A Meta-Analysis of the Accuracy of the Mini-Mental State Examination in the Detection of Dementia and Mild Cognitive Impairment
Journal of Psychiatric Research
Mitchell, A. J. (2009).
Journal of Psychiatric Research, 43(4), 411-431.
This meta-analysis investigates the accuracy of the Mini-Mental State Examination (MMSE) for the detection of dementia and mild cognitive impairment (MCI). While SLPs do not diagnose dementia or MCI, the findings may be helpful when conducting cognitive assessments or considering referral for dementia workup.
No funding received
Through April 2008
Not further specified
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The following findings were noted regarding the accuracy of the MMSE in differentiating dementia from MCI in non-specialist settings: sensitivity= 88.7%, specificity= 45.8%, positive predictive value (PPV)= 64.7%, negative predictive value (NPV)= 87.4%.
There was limited evidence to support the use of MMSE to diagnose suspected MCI. The following accuracy was noted for the MMSE in diagnosing MCI:<br />
<ul>
<li><span style="color: #333333;">within specialist settings: sensitivity= 62.7%, specificity= 63.3%, positive predictive value (PPV)= 37.0%, negative predictive value (NPV)= 83.2%. </span></li>
<li><span style="color: #333333;">within non-specialist settings: sensitivity= 88.7%, specificity= 45.8%, positive predictive value (PPV)= 64.7%, negative predictive value (NPV)= 87.4%</span></li>
</ul>
Findings demonstrated the following regarding the accuracy of the MMSE for ruling out a diagnosis of dementia in various settings:<br />
<ul>
<li><strong>memory clinic settings</strong>: sensitivity: 79.8%, specificity= 81.3%, positive predictive value (PPV)= 86.3%, negative predictive value (NPV)= 73.0%;</li>
<li><strong>mixed specialist hospital settings</strong>: sensitivity= 71.1%, specificity= 95.6%, positive predictive value (PPV)= 94.2%, negative predictive value (NPV)= 76.4%;</li>
<li><strong>non-clinical community settings</strong>: sensitivity= 85.1%, specificity= 85.5%, positive predictive value (PPV)= 34.5%, negative predictive value (NPV)= 95.8%; and</li>
<li><strong>primary care settings</strong>: sensitivity= 78.4%, specificity= 87.8%, positive predictive value (PPV)= 53.6%, negative predictive value (NPV)= 95.7%</li>
</ul>
