The Mini-Mental State Examination (MMSE): An Update on Its Diagnostic Validity for Cognitive Disorders View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2013

AUTHORS

Alex J. Mitchell

ABSTRACT

The Mini-Mental State Examination (MMSE) is the most commonly used brief cognitive tool in the assessment of a variety of cognitive disorders. The tool comprises a short battery of 20 individual tests covering 11 domains and totalling 30 points. Typical completion time is 8 min in cognitively unimpaired individuals rising to 15 min in those with dementia. Internal consistency appears to be moderate and test-retest reliability good. However, the main psychometric issue concerns the MMSE’s diagnostic validity against dementia, mild cognitive impairment, and delirium. This chapter updates previous meta-analytic summary analyses for the performance of the MMSE in specialist and nonspecialist settings. Summary sensitivity, specificity, positive, and negative predictive values are presented. Results suggest against dementia, mild cognitive impairment, and delirium it did not perform well as a confirmatory (case-finding) tool, but it did perform adequately in a rule-out (screening) capacity. In clinical practice, this means that a high score on the MMSE would lead to about a 10 % false negative rate, and further, a low (positive) score must be followed by more extensive neuropsychological or clinical evaluation. The MMSE is neither the most accurate nor more efficient tool with which to evaluate cognitive disorders, but it has provided a benchmark against which all newer tools can be measured. More... »

PAGES

15-46

Book

TITLE

Cognitive Screening Instruments

ISBN

978-1-4471-2451-1
978-1-4471-2452-8

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-1-4471-2452-8_2

DOI

http://dx.doi.org/10.1007/978-1-4471-2452-8_2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1020335115


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110 schema:description The Mini-Mental State Examination (MMSE) is the most commonly used brief cognitive tool in the assessment of a variety of cognitive disorders. The tool comprises a short battery of 20 individual tests covering 11 domains and totalling 30 points. Typical completion time is 8 min in cognitively unimpaired individuals rising to 15 min in those with dementia. Internal consistency appears to be moderate and test-retest reliability good. However, the main psychometric issue concerns the MMSE’s diagnostic validity against dementia, mild cognitive impairment, and delirium. This chapter updates previous meta-analytic summary analyses for the performance of the MMSE in specialist and nonspecialist settings. Summary sensitivity, specificity, positive, and negative predictive values are presented. Results suggest against dementia, mild cognitive impairment, and delirium it did not perform well as a confirmatory (case-finding) tool, but it did perform adequately in a rule-out (screening) capacity. In clinical practice, this means that a high score on the MMSE would lead to about a 10 % false negative rate, and further, a low (positive) score must be followed by more extensive neuropsychological or clinical evaluation. The MMSE is neither the most accurate nor more efficient tool with which to evaluate cognitive disorders, but it has provided a benchmark against which all newer tools can be measured.
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