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The role of tests of frontal executive function in the detection of mild dementia

The role of tests of frontal executive function in the detection of mild dementia
The role of tests of frontal executive function in the detection of mild dementia
Objective: to compare the performance of patients with mild dementia (Mini Mental State Examination (MMSE) >23), depression (Montgomery-Åsberg depression rating scale (MADRS) >12) and controls on tests of frontal executive function (FEF), to see if simple tools could be an adjunct to early recognition of dementia in primary care.
Design: subjects were required to score above 23 on the MMSE, and to be non-depressed unless in the depression group. Tests of FEF used were a letter based verbal fluency test, a cognitive estimates test, trail marking parts A and B, and a Stroop colour word test. Subjects were followed up at one year to assess long-term outcomes.
Setting: the Thornhill Unit, an old age psychiatry unit, Moorgreen Hospital, Southampton, UK.
Patients: sixteen patients with a clinical diagnosis of dementia but with normal or borderline MMSE scores, 16 subjects with depression and 19 healthy control subjects.
Results: subjects with mild dementia scored significantly worse than control subjects on all FEF tests used other than verbal fluency. Subjects with mild dementia were only found to score worse than depressed subjects on the cognitive estimates test and Stroop test, with the Stroop test providing better discrimination between these groups. At follow-up, MMSE scores of both dementia and depression groups were worse.
Conclusions: many simple tests of FEF can distinguish subjects with mild dementia from controls, although caution must be taken in the presence of depression. Of these tests, the cognitive estimates test may provide a simple test which can be used in conjunction with screening tests for dementia, such as the MMSE. The Stroop colour test was the most successful at distinguishing subjects with mild dementia from those with depression, but was more difficult to use. The depression group remained cognitively impaired at follow-up, despite improvements in depressive symptoms.
dementia, depression, mini mental state examination (MMSE), frontal executive function (FEF)
18-26
Nathan, Joanna
f23e1534-94e1-47eb-9835-a0af287ce788
Wilkinson, David
9a6b3b11-ec00-45b8-a63a-ff0669695d58
Stammers, Sue
0a30aec2-019b-44fc-a7cb-6fb377ac2d8b
Low, J. Lorraine
65c429eb-66a8-45b0-a719-e1f59c0338eb
Nathan, Joanna
f23e1534-94e1-47eb-9835-a0af287ce788
Wilkinson, David
9a6b3b11-ec00-45b8-a63a-ff0669695d58
Stammers, Sue
0a30aec2-019b-44fc-a7cb-6fb377ac2d8b
Low, J. Lorraine
65c429eb-66a8-45b0-a719-e1f59c0338eb

Nathan, Joanna, Wilkinson, David, Stammers, Sue and Low, J. Lorraine (2001) The role of tests of frontal executive function in the detection of mild dementia. International Journal of Geriatric Psychiatry, 16 (1), 18-26. (doi:10.1002/1099-1166(200101)16:1<18::AID-GPS265>3.0.CO;2-W).

Record type: Article

Abstract

Objective: to compare the performance of patients with mild dementia (Mini Mental State Examination (MMSE) >23), depression (Montgomery-Åsberg depression rating scale (MADRS) >12) and controls on tests of frontal executive function (FEF), to see if simple tools could be an adjunct to early recognition of dementia in primary care.
Design: subjects were required to score above 23 on the MMSE, and to be non-depressed unless in the depression group. Tests of FEF used were a letter based verbal fluency test, a cognitive estimates test, trail marking parts A and B, and a Stroop colour word test. Subjects were followed up at one year to assess long-term outcomes.
Setting: the Thornhill Unit, an old age psychiatry unit, Moorgreen Hospital, Southampton, UK.
Patients: sixteen patients with a clinical diagnosis of dementia but with normal or borderline MMSE scores, 16 subjects with depression and 19 healthy control subjects.
Results: subjects with mild dementia scored significantly worse than control subjects on all FEF tests used other than verbal fluency. Subjects with mild dementia were only found to score worse than depressed subjects on the cognitive estimates test and Stroop test, with the Stroop test providing better discrimination between these groups. At follow-up, MMSE scores of both dementia and depression groups were worse.
Conclusions: many simple tests of FEF can distinguish subjects with mild dementia from controls, although caution must be taken in the presence of depression. Of these tests, the cognitive estimates test may provide a simple test which can be used in conjunction with screening tests for dementia, such as the MMSE. The Stroop colour test was the most successful at distinguishing subjects with mild dementia from those with depression, but was more difficult to use. The depression group remained cognitively impaired at follow-up, despite improvements in depressive symptoms.

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More information

Published date: 2001
Keywords: dementia, depression, mini mental state examination (MMSE), frontal executive function (FEF)

Identifiers

Local EPrints ID: 27670
URI: http://eprints.soton.ac.uk/id/eprint/27670
PURE UUID: d791fe3f-84ec-4ccb-8d06-dff061b9ff8b

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Date deposited: 27 Apr 2006
Last modified: 15 Mar 2024 07:20

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Contributors

Author: Joanna Nathan
Author: David Wilkinson
Author: Sue Stammers
Author: J. Lorraine Low

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