The use of the mini-mental state examination in recruitment for substance abuse research studies

Smith, Kristofer L.; Horton, Nicholas J.; Saitz, Richard; Samet, Jeffrey H.

doi:10.1016/j.drugalcdep.2005.09.012

Cited by 49 publications

(41 citation statements)

References 34 publications

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“…Additionally, our sample includes not only elderly participants but also adults aged 25 and older. Due to the extensive use of the MMSE in several clinical populations [e.g., traumatic brain injury (de Guise, et al, 2011), cancer (Meyers & Wefel, 2003), substance abuse (Smith, Horton, Saitz, & Samet, 2006)], we decided to include participants aged 25 years and older in order to allow the use of this instrument with younger subjects with other diseases beyond the dementia spectrum. Therefore, our main objective was to conduct a normative study of the MMSE in the Portuguese population, based on a stratified and greater sample size that was determined by a range of socio demographic variables representative of the target population, so as to ensure a more precise use of the instrument in this country.…”

Section: Introductionmentioning

confidence: 99%

The Relevance of Sociodemographic and Health Variables on MMSE Normative Data

Freitas

Simões

Alves

et al. 2014

Applied Neuropsychology: Adult

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The Mini-Mental State Examination (MMSE) is the most broadly used cognitive screening instrument in clinical and research contexts. The MMSE was administered to a community-based sample of cognitively healthy adults (n=850), stratified according to several sociodemographic variables, with a distribution similar to that observed in the Portuguese population. This study aimed to analyse the influence of sociodemographic (age, gender, educational level, marital and employment status, geographic region, geographic localisation, and residence area) and health variables (subjective memory complaints of the participant and evaluated by the informant, depressive symptoms and family history of dementia) on the subjects' performance on the MMSE and to establish normative data for the Portuguese population. Educational level and age significantly contributed to the prediction of the MMSE scores, explaining 26% of its variance.Regarding health variables, only the subjective memory complaints of the participant showed a small contribution (4%) to the variance of the MMSE scores. According to these results, age and education were considered in the development of the normative data of the MMSE for the Portuguese population.

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Section: Introductionmentioning

confidence: 99%

The Relevance of Sociodemographic and Health Variables on MMSE Normative Data

Freitas

Simões

Alves

et al. 2014

Applied Neuropsychology: Adult

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“…Only 3.5% of the analyzed sample qualified for cognitive impairment when considering a MMSE cutoff score ≤ 23, in contrast with prevalences ranging from 8.7% to 19.1% reported for ampler samples (Saitz et al, 2007;Williams et al, 2010). When considering a score ≤ 20 (which has been advocated as more suitable for samples with low degree of education [Smith et al, 2006]), this prevalence decreased to less than 1%. This suggests that education degree, and not any substance-induced brain impairment, most likely conditioned participants' exclusion from research due to "cognitive impairment".…”

Section: Discussionmentioning

confidence: 64%

“…Inconsistent findings about the MMSE score's ability to predict completion of follow-up (Smith et al, 2006), values of good specificity/poor sensitivity to determine decision-making capacity in elderlies (Pachet, Astner, & Brown, 2010), and moderate associations with some proposed measures of capacity to consent in non-substance users (Palmer & Savla, 2007), might justify to an extent the use of MMSE in eligibility procedures. Nonetheless, effects of SUD upon MMSE score have not been sufficiently reported as to conclude its pertinence for eligibility screening in this context, let alone its validity to assess impact on actual abilities needed to provide meaningful consent or accurate information.…”

Section: Introductionmentioning

confidence: 99%

“…Impairments of cognitive abilities such as working memory, decision-making, and self-awareness are often reported within studies on SUD (Goldstein & Volkow, 2011;Verdejo-García & Pérez-García, 2008;Yücel, Lubman, Solowij, & Brewer, 2007) and some psychiatric disorders (Bearden & Freimer, 2006;Robbins, Gillan, Smith, de Wi, & Ersche, 2012). This is an ethical and methodological concern in research settings, as cognitively-impaired potential research participants may have difficulties providing meaningful informed consent or accurate information (Smith, Horton, Saitz, & Samet, 2006), which in turn could have important implications, like denial of benefits of participation due to exclusion (Carter & Hall, 2008), or inaccurate data (Smith et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…The MMSE has been recommended as a cognitive screening tool in research eligibility procedures (Smith et al, 2006). Recent clinical trials (Saitz et al, 2013;Saitz et al, 2007), cohort (Williams et al, 2007), and cross-sectional (Conner et al, 2012) studies on SUD have used the MMSE to screen for participants with sufficient capacity to consent -sometimes complemented with interviewer's judgement-, often resulting in exclusion of a considerable number of participants (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Is the Mini-Mental State Examination (MMSE) useful for eligibility screening of research participants with substance use disorder?

