych. Soc.

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Error monitoring is critical to an individual's ability to function autonomously. This study characterized error detection and correction behaviors within the service of everyday tasks in individuals with dementia. Also, the impact of neuropsychological functioning on error detection and correction was examined. Fifty-three participants diagnosed with Alzheimer's disease (AD) or vascular dementia (VaD) were administered a neuropsychological protocol and the Naturalistic Action Test, which requires performance of three everyday tasks. Error detection, correction, and the point at which correction occurred (i.e., microslip-before the error was completed, immediate-just after the error was made, delayed-after performing other task steps) was coded. Dementia participants detected 32.7% of their errors and corrected 75.8% of detected errors. Participants were more likely to engage in microslips than delayed corrections. Tests of executive control and language predicted detection and correction variables; moreover, detection and correction were each related to different aspects of executive functioning. Microslips were related to naming ability. AD and VaD patients did not differ on detection0correction variables, and regression analyses indicated that dementia severity and memory abilities were unrelated to detection0correction. The results specify the error monitoring deficits in AD and VaD and have implications for improving functional abilities in dementia. (JINS, 2008, 14, 199-208.)

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“…The failure to find an association between the degree of WMA and the scores on the MMSE is because the MMSE primarily assesses memory and cognitive functions such as language and provides little assessment of executive functions. 40 Thus, the MMSE would be a relatively insensitive instrument in the assessment for the presence and degree of subcortical VaD.…”

Section: Discussionmentioning

confidence: 99%