Qualitative Analysis of Mini Mental State Examination Pentagon in Vascular Dementia and Alzheimer's Disease:A Longitudinal Explorative Study

Viviana Lo Buono, Lilla Bonanno, Francesco Corallo, Maria Foti, Rosanna Palmeri, Angela Marra, Giuseppe Di Lorenzo, Antonino Todaro, Placido Bramanti, Alessia Bramanti, Silvia Marino

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Vascular dementia and Alzheimer's disease are the most diffuse forms of dementia. Sometimes, they are difficult to distinguish due to overlaps in symptomatology, pathophysiology, and comorbidity. Visual constructive apraxia is very common in dementia and impairment in these abilities can provide clinical information for differential diagnosis.

MATERIALS AND METHODS: All patients underwent Mini Mental State Examination (MMSE) at basal visit (T0) and after 1 year (T1). We analyzed differences in Qualitative Scoring Method for the Pentagon Copying Test and we explored the visual constructive apraxia evolution in these 2 types of dementia.

RESULTS: In intragroup analysis, we found a significant difference in each group between T0 and T1 in MMSE score (P < .001) and total qualitative scores (P < .001). In intergroup analysis, at T0, we found significance difference in total qualitative scores (P < .001), in numbers of angles (P = .005), in distance/intersection (P < .001), in closure/opening (P = .01), in rotation (P < .001), and in closing-in (P < .001). At T1, we found significance difference in total qualitative scores (P < .001), in particular, in numbers of angles (P < .001), in distance/intersection (P < .001), in closure/opening (P < .001), in rotation (P < .001), and in closing-in (P < .001). The total score showed the highest classification accuracy (.90, 95%CI = .81-0.96) in differentiating patients with Alzheimer's disease from patients with vascular dementia. The optimal threshold value was k = 5. with .84 (95%CI = .69-0.93) sensitivity and .81 (95%CI = .64-0.93) specificity.

CONCLUSION: Patients with vascular dementia showed more accuracy errors and graphic difficulties than patients with Alzheimer's disease. Qualitative analysis of copy provided a sensitive measure of visual constructive abilities in differentiating dementias, underlining a particularly vulnerability of visuoconstructive functions in vascular dementia compared with Alzheimer's disease.

Original languageEnglish
Pages (from-to)1666-1672
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume27
Issue number6
DOIs
Publication statusPublished - Jun 2018

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Vascular Dementia
Vascular Diseases
Longitudinal Studies
Alzheimer Disease
Dementia
Apraxias
Aptitude
Comorbidity
Differential Diagnosis
Research Design

Keywords

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease/diagnosis
  • Apraxias/diagnosis
  • Area Under Curve
  • Dementia, Vascular/diagnosis
  • Diagnosis, Differential
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Status and Dementia Tests
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Qualitative Research
  • ROC Curve
  • Reproducibility of Results
  • Visual Perception

Cite this

Qualitative Analysis of Mini Mental State Examination Pentagon in Vascular Dementia and Alzheimer's Disease:A Longitudinal Explorative Study. / Lo Buono, Viviana; Bonanno, Lilla; Corallo, Francesco; Foti, Maria; Palmeri, Rosanna; Marra, Angela; Di Lorenzo, Giuseppe; Todaro, Antonino; Bramanti, Placido; Bramanti, Alessia; Marino, Silvia.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 27, No. 6, 06.2018, p. 1666-1672.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Vascular dementia and Alzheimer's disease are the most diffuse forms of dementia. Sometimes, they are difficult to distinguish due to overlaps in symptomatology, pathophysiology, and comorbidity. Visual constructive apraxia is very common in dementia and impairment in these abilities can provide clinical information for differential diagnosis.MATERIALS AND METHODS: All patients underwent Mini Mental State Examination (MMSE) at basal visit (T0) and after 1 year (T1). We analyzed differences in Qualitative Scoring Method for the Pentagon Copying Test and we explored the visual constructive apraxia evolution in these 2 types of dementia.RESULTS: In intragroup analysis, we found a significant difference in each group between T0 and T1 in MMSE score (P < .001) and total qualitative scores (P < .001). In intergroup analysis, at T0, we found significance difference in total qualitative scores (P < .001), in numbers of angles (P = .005), in distance/intersection (P < .001), in closure/opening (P = .01), in rotation (P < .001), and in closing-in (P < .001). At T1, we found significance difference in total qualitative scores (P < .001), in particular, in numbers of angles (P < .001), in distance/intersection (P < .001), in closure/opening (P < .001), in rotation (P < .001), and in closing-in (P < .001). The total score showed the highest classification accuracy (.90, 95{\%}CI = .81-0.96) in differentiating patients with Alzheimer's disease from patients with vascular dementia. The optimal threshold value was k = 5. with .84 (95{\%}CI = .69-0.93) sensitivity and .81 (95{\%}CI = .64-0.93) specificity.CONCLUSION: Patients with vascular dementia showed more accuracy errors and graphic difficulties than patients with Alzheimer's disease. Qualitative analysis of copy provided a sensitive measure of visual constructive abilities in differentiating dementias, underlining a particularly vulnerability of visuoconstructive functions in vascular dementia compared with Alzheimer's disease.",
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T1 - Qualitative Analysis of Mini Mental State Examination Pentagon in Vascular Dementia and Alzheimer's Disease:A Longitudinal Explorative Study

