Mini-mental state examination performance in Alzheimer's disease and frontotemporal dementia

We performed an item analysis on the Mini-Mental State Examination (MMSE) in a group of 52 frontotemporal dementia (FTD) and 110 Alzheimer's disease (AD) patients. FTD patients performed significantly better than did AD patients on construction, time orientation, and recall tasks. AD patients performed better on naming than did FTD patients. In a subsample of 41 FTD patients and 41 age-, education-, and severity-matched AD patients, the construction and naming items remained significantly different between diagnostic categories. Logistic regression analysis determined that the single construction item successfully discriminated 67% of the subjects in the matched sample. A five-item set of MMSE items representing the domains of construction, time orientation, mental control, recall, and naming classified 79% of the sample accurately, and these results were consistent with a replication study using an independent sample of AD and FTD patients. Longitudinally, AD patients declined an average of 3.7 points per year, compared with 1.9 points per year for the FTD patients; this difference, however, was not statistically significant. These results suggest that different cognitive profiles may differentially result from these progressive cortical dementias and that screening tests may aid in differential diagnosis in a clinical setting.