A Guide to the Standardized Mini-Mental State Examination

1997 ◽  
Vol 9 (S1) ◽  
pp. 87-94 ◽  
Author(s):  
D. William Molloy ◽  
Timothy I. M. Standish
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mental State ◽  
Screening Test ◽  
Mini Mental State Examination ◽  
Intraclass Correlation ◽  
Intrarater Reliability ◽  
Near Misses ◽  
Time Limits ◽  
State Examination

The Mini-Mental State Examination (MMSE) is a widely used screening test for cognitive impairment in older adults. Because the guidelines for its application are brief, the administration and scoring of the test can vary between different individuals. This can diminish its reliability. Furthermore, some of the items must be changed to accommodate different settings, such as the clinic, home, or hospital. Because there are no time limits, it is not clear how long one should wait for a reply to a question. It is also not clear how one deals with answers that are “near misses.” The goal of the Standardized Mini-Mental State Examination (SMMSE) was to impose strict guidelines for administration and scoring to improve the reliability of the instrument. The reliability of the MMSE was compared with the reliability of the SMMSE in 48 older adults who had the tests administered by university students on three different occasions to assess the interrater and intrarater reliability of the tests. The SMMSE had significantly better interrater and intrarater reliability compared with the MMSE: The interrater variance was reduced by 76% and the intrarater variance was reduced by 86%. It took less time to administer the SMMSE compared with the MMSE (average 10.5 minutes and 13.4 minutes, respectively). The intraclass correlation for the MMSE was .69, and .9 for the SMMSE. Administering and scoring the SMMSE on a task-by-task basis are discussed.

Comparison of the Mini-Mental State Examination and Computerized Brief Cognitive Screening Test as Cognitive Screening Tools in Patients with Mild Cognitive Impairment

2021 ◽  
Vol 18 ◽  
Author(s):  
Che-Sheng Chu ◽  
I-Chen Lee ◽  
Chuan-Cheng Hung ◽  
I-Ching Lee ◽  
Chi-Fa Hung ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Normal Control ◽  
Internal Consistency ◽  
Mental State ◽  
Screening Test ◽  
Mini Mental State Examination ◽  
Cognitive Screening ◽  
Validity And Reliability ◽  
State Examination

Background: The aim of this study was to establish the validity and reliability of the Computerized Brief Cognitive Screening Test (CBCog) for early detection of cognitive impairment. Method: One hundred and sixty participants, including community-dwelling and out-patient volunteers (both men and women) aged ≥ 65 years, were enrolled in the study. All participants were screened using the CBCog and Mini-Mental State Examination (MMSE). The internal consistency of the CBCog was analyzed using Cronbach’s α test. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of the CBCog in detecting mild cognitive impairment (MCI) in order to set an appropriate cutoff point. Results: The CBCog scores were positively correlated with the MMSE scores of patients with MCI-related dementia (r = 0.678, P < .001). The internal consistency of the CBCog (Cronbach’s α) was 0.706. It was found that the CBCog with a cutoff point of 19/20 had a sensitivity of 97.5% and a specificity of 53.7% for the diagnosis of MCI with education level ≥ 6 years. The AUC of the CBCog for discriminating the normal control elderly from patients with MCI (AUC = 0.827, P < 0.001) was larger than that of the MMSE for discriminating the normal control elderly from patients with MCI (AUC= 0.819, P < .001). Conclusion: The CBCog demonstrated to have sufficient validity and reliability to evaluate mild cognitive impairment, especially in highly educated elderly people.

Comparing the Mini-Mental State Examination and the modified Mini-Mental State Examination in the detection of mild cognitive impairment in older adults

2018 ◽  
Vol 31 (5) ◽  
pp. 693-701 ◽  
Author(s):  
Ryan Van Patten ◽  
Karysa Britton ◽  
Geoffrey Tremont
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mental State ◽  
Normative Data ◽  
Mini Mental State Examination ◽  
Area Under The Curve ◽  
Neuropsychological Evaluations ◽  
Composite Scores ◽  
State Examination

ABSTRACTObjectives:To show enhanced psychometric properties and clinical utility of the modified Mini-Mental State Examination (3MS) compared to the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI).Design:Psychometric and clinical comparison of the 3MS and MMSE.Setting:Neuropsychological clinic in the northeastern USA.Participants:Older adults referred for cognitive concerns, 87 of whom were cognitively intact (CI) and 206 of whom were diagnosed with MCI.Measurements:The MMSE, the 3MS, and comprehensive neuropsychological evaluations.Results:Both instruments were significant predictors of diagnostic outcome (CI or MCI), with comparable odds ratios, but the 3MS explained more variance and showed improved classification accuracies relative to the MMSE. The 3MS also demonstrated greater receiver operating characteristic area under the curve values (0.85, SE = 0.02) compared to the MMSE (0.74, SE = 0.03). Scoring lower than 95/100 on the 3MS suggested MCI, while scoring lower than 28/30 on the MMSE suggested MCI. Additionally, compared to the MMSE, the 3MS shared more variance with neuropsychological composite scores in Language and Memory domains but not in Attention, Visuospatial, and Executive domains. Finally, 65.5% MCI patients were classified as impaired (scoring ≤1 SD below the mean) using 3MS normative data, compared to only 11.7% of patients who were classified as impaired using MMSE normative data.Conclusions:Broadly speaking, our data strongly favor the widespread substitution of the MMSE with the 3MS in older adults with concerns for cognitive decline.

