Psychiatry Investig.  2014 Jan;11(1):44-51.

Improvement of Screening Accuracy of Mini-Mental State Examination for Mild Cognitive Impairment and Non-Alzheimer's Disease Dementia by Supplementation of Verbal Fluency Performance

  • 1Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.
  • 2Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
  • 3Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Republic of Korea.
  • 4Department of Neuropsychiatry, Soonchunhyang University Hospital, Bucheon, Republic of Korea.
  • 5Department of Neuropsychiatry, Daelim Saint Mary's Hospital, Seoul, Republic of Korea.
  • 6Department of Neuropsychiatry, Chosun University Hospital, Gwangju, Republic of Korea.
  • 7Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea.
  • 8Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, Republic of Korea.
  • 9Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.


This study aimed to investigate whether the supplementation of Verbal Fluency: Animal category test (VF) performance can improve the screening ability of Mini-Mental State Examination (MMSE) for mild cognitive impairment (MCI), dementia and their major subtypes.
Six hundred fifty-five cognitively normal (CN), 366 MCI [282 amnestic MCI (aMCI); 84 non-amnestic MCI (naMCI)] and 494 dementia [346 Alzheimer's disease (AD); and 148 non-Alzheimer's disease dementia (NAD)] individuals living in the community were included (all aged 50 years and older) in the study.
The VF-supplemented MMSE (MMSE+VF) score had a significantly better screening ability for MCI, dementia and overall cognitive impairment (MCI plus dementia) than the MMSE raw score alone. MMSE+VF showed a significantly better ability than MMSE for both MCI subtypes, i.e., aMCI and naMCI. In the case of dementia subtypes, MMSE+VF was better than the MMSE alone for NAD screening, but not for AD screening.
The results support the usefulness of VF-supplementation to improve the screening performance of MMSE for MCI and NAD.


Mini-Mental State Examination; Verbal fluency; Screening accuracy; Mild cognitive impairment; Non-Alzheimer's disease dementia
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