AU - Lo Buono, Viviana

AU - Bonanno, Lilla

AU - Corallo, Francesco

AU - Foti, Maria

AU - Palmeri, Rosanna

AU - Marra, Angela

AU - Di Lorenzo, Giuseppe

AU - Todaro, Antonino

AU - Bramanti, Placido

AU - Bramanti, Alessia

AU - Marino, Silvia

N1 - Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - BACKGROUND: Vascular dementia and Alzheimer's disease are the most diffuse forms of dementia. Sometimes, they are difficult to distinguish due to overlaps in symptomatology, pathophysiology, and comorbidity. Visual constructive apraxia is very common in dementia and impairment in these abilities can provide clinical information for differential diagnosis.MATERIALS AND METHODS: All patients underwent Mini Mental State Examination (MMSE) at basal visit (T0) and after 1 year (T1). We analyzed differences in Qualitative Scoring Method for the Pentagon Copying Test and we explored the visual constructive apraxia evolution in these 2 types of dementia.RESULTS: In intragroup analysis, we found a significant difference in each group between T0 and T1 in MMSE score (P < .001) and total qualitative scores (P < .001). In intergroup analysis, at T0, we found significance difference in total qualitative scores (P < .001), in numbers of angles (P = .005), in distance/intersection (P < .001), in closure/opening (P = .01), in rotation (P < .001), and in closing-in (P < .001). At T1, we found significance difference in total qualitative scores (P < .001), in particular, in numbers of angles (P < .001), in distance/intersection (P < .001), in closure/opening (P < .001), in rotation (P < .001), and in closing-in (P < .001). The total score showed the highest classification accuracy (.90, 95%CI = .81-0.96) in differentiating patients with Alzheimer's disease from patients with vascular dementia. The optimal threshold value was k = 5. with .84 (95%CI = .69-0.93) sensitivity and .81 (95%CI = .64-0.93) specificity.CONCLUSION: Patients with vascular dementia showed more accuracy errors and graphic difficulties than patients with Alzheimer's disease. Qualitative analysis of copy provided a sensitive measure of visual constructive abilities in differentiating dementias, underlining a particularly vulnerability of visuoconstructive functions in vascular dementia compared with Alzheimer's disease.

AB - BACKGROUND: Vascular dementia and Alzheimer's disease are the most diffuse forms of dementia. Sometimes, they are difficult to distinguish due to overlaps in symptomatology, pathophysiology, and comorbidity. Visual constructive apraxia is very common in dementia and impairment in these abilities can provide clinical information for differential diagnosis.MATERIALS AND METHODS: All patients underwent Mini Mental State Examination (MMSE) at basal visit (T0) and after 1 year (T1). We analyzed differences in Qualitative Scoring Method for the Pentagon Copying Test and we explored the visual constructive apraxia evolution in these 2 types of dementia.RESULTS: In intragroup analysis, we found a significant difference in each group between T0 and T1 in MMSE score (P < .001) and total qualitative scores (P < .001). In intergroup analysis, at T0, we found significance difference in total qualitative scores (P < .001), in numbers of angles (P = .005), in distance/intersection (P < .001), in closure/opening (P = .01), in rotation (P < .001), and in closing-in (P < .001). At T1, we found significance difference in total qualitative scores (P < .001), in particular, in numbers of angles (P < .001), in distance/intersection (P < .001), in closure/opening (P < .001), in rotation (P < .001), and in closing-in (P < .001). The total score showed the highest classification accuracy (.90, 95%CI = .81-0.96) in differentiating patients with Alzheimer's disease from patients with vascular dementia. The optimal threshold value was k = 5. with .84 (95%CI = .69-0.93) sensitivity and .81 (95%CI = .64-0.93) specificity.CONCLUSION: Patients with vascular dementia showed more accuracy errors and graphic difficulties than patients with Alzheimer's disease. Qualitative analysis of copy provided a sensitive measure of visual constructive abilities in differentiating dementias, underlining a particularly vulnerability of visuoconstructive functions in vascular dementia compared with Alzheimer's disease.

KW - Aged

KW - Aged, 80 and over

KW - Alzheimer Disease/diagnosis

KW - Apraxias/diagnosis

KW - Area Under Curve

KW - Dementia, Vascular/diagnosis

KW - Diagnosis, Differential

KW - Female

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Mental Status and Dementia Tests

KW - Neuropsychological Tests

KW - Predictive Value of Tests

KW - Qualitative Research

KW - ROC Curve

KW - Reproducibility of Results

KW - Visual Perception

U2 - 10.1016/j.jstrokecerebrovasdis.2018.01.021

DO - 10.1016/j.jstrokecerebrovasdis.2018.01.021

M3 - Article

C2 - 29503167

VL - 27

SP - 1666

EP - 1672

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 6

ER -