Measurement Equivalence between the Original and Estimated Mini-Mental State Examination in People with Dementia

Abstract

Background: The Cognitive Abilities Screening Instrument (CASI) is increasingly used to assess general cognitive function in people with dementia. The Mini-Mental State Examination (MMSE) score can be converted from the CASI (i.e., the estimated MMSE). Recognizing that measurement equivalence is critical to meaningfully representing one with the other, we aimed to determine whether the estimated MMSE score obtained from the CASI was equivalent to the original MMSE in people with dementia. Methods: We obtained 110 data points for the MMSE and CASI scores in people with dementia. The intraclass correlation coefficient (ICC), Pearson’s r, percent of standard error of measurement (SEM%), paired t-test, and effect size (Cohen’s d) were used to investigate the equivalence. Results: To examine the equivalence between the original and estimated MMSE score, the ICC and Pearson’s r of the total score and six domains were 0.62–0.95 and 0.62–0.96, respectively. The SEM% of the total score and six domains were 0.6–8.9%. The paired t-test results showed a significant difference (p < 0.05) between the total score and the three domains. The Cohen’s d of the total score and six domains were 0.06–0.27. Conclusions: The estimated MMSE score was found to have moderate to excellent equivalence to the original MMSE score. The three domains (i.e., registration, attention and calculation, and visual-constructional ability) with moderate equivalence should be used cautiously to interchange with the original MMSE in people with dementia.

Association of multiple metabolic and cardiovascular markers with the risk of cognitive decline and mortality in adults with Alzheimer’s disease and AD-related dementia or cognitive decline: a prospective cohort study

“…The CASI was designed based on symptoms diagnosed as dementia and three cognitive screening tools, such as the Mini-Mental State Examination, the Modified Mini-Mental State Test, and the Hasegawa Dementia Screening Scale. The CASI offers two significant advantages: first, it evaluates overall cognitive function with nine dimensions, providing comprehensive cognitive portraits and second, it demonstrates cross-cultural application in measuring global cognitive function and the risk of dementia ( Teng et al, 1994 ; Fitzpatrick et al, 2015 ; Chiu et al, 2021 ). In brief, the CASI includes 25 items representing 9 cognitive domains: attention, concentration, orientation, language, verbal fluency, visual construction, abstraction/judgment, and short- and long-term memory.…”

A 12-Year Comparison of Alzheimer’s Dementia Patients With Their Informants in Taiwan

“…The Mini-Mental State Examination (MMSE) score used in the present study was converted from the CASI, which has been reported to have a moderate to excellent equivalence with the original MMSE score. 12 Diagnosis of AD was based on the NINCDS-ADRDA criteria. 13 Patients with other conditions that may have contributed to the diagnosis of dementia were excluded.…”

Imaging Markers of Subcortical Vascular Dementia in Patients With Multiple-Lobar Cerebral Microbleeds

“…The Charlson comorbidity index (CCI), which contains 19 weighted comorbidities, was also gathered to determine the overall systemic health of each individual ( 21 ). Cognitive performance in the subjects with cognitive decline was assessed by neuropsychologists using 12-item word recall test (total correct trials 1–3, and 15-min delayed free recall) ( 22 , 23 ), estimated Mini-Mental State Examination (MMSE) converted from Cognitive Abilities Screening Instrument ( 24 , 25 ), Montreal Cognitive Assessment (MoCA) ( 26 ), and Clinical Dementia Rating scale ( 27 ). Cognitive performance was documented as well as the contents of diagnostic workups, dementia disorder type, pharmacological and non-pharmacological treatments, and support for the patient from the county.…”