COMMENTARY

The Value of the Mini-Mental State Exam

Peter M. Yellowlees, MBBS, MD

Disclosures

May 22, 2015

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This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

The Mini-Mental State Examination (MMSE) is the best-known and most often used short screening tool for providing an overall measure of cognitive impairment in clinical, research, and community settings.

We know that some people with mild cognitive impairment (MCI) progress to dementia while others remain stable or recover full function. We have not had good tools for predicting the onset of dementia in people with MCI. Now a team of investigators from Bogota, Colombia, have performed a Cochrane Review[1] to determine the diagnostic accuracy of the MMSE at various thresholds for detecting individuals with baseline MCI who might convert to dementia.

The review included 1569 MCI patients from 11 heterogeneous studies.[1] For predicting conversion from MCI to dementia in general, the accuracy of baseline MMSE scores ranged from sensitivities of 23% to 76% and specificities from 40% to 94%.

The authors concluded that there was no evidence supporting a substantial role of the MMSE as a stand-alone, single-administration test for identifying MCI patients who could develop dementia.

The Cochrane review supports the current clinical opinion that the MMSE, by itself, is not a good indicator of likely future dementia and that a more comprehensive battery of cognitive tests is required for this task.

I'm Dr Peter Yellowlees. Please leave your comments below.

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