scholarly journals Mini-Mental State Examination: Avaliação dos Novos Dados Normativos no Rastreio e Diagnóstico do Défice Cognitivo

2016 ◽  
Vol 29 (4) ◽  
pp. 240 ◽  
Author(s):  
Isabel Santana ◽  
Diana Duro ◽  
Raquel Lemos ◽  
Vanessa Costa ◽  
Miguel Pereira ◽  
...  

<p><strong>Introduction:</strong> The Mini-Mental State Examination is the most commonly used cognitive screening test. In Portugal, the cut-off scores are defined according to literacy groups, but different proposals have been recommended by more representative studies. We therefore propose to confirm the influence of demographical variables, such as age and education, in the subject’s performance; evaluating the discriminant ability of the new normative data; and to further examine the diagnostic acuity of the validated cut-off scoring for mild cognitive impairment and for the most prevalent types of dementia.<br /><strong>Material and Methods:</strong> Our study includes 1 441 educated subjects, divided into seven subgroups: Mild cognitive impairment, Alzheimer’s disease, frontotemporal dementia, vascular dementia, dementia with Lewy bodies, community-controls and memory clinic-controls.<br /><strong>Results:</strong> Altogether age and education explain 10.4% of the Mini-Mental State Examination results variance, with both variables contributing significantly to the results’ prediction. The diagnostic acuity based on the most recent normative data was always higher than the one obtained through the validation cut-off scoring, revealing an overall excellent specificity (superior to 90%) and different sensitivity values: excellent for mild Alzheimer’s disease (91%), good for dementia with Lewy Bodies (78%) and low for mild cognitive impairment (65%), frontotemporal dementia and vascular dementia (55%).<br /><strong>Discussion and Conclusions:</strong> The performance on the Mini-Mental State Examination is influenced by age and education, supporting the use of normative data that consider those variables. With this approach, the Mini-Mental State Examination could be a sensitive and specific instrument for the Alzheimer’s disease screening among all healthcare levels. Nevertheless, its diagnostic acuity is limited in other conditions frequently seen in memory clinics, such as Mild Cognitive Impairment and other types of dementia.</p>

2018 ◽  
Vol 31 (04) ◽  
pp. 491-504 ◽  
Author(s):  
Tiago C. C. Pinto ◽  
Leonardo Machado ◽  
Tatiana M. Bulgacov ◽  
Antônio L. Rodrigues-Júnior ◽  
Maria L. G. Costa ◽  
...  

ABSTRACTObjective:To compare the accuracy of Mini-Mental State Examination (MMSE) and of the Montreal Cognitive Assessment (MoCA) in tracking mild cognitive impairment (MCI) and Alzheimer’s Disease (AD).Method:A Systematic review of the PubMed, Bireme, Science Direct, Cochrane Library, and PsycInfo databases was conducted. Using inclusion and exclusion criteria and staring with 1,629 articles, 34 articles were selected. The quality of the selected research was evaluated through the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2).Result:More than 80% of the articles showed MoCA to be superior to MMSE in discriminating between individuals with mild cognitive impairment and no cognitive impairment. The area under the curve varied from 0.71 to 0.99 for MoCA, and 0.43 to 0.94 for MMSE, when evaluating the ability to discriminate MCI in the cognitively healthy elderly individuals, and 0.87 to 0.99 and 0.67 to 0.99, respectively, when evaluating the detection of AD. The AUC mean value for MoCA was significantly larger compared to the MMSE in discriminating MCI from control [0.883 (CI 95% 0.855-0.912) vs MMSE 0.780 (CI 95% 0.740-0.820) p &lt; 0.001].Conclusion:The screening tool MoCA is superior to MMSE in the identification of MCI, and both tests were found to be accurate in the detection of AD.


2015 ◽  
Vol 21 (6) ◽  
pp. 362-362 ◽  
Author(s):  
Ingrid Arevalo-Rodriguez ◽  
Nadja Smailagic ◽  
Marta Roqué i Figuls ◽  
Agustín Ciapponi ◽  
Erick Sanchez-Perez ◽  
...  

2016 ◽  
Vol 42 (1-2) ◽  
pp. 50-57 ◽  
Author(s):  
Ales Bartos ◽  
Miloslava Raisova

Background: There is a lack of normative studies of the Mini-Mental State Examination (MMSE) for comparison with early Alzheimer's disease (AD) according to new diagnostic criteria. Participants and Methods: We administered the MMSE to normal elderly Czechs and to patients with mild cognitive impairment (MCI) and mild dementia due to AD according to NIA-AA criteria. Results: We established percentile- and standard deviation-based norms for the MMSE from 650 normal seniors (age 69 ± 8 years, education 14 ± 3 years, MMSE score 28 ± 2 points) stratified by education and age. Dementia patients scored significantly lower than the MCI patients and both groups (110 early AD patients) had significantly lower MMSE scores than the normal seniors (22 ± 5 or 25 ± 3 vs. 28 ± 2 points) (p < 0.01). The optimal cutoff was ≤27 points with sensitivity of 86% and specificity of 79% for early detection of AD patients. Conclusion: We provided MMSE norms, several cutoffs, and higher cutoff scores for early AD using recent guidelines.


2013 ◽  
Vol 25 (11) ◽  
pp. 1839-1848 ◽  
Author(s):  
Carol Sheei-Meei Wang ◽  
Ming-Chyi Pai ◽  
Pai-Lien Chen ◽  
Nien-Tsen Hou ◽  
Pei-Fang Chien ◽  
...  

ABSTRACTBackground:The aim of this study was to examine and test the sensitivity, specificity, and threshold scores of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) and determine those that best correspond to a clinical diagnosis of dementia with Lewy bodies (DLB).Methods:Sixty-seven Alzheimer's disease (AD), 36 DLB, and 62 healthy participants without dementia (NC), aged 60 to 90, were enrolled. All three groups took the MoCA and MMSE tests at the same time. The Cochran–Mantel–Haenszel tests and receiver operating characteristics curve analysis were used to compare the different neuropsychological test results among the groups.Results:The cut-off point of the MoCA for AD was 21/22 with a sensitivity of 95.5% and a specificity of 82.3% (area under the curve (AUC): 0.945), and the cut-off point for DLB was 22/23 with a sensitivity of 91.7% and a specificity of 80.6% (AUC: 0.932). For the MMSE, the cut-off points for AD and for DLB from NC were all 24/25, with a sensitivity of 88.1% and a specificity of 85.5% for AD (AUC: 0.92), and a sensitivity of 77.8% and a specificity of 85.5% for DLB (AUC: 0.895). After controlling sex, age, and education, AD and DLB had lower scores in all MoCA subscales than the NC group (p < 0.05), except for the orientation and naming in DLB. In addition, AD had a lower score in the MoCA orientation (p = 0.03) and short-term memory (p = 0.02) than did DLB.Conclusions:The MoCA is a more sensitive instrument than the MMSE to screen AD or DLB patients from non-dementia cases.


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