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The Mini-Mental State Examination (MMSE): Update on Its Diagnostic Accuracy and Clinical Utility for Cognitive Disorders

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Cognitive Screening Instruments

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 non-specialist settings. Summary sensitivity, specificity, positive and negative predictive values are presented. Results suggest that MMSE does not perform well as a confirmatory (case-finding) tool for dementia, mild cognitive impairment, and delirium but it does perform adequately in a rule-out (screening) capacity. For those scoring below threshold (positive) on MMSE, a more extensive neuropsychological and clinical evaluation should be pursued. The MMSE is neither the most accurate nor most 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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Authors and Affiliations

  1. Department of Psycho-oncology, Leicestershire Partnership Trust and Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK

    Alex J. Mitchell

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  1. Alex J. Mitchell
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Correspondence to Alex J. Mitchell .

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Editors and Affiliations

  1. Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Liverpool, UK

    A. J. Larner

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Mitchell, A.J. (2017). The Mini-Mental State Examination (MMSE): Update on Its Diagnostic Accuracy and Clinical Utility for Cognitive Disorders. In: Larner, A.J. (eds) Cognitive Screening Instruments. Springer, Cham. https://doi.org/10.1007/978-3-319-44775-9_3

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  • DOI: https://doi.org/10.1007/978-3-319-44775-9_3

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44774-2

  • Online ISBN: 978-3-319-44775-9

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