Detecting Dementia with the Mini-Mental State Examination (MMSE) in Highly Educated Individuals
By S. O'Bryant, J. Humphreys, Glenn E. Smith, R. Ivnik, N. Graff-Radford, Ronald C. Petersen, J. Lucas. Archives of Neurology, 2008
699 citations recorded by the source corpus.
Objectives To evaluate the utility of Mini-Mental State Examination (MMSE) scores in detecting cognitive dysfunction in a sample of highly educated individuals. Design Archival data were reviewed on 4248 participants enrolled in the Mayo Clinic Alzheimer's Disease Research Center (ADRC) and Alzheimer's Disease Patient Registry (ADPR). Patients 1141 primarily Caucasian (93%) individuals with 16 or more years of self-reported education were identified. These included 307 (164 males and 143 females) dementia cases (any type), 176 patients with Mild Cognitive Impairment (106 males and 70 females), and 658 nondemented controls (242 males and 416 females). Setting Mayo Clinic ADRC and ADPR cohort. Main Outcome Measures Diagnostic accuracy estimates (sensitivity, specificity, positive and negative predictive power) of MMSE cut-scores in detecting cognitive dysfunction. Results In this sample of highly educated, largely Caucasian older adults, the standard MMSE cut-score of 24 (23 or below) yielded a sensitivity of .66, specificity of .99 and an overall correct classification rate of 89% in detecting dementia. A cut score to 27 (26 or below) resulted in an optimal balance of sensitivity and specificity (.89 and .91, respectively) with an overall correct classification rate of 90%. In a cognitively impaired group (dementia and MCI), a cut-score of 27 (sensitivity = .69, specificity = .91) or 28 (sensitivity and specificity = .78) might be more appropriate. Conclusion Elderly patients with college education who present with complaints of cognitive decline (self- or other-report) and score below 27 on the MMSE are at greater risk of being diagnosed with dementia and should be referred for a comprehensive dementia evaluation, including formal neuropsychological testing.
Subfields: Epidemiology, Physiology, Psychiatry and Mental health
View Paper: https://www.semanticscholar.org/paper/4a253cd732bda5320c593f56044c06ba255ea88f
How researchers see this paper
The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.
Citations in the corpus
- Multi-cause causal inference with unmeasured confounding and binary outcome. (2019, methodology): “The outcome is an indicator that the Mini Mental State Examination score is smaller than 24, a measure of cognitive decline that has been commonly used in diagnosis of Alzheimer’s disease (O’Bryant et al., 2008).”