Mini-Mental State Examination (Mmse) for the Detection of Dementia in Clinically Unevaluated People Aged 65 and over in Community and Primary Care Populations

Summary

A Cochrane review [Abstract] 1 included 48 studies. A meta-analysis was performed on 28 studies in the community setting (44 articles) and on 6 studies in primary care (8 articles). All of the studies in the community were in asymptomatic people, whereas 2 of the 6 studies in primary care were conducted in people who had symptoms of possible dementia. In the meta-analysis there were 12,110 participants in community studies and 1681 participants in primary care studies.The accuracy of the MMSE for diagnosing dementia was reported at 18 cut points in the community (MMSE score 10, 14-30 inclusive) and 10 cut points in primary care (MMSE score 17-26 inclusive). The total number of participants in studies included in the meta-analyses ranged from 37 to 2727, median 314 (interquartile range (IQR) 160 to 647). In the community, the pooled accuracy at a cut point of 24 (15 studies) was sensitivity 0.85 (95% CI 0.74 to 0.92), specificity 0.90 (95% CI 0.82 to 0.95); at a cut point of 25 (10 studies), sensitivity 0.87 (95% CI 0.78 to 0.93), specificity 0.82 (95% CI 0.65 to 0.92); and in 7 studies that adjusted accuracy estimates for level of education, sensitivity 0.97 (95% CI 0.83 to 1.00), specificity 0.70 (95% CI 0.50 to 0.85). There was insufficient data to evaluate the accuracy of the MMSE for diagnosing dementia subtypes.