Abstract

The Mini-Mental State Examination (MMSE; Folstein et al., 1975) and the Revised Hasegawa’s Dementia Scale (HDS-R; Imai & Hasegawa, 1994) have been widely used for screening dementia in both clinic and community settings. Although in most people, MMSE scores are usually somewhat higher than HDS-R scores, in the dementia clinic, there were cases of HDS-R scores being much lower than MMSE scores and vice versa This study was conducted to examine the cognitive characteristics of the patients who showed significantly lower or higher HDS-R scores as compared to the MMSE. A total of 2053 neurological patients were administered both the MMSE and the HDS-R along with a comprehensive neuropsychological test battery (Seoul Neuropsychological Screening Battery, SNSB). Eighty-four percent of the total patients had higher scores on the MMSE than on the HDS-R. The mean difference in scores between the MMSE and HDS-R was 3.64±3.10. Based on this score, patients whose HDS-R score was lower than their corresponding MMSE score by seven or more points were selected for the “HDS-R Low group” (n=330). Alternatively patients whose HDS-R score was equal to or higher their corresponding MMSE score were selected for the “HDS-R High group” (n=399). Further patients who exhibited a mean difference score (3~4 points) were selected for the “Average difference group” (n=458). Although there were significant differences in the HDS-R scores among the groups, three groups did not show any differences with respect to MMSE scores. Further, there were significant correlations between the difference scores and the subtests for verbal & visual memory, frontal/executive function, and language in the SNSB. These subtests explained about 20% of the total variance for the difference in scores. The “Low” group exhibited significantly lower performance than the other two groups on these subtests. Together, the results suggest that the size of the difference between the MMSE and HDS scores may provide a clue regarding the cognitive profile of dementia patients. Therefore, it is recommended that both the both the MMSE and HDS be administered together. This would allow for the gathering of a substantial amount of information in a relatively short time period, which is beneficial in dementia screening.