Polarity of the freely formulated MMST sentence and state of health of people with dementia : Results of a cross-sectional study

Abstract

The mini-mental status examination (MMSE) includes a task in which participants are asked to write a sentence of their own choice. The emotional tone of the sentence may be related to the emotions of the writer; therefore, it was investigated whether the emotional tone of the sentence in the MMSE written by people with dementia was associated with health-related quality of life and depressive symptoms. A secondary analysis was carried out based on the cross-sectional data of 107 people with dementia included in the "7th framework EU project RightTimePlaceCare". Two raters assessed the emotional tone of the sentence based on a standardized procedure as positive, neutral or negative. The association between the emotional tone of the sentence, health-related quality of life and depressive symptoms was investigated. Health-related quality of life was assessed by the quality of life in Alzheimer's disease questionnaire and depressive symptoms by the Cornell scale for depression in dementia questionnaire. The sentences were rated as either positive or neutral in both cases with 42 % and 16 % were judged to have anegative emotional tone. The variance analysis by ANOVA indicated significant differences between the three groups of sentences regarding health-related quality of life of the writer (p= 0.04). The results of the Scheffé test confirmed asignificant difference between sentences with apositive and negative tone and the health-related quality of life where people who wrote asentence with anegative tone showed alower health-related quality of life (p= 0.043). No significant association was revealed regarding depressive symptoms (p= 0.97). It remains to be investigated in future studies whether the emotional tone is areliable indicator of health-related quality of life and depressive symptoms of people with dementia, so that the written MMSE sentence can be used for diagnostic purposes.