Toledo-Fernández¹,

Villalobos-Gallegos²,

Marín-Navarrete³

2016

RIIAD

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RESUMENIntroducción: el Mini Examen del Estado Mental (MMSE) está recomendado para tamizaje de elegibilidad de potenciales participantes con diagnóstico de trastorno por uso de sustancias (TUS) en protocolos de investigación, debido a que las habilidades necesarias para proveer consentimiento informado válido o información precisa pueden estar deterioradas por el abuso crónico de sustancias y la presencia de algunos trastornos psiquiátricos. Hay poco conocimiento sobre la utilidad del MMSE para evaluar la alteración de estas habilidades o cuando menos sobre su capacidad de registrar efecto de TUS sobre su resultado principal. Esto tiene importantes implicaciones éticas y metodológicas. Objetivo: analizar los efectos del TUS, las principales sustancias de abuso, la edad de inicio de consumo, el consumo reciente y la comorbilidad psiquiá-trica sobre el MMSE. El propósito final fue evaluar la utilidad del MMSE en el tamizaje de potenciales participantes de investigación. Método: los participantes fueron reclutados en centros de tratamiento para consumo de sustancias. Se administró cuestionario demográfico, MMSE y Mini Entrevista Neuropsiquiátrica Internacional. Resultados: se analizaron 601 casos para objetivo principal. Controlando grado de educación, no se encontraron efectos de edad de inicio de consumo ni de consumo reciente de sustancias específicas sobre puntaje del MMSE, según regresión lineal. Tampoco se hallaron diferencias en desempeño en MMSE con relación a las sustancias principales de abuso (F=1.25 [4,529], p=.28) ni al comparar TUS con y sin comorbilidad psiquiátrica (F=.58 [1,597], p=.44). Discusión y conclusiones: si de hecho existe deterioro cognitivo en esta población clínica, éste no es evaluado de forma pertinente por el MMSE. Esto arroja dudas sobre su utilidad en el tamizaje de elegibilidad.Palabras clave: alteraciones cognitivas, comorbilidad, problemas éticos, procedimientos, reclutamiento de sujetos de investigación, trastorno por uso de sustancias. SUMMARYIntroduction: the MMSE is used for eligibility screening of potential research participants diagnosed with substance use disorder (SUD), as abilities needed to provide a valid informed consent or accurate information could be impaired in these clinical populations. Knowledge about the capacity of the MMSE to detect impairment in these abilities or at least to assess impact of SUD on its total score, however, is rather diffuse. This has important ethical and methodological implications. Objective: to analyze effects of SUD only, main substances of abuse, age of onset of substance use, recent substance use, and psychiatric comorbidity upon MMSE outcome. The overall purpose of the study was to assess the utility of the MMSE for eligibility screening of potential research participants with SUD. Method: individuals were recruited from residential facilities for substance use treatment. A demographic questionnaire, MMSE and Mini International Neuropsychiatric Interview were used. Results: A total of 601 participants were gathered for main analy...

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Chronic Care Management for Dependence on Alcohol and Other Drugs

Saitz

Cheng

Winter

et al. 2013

JAMA

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117

125

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IMPORTANCE People with substance dependence have health consequences, high health care utilization, and frequent comorbidity but often receive poor-quality care. Chronic care management (CCM) has been proposed as an approach to improve care and outcomes.OBJECTIVE To determine whether CCM for alcohol and other drug dependence improves substance use outcomes compared with usual primary care. DESIGN, SETTING, AND PARTICIPANTSThe AHEAD study, a randomized trial conducted among 563 people with alcohol and other drug dependence at a Boston, Massachusetts, hospital-based primary care practice. Participants were recruited from September 2006 to September 2008 from a freestanding residential detoxification unit and referrals from an urban teaching hospital and advertisements; 95% completed 12-month follow-up.INTERVENTIONS Participants were randomized to receive CCM (n=282) or no CCM (n=281). Chronic care management included longitudinal care coordinated with a primary care clinician; motivational enhancement therapy; relapse prevention counseling; and on-site medical, addiction, and psychiatric treatment, social work assistance, and referrals (including mutual help). The no CCM (control) group received a primary care appointment and a list of treatment resources including a telephone number to arrange counseling. MAIN OUTCOMES AND MEASURESThe primary outcome was self-reported abstinence from opioids, stimulants, or heavy drinking. Biomarkers were secondary outcomes. RESULTSThere was no significant difference in abstinence from opioids, stimulants, or heavy drinking between the CCM (44%) and control (42%) groups (adjusted odds ratio, 0.84; 95% CI, 0.65-1.10; P=.21). No significant differences were found for secondary outcomes of addiction severity, health-related quality of life, or drug problems. No subgroup effects were found except among those with alcohol dependence, in whom CCM was associated with fewer alcohol problems (mean score, 10 vs 13; incidence rate ratio, 0.85; 95% CI, 0.72-1.00; P=.048).CONCLUSIONS AND RELEVANCE Among persons with alcohol and other drug dependence, CCM compared with a primary care appointment but no CCM did not increase self-reported abstinence over 12 months. Whether more intensive or longer-duration CCM is effective requires further investigation.

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The use of the mini-mental state examination in recruitment for substance abuse research studies

Cited by 49 publications

References 34 publications

The Relevance of Sociodemographic and Health Variables on MMSE Normative Data

The Relevance of Sociodemographic and Health Variables on MMSE Normative Data

Is the Mini-Mental State Examination (MMSE) useful for eligibility screening of research participants with substance use disorder?

Chronic Care Management for Dependence on Alcohol and Other Drugs

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