Diagnostic Evaluation of Elderly Patients with Mild Memory Problems
Authors: Monica S. Horton, Jason E. Schillerstrom
Journal: Annals of Internal Medicine (2004)

Letters6 January 2004Diagnostic Evaluation of Elderly Patients with Mild Memory ProblemsMonica S. Horton, MD and Jason E. Schillerstrom, MDMonica S. Horton, MDFrom The University of Texas Health Science Center, San Antonio, TX 78229.Search for more papers by this author and Jason E. Schillerstrom, MDFrom The University of Texas Health Science Center, San Antonio, TX 78229.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-1-200401060-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Drs. Karlawish and Clark (1) stated that the Mini-Mental Status Examination (MMSE) measures executive function. This conflicts with many publications that have shown otherwise. Valid bedside executive instruments, such as the Executive Interview (EXIT25) and an executive clock-drawing task (CLOX), continuously outperform the MMSE in detecting executive impairment (2, 3). Our unpublished data showed that 53% of general medicine patients did not pass either CLOX1 or the EXIT25, compared with 9% who did not pass the MMSE (using a cut-point of 24). Our published data showed that 72% of medicine and surgery patients seen by a psychiatry ...References1. Karlawish JH, Clark CM. Diagnostic evaluation of elderly patients with mild memory problems. Ann Intern Med. 2003;138:411-9. [PMID: 12614094] LinkGoogle Scholar2. Royall DR, Mahurin RK, Gray KF. Bedside assessment of executive cognitive impairment: the executive interview. J Am Geriatr Soc. 1992;40:1221-6. [PMID: 1447438] CrossrefMedlineGoogle Scholar3. Royall DR, Cordes JA, Polk M. CLOX: an executive clock drawing task. J Neurol Neurosurg Psychiatry. 1998;64:588-94. [PMID: 9598672] CrossrefMedlineGoogle Scholar4. Schillerstrom JE, Deuter MS, Wyatt R, Stern SL, Royall DR. Prevalence of executive impairment in patients seen by a psychiatry consultation service. Psychosomatics. 2003;44:290-7. [PMID: 12832594] CrossrefMedlineGoogle Scholar5. Folstein M. Mini-mental and son. Int J Geriatr Psychiatry. 1998;13:290-4. [PMID: 9658261] MedlineGoogle Scholar6. Royall DR, Mulroy AR, Chiodo LK, Polk MJ. Clock drawing is sensitive to executive control: a comparison of six methods. J Gerontol B Psychol Sci Soc Sci. 1999;54:P328-33. [PMID: 10542825] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The University of Texas Health Science Center, San Antonio, TX 78229. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnostic Evaluation of Elderly Patients with Mild Memory Problems Jason H.T. Karlawish and Christopher M. Clark Alzheimer Disease: Current Concepts and Emerging Diagnostic and Therapeutic Strategies Christopher M. Clark and Jason H.T. Karlawish Diagnostic Evaluation of Elderly Patients with Mild Memory Problems Ronald Hirsch Metrics 6 January 2004Volume 140, Issue 1Page: 71-72KeywordsCognitionElderlyMemoryMini mental state examinationSurgery ePublished: 6 January 2004 Issue Published: 6 January 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...