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"Sentence Writing In the Mini Mental State Examination:A Possible Marker for Progression of Mild Cognitive Impairment to Dementia

Author(s): Corallo Francesco, Marra Angela, Bonanno Lilla, Impellizzeri Federica, Lo Buono Viviana, Alagna Antonella, Di Cara Marcella, Cettina Allone, Cecilia Cannistraci, Pria Deborah, Formica Caterina, Romeo Laura, Todaro Antonino, Bramanti Placido, Marino Silvia

The Mini Mental State Examination’s (MMSE) has different cognitive domains (orientation,registration, concentration, short term memory, language and visuo-spatial function) which have been studied as possible discriminating factors for various types of Dementias.

In this work, we analyzed if there is a correlation among: (a) the Sentence Writing of MMSE and global outcome score at the same test; (b) the length of the sentence (n° of words) and disability’s degree (healthy subjects, Mild Cognitive Impairment, Dementia); (c) the semantic
meaning (Abstract Thinking - AT vs. Concrete Meaning - CT) of the phrase and different Disease such are: probable/possible Alzheimer’s Disease (AD), Parkinson Disease (PD), Fronto-Temporal dementia (FTD)and Vascular dementia (VD).

We observed and detected a statistic difference among Control Group (CG), MCI Group and Dementia Group (DG), and MMSE score; a significant association between CG phrases in DG has been found, such as in MCI, AD, VD, PD and FTD respectively. These findings
suggest that the progression from MCI to Dementia could led to a progressive loss of Abstract Thinking, and a tendency towards Concrete Thinking in writing. As shown in Intra-Group analysis, significant correlations have been reported between: MMSE overall score and Number of Words written in Sentence Writing in FTD Group and VD Group and, moreover, a significant positive correlation was found in CG and MMSE score (especially in PD group).

Number of words and significance of the MMSE sentences (abstract/concrete) seems to be an important clinical marker for progression of neurodegenerative process from MCI to Dementia.

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