scholarly journals Helicobacter pylori, Vascular Risk Factors and Cognition in U.S. Older Adults

2019 ◽  
Vol 9 (12) ◽  
pp. 370 ◽  
Author(s):  
Cárdenas ◽  
Boller ◽  
Román
Keyword(s):  
Older Adults ◽  
Helicobacter Pylori ◽  
Risk Factor ◽  
Cognitive Impairment ◽  
Confidence Interval ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Helicobacter Pylori Infection ◽  
H Pylori ◽  
State Examination

Previous studies suggested that Helicobacter pylori infection could be a risk factor for stroke, dementia, and Alzheimer’s disease (AD). The authors examined data from participants, 60 years old and older in the Third National Health and Nutrition Examination Survey (NHANES-III) to assess the relation between Helicobacter pylori infection and results of the Mini-Mental State Examination (n = 1860) using logistic regression analysis controlling for age, gender, race/ethnicity, education, poverty and history of medically diagnosed diabetes. Moreover, we examined performance on the digit-symbol substitution test (DSST) of 1031 participants in the 1999–2000 NHANES according to their H. pylori infection status controlling for potential confounders using multiple linear regression analyses. In 1988–1991, older adults infected with CagA strains of H. pylori had a 50% borderline statistically significant increased level of cognitive impairment, as measured by low Mini-Mental State Examination (MMSE) scores (age–education adjusted prevalence ratio: 1.5; 95% confidence interval: 1.0, 2.0). In 1999–2000, older US adults infected with H. pylori scored 2.6 fewer points in the DSST than those uninfected (mean adjusted difference: −2.6; 95% confidence interval −5.1, −0.1). The authors concluded that H. pylori infection might be a risk factor for cognitive decline in the elderly. They also found that low cobalamin and elevated homocysteine were associated with cognitive impairment.

Beyond the Mini-Mental State Examination: The Use of Physical and Spatial Navigation Tests to Help to Screen for Mild Cognitive Impairment and Alzheimer’s Disease

2021 ◽  
pp. 1-10
Author(s):  
Jessica Plácido ◽  
José Vinicius Ferreira ◽  
Juliana Araújo ◽  
Felipe de Oliveira Silva ◽  
Renan Baltar Ferreira ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Spatial Navigation ◽  
Motor Test ◽  
State Examination

Background: Spatial navigation and dual-task (DT) performance may represent a low-cost approach to the identification of the cognitive decline in older adults and may support the clinical diagnosis of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Objective: To assess the accuracy of different types of motor tasks in differentiating older persons with MCI and AD from healthy peers. Methods: Older adults aged 60 years or over (n = 105; healthy = 39; MCI = 23; AD = 43) were evaluated by the floor maze test (FMT), the senior fitness test, and DT performance. Receiver operating characteristic curve (ROC) analysis was used to evaluate the accuracy of the tests. We also performed principal component analysis (PCA) and logistic regression analysis to explore the variance and possible associations of the variables within the sample. Results: FMT (AUC = 0.84, sensitivity = 75.7%, specificity = 76.1%, p <  0.001) and DT (AUC = 0.87, sensitivity = 80.4%, specificity = 86.9%, p <  0.001) showed the highest performance for distinguishing MCI from AD individuals. Moreover, FMT presented better sensitivity in distinguishing AD patients from their healthy peers (AUC = 0.93, sensitivity = 94%, specificity = 85.6%, p <  0.001) when compared to the Mini-Mental State Examination. PCA revealed that the motor test performance explains a total of 73.9% of the variance of the sample. Additionally, the results of the motor tests were not influenced by age and education. Conclusion: Spatial navigation tests showed better accuracy than usual cognitive screening tests in distinguishing patients with neurocognitive disorders.

Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI)

2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Ingrid Arevalo-Rodriguez ◽  
Nadja Smailagic ◽  
Marta Roqué-Figuls ◽  
Agustín Ciapponi ◽  
Erick Sanchez-Perez ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Early Detection ◽  
Mental State ◽  
Mini Mental State Examination ◽  
State Examination

scholarly journals Preoperative Cognitive Impairment as a Predictor of Postoperative Outcomes in Elderly Patients Undergoing Spinal Surgery for Degenerative Spinal Disease

2021 ◽  
Vol 10 (7) ◽  
pp. 1385
Author(s):  
Hyung Cheol Kim ◽  
Seong Bae An ◽  
Hyeongseok Jeon ◽  
Tae Woo Kim ◽  
Jae Keun Oh ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Operation Time ◽  
Cognitive Status ◽  
Blood Analysis ◽  
Spinal Disease ◽  
Degenerative Spinal Disease ◽  
State Examination

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.

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