Abstract
Objectives
This study assesses the properties of the Mini-Mental State Examination (MMSE) with
the purpose of improving the efficiencies of the methods of screening for cognitive
impairment and dementia. A specific purpose was to determine whether an abbreviated
version would be as accurate as the original MMSE in predicting dementia.
Study Design and Setting
A population-based post hoc examination of the performance characteristics of the
MMSE for detecting dementia in an existing data set of 243 elderly persons.
Results
Sensitivity, specificity, and predictive values were computed for the original MMSE
as well as new MMSE scale models derived from a Rasch model item analysis. The optimal
threshold for the original MMSE screen yielded sensitivity and specificity estimates
of 72.5% and 91.3%, respectively. The use of a subscale resulted in a slightly lower
sensitivity (71.0%), specificity (88.4%), and positive predictive value (71.0%) but
equal area under the receiver operating characteristic curve. Cross-validation on
follow-up data confirmed the results.
Conclusion
A short, valid MMSE, which is as sensitive and specific as the original MMSE for the
screening of cognitive impairments and dementia is attractive for research and clinical
practice, particularly if predictive power can be enhanced by combining the short
MMSE with neuropsychological tests or informant reports.
Keywords
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Article info
Publication history
Published online: August 14, 2006
Accepted:
June 26,
2006
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
