The Mini-Mental State Examination in the Early Diagnosis of Alzheimer's Disease

TLDR

The Mini‑Mental State Examination (MMSE) is a brief cognitive test widely used to screen for dementia. The study aimed to compare MMSE item scores between Alzheimer’s disease patients and controls and to develop a shorter MMSE that preserves diagnostic accuracy. Researchers administered the MMSE to 74 probable AD patients and 74 matched controls, then applied logistic regression to identify a concise set of items that maintained performance of the full test. The abbreviated MMSE, comprising recall, orientation to place, and verbal fluency items, achieved sensitivity comparable to the full test and lowered diagnostic error for patients scoring in the nondemented range.

Abstract

• The Mini-Mental State Examination (MMSE), a brief test of cognitive function, has been widely used to screen for dementia. We administered the MMSE to 74 community-dwelling patients meeting criteria for probable Alzheimer's disease (AD) and 74 age- and education-matched controls. Twenty-four patients with AD performed in the nondemented range by scoring above the recommended cutoff point of 23 of a possible 30 on the MMSE. We compared the scores for items of the MMSE in controls and subjects with AD and used logistic regression to model a shorter MMSE that retained the accuracy of the complete test. A score summing tests of recall and orientation for place had similar sensitivity to the full MMSE. Adding a verbal fluency test to the MMSE reduced the error rate by improving the accuracy of diagnosis of patients with AD scoring in the nondemented range.