Mini-Mental State Examination (MMSE) and the Modified MMSE (3MS): A psychometric comparison and normative data.

Abstract

were compared psychometrically. In this study, 525 community-dwelling participants, aged 65-89, were divided into 2 groups: no cognitive impairment (NCI; n -406) and Alzheimer's disease (n = 119). Both tests yielded comparable reliability estimates. Fewer years of education decreased specificity and increased sensitivity, whereas increasing age primarily decreased specificity. It is concluded that although the 2 tests produce comparable effects, the inclusion of a verbal fluency test would increase the sensitivity of the MMSE. Normative data for the NCI group, stratified for 2 age levels (65-79 and 80-89) and 2 educational levels (0-8 and 9+ years), are presented. Folstein, Folstein, and McHugh (1975) introduced the Mini-Mental State Examination (MMSE) as a brief, objective assessment of cognitive functioning and as a measure of changes in cognitive status. The MMSE usually can be administered in 5-10 min and has been employed extensively in clinical settings, community surveys, and epidemiological studies. In a recent review of the literature, Tombaugh and Mclntyre (1992) concluded that the MMSE possessed moderate to high reliability coefficients, demonstrated high levels of sensitivity for cognitive deficits in patients suffering from moderate to severe Alzheimer's disease, and reflected the cognitive decline typical of dementia patients. Criticisms of the MMSE included (a) its failure to discriminate between people with mild dementia and those who are not demented, (b) a limited ability to detect impairment caused by focal lesions, particularly those in the right hemisphere, (c) overly simple language items that reduce sensitivity to mild linguistic deficits, and (d) a large number of false-positive errors because of its bias against individuals with low education. In response to these problems, several attempts have been made to improve the MMSE. Of these, the Modified Mini-Mental State Examination (3MS; Teng & Chui, 1987) represents the most extensive revision. Teng and Chui (1987) added four additional subtests (date and place of birth, word fluency, similarities, and delayed recall of words). The maximum score was

Apolipoprotein E ε4 and Later-Life Decline in Cognitive Function and Grip Strength

“…Following consideration of the broader literature (31,32), participants with MMSE scores ≤ 24 at any assessment were excluded to assess whether any effects of APOE on cognitive performance were attributable to possible dementia. Norms for the MMSE indicate sensitivity of 95% and specificity of 82% for detecting Alzheimer's Disease at this cut point in community-based individuals who are 80 years or older with nine or more years of education (most participants in the present study were in this category by the second wave) (33).…”

Validation and diagnostic accuracy of predictive curves for age-associated longitudinal cognitive decline in older adults

“…37,38 Nonetheless, it has gained international acceptance for use in research involving cognition and dementia. 11,15,18,31,33,[39][40][41][42][43] Moreover, using a test developed in 1975 is quite useful for tracking cognition over time, because most patients have completed one previously. Although data are based on Mini-Mental State Examination scores that were extracted from testing using the Modified Mini-Mental State Examination administered as part of the Canadian Study of Health and Aging, 22 formal psychometric com- 22 The data were collected 2 decades ago, but external validation on the National Alzheimer's Coordinating Center's Uniform Data Set, which started in 2005, yielded similar findings.…”

More Than the Epidemiology of Alzheimer's Disease: Contributions of the Canadian Study of Health and Aging

“…In seeking to characterize normal cognitive aging, the CSHA has contributed to the establishment of norms, reliability, and validity for several neuropsychological tests (44,45,(53)(54)(55)(56)(57)(58). Few studies have included such extensive neuropsychological testing of cognitively normal participants.…”