Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-30T07:13:47.311Z Has data issue: false hasContentIssue false

A retrospective analysis of the sentence writing component of Folstein's MMSE

Published online by Cambridge University Press:  13 June 2014

Frances McCarthy
Affiliation:
Medicine for the Elderly, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
Frances Kennedy
Affiliation:
Surgical Department, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
Joe Duggan
Affiliation:
Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
John Sheehan
Affiliation:
Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
Dermot Power
Affiliation:
Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland

Abstract

Objectives: Agraphia is the loss or impairment of the ability to produce written language as a consequence of brain damage and is a well recognised feature of dementia. However there is no generally accepted classification of agraphic disorders. Our aim was to determine the influence of writing style, lettercase and sentence polarity of the writing component of Folstein's MMSE on the overall test score.

Methods: We retrospectively reviewed the ‘write a sentence’ request of Folstein's MMSE of 280 randomly selected patients attending a geriatric day hospital. We analysed four sentence characteristics: 1 Number of words, 2 Writing legibility, 3 Sentence polarity, 4 Letter case.

Results: 280 MMSE forms were examined, 165 were from female patients. Mean age was 81.7(± 6.6) years. Mean MMSE score was 21.6 (males: 21.9, females: 21.4). Significant correlation was detected between the overall MMSE score and both legibility and number of words. Legibility scores were significantly higher for females than for males (7.2 vs. 6.6, p < 0.03). The mean MMSE of females writing in lowercase was significantly higher than for those writing in uppercase (21.5 vs. 18.6, p < 0.05). The mean MMSE score of subjects writing sentences with a positive tone was significantly higher than that of those writing a neutral or negative sentence (22.6 vs. 21.0 p < 0.03).

Conclusions: We have demonstrated a relationship between the content and structure of the writing assessment aspect of the MMSE and the overall test score.

Type
Brief reports
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task force on Alzheimer's disease. Neurology 1984; 34: 939–44.CrossRefGoogle ScholarPubMed
2.Alzheimer, A. A unique illness involving the cerebral cortex. Allge Z Psych Psychgerichtlich Med 1907; 64: 146–8.Google Scholar
3.Goldstein, K. Language and Language disturbances. New York, NY: Grune and Stratton; 1948.Google Scholar
4.Horner, J, Heyman, A, Dawson, D, Rogers, H. The relationship of agraphia to the severity of Dementia in Alzheimer's disease. Arch Neurol 1988; 45: 760–3.CrossRefGoogle Scholar
5.Folstein, MF, Folstein, SE, McHugh, PR. MiniMental State: A practical method for grading the cognitive state of patients for the clinician. Psychiatric Res 1975; 12: 189–98.CrossRefGoogle Scholar
6.Hughes, JC, Graham, N, Patterson, K, Hodges, JR. Dysgraphia in mild dementia of Alzheimer's type. Neuropsychologia 1997; 35(4): 533–45.CrossRefGoogle ScholarPubMed
7.Platel, H, Lambert, J, Eustache, Fet al.Characteristics and evolution of writing impairment in Alzheimer's disease. Neuropsychologia 1993; 31(11): 1147–58.CrossRefGoogle ScholarPubMed
8.Lyketsos, CG, Lopez, O, Jones, B, Fitzpatrick, AL, Breitner, J, DeKosky, S. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA 2002; 288(12): 1475–83.CrossRefGoogle ScholarPubMed
9.Taylor, WD, Wagner, HR, Steffens, DC. Greater depression severity associated with less improvement in depression-associated cognitive deficits in older subjects. Am J Geriatr Psychiatry. 2002; 10(5): 632–5.CrossRefGoogle ScholarPubMed
10.Neils, J, Boiler, F, Gerdeman, B, Cole, M. Descriptive writing abilities in Alzheimer's disease. J Clin Exp Neurapsychol. 1989 10; 11 (5): 692–8.CrossRefGoogle ScholarPubMed