Accuracy of MMSE in general practice

August 2017

General Practitioners

Country of origin: Italy

The Mini-Mental State Examination (MMSE) has contributed to detecting cognitive impairment, yet few studies have evaluated its accuracy when used by general practitioners in an actual public-health setting.

Researchers evaluated the accuracy of MMSE scores obtained by GPs by comparing them to scores obtained by Alzheimer's Evaluation Units (UVA).

The study was observational in design and involved 59 voluntary GPs who, after having undergone training, administered the MMSE to patients with symptoms of cognitive disturbances. Individuals who scored ¡Ü 24 (adjusted by age and educational level) were referred to Alzheimer's Evaluation Units (UVA) for diagnosis (including the MMSE). UVAs were unblinded to the MMSE score of the GP. To measure interrater agreement, the weighted Kappa statistic was calculated. To evaluate factors associated with the magnitude of the difference between paired scores, a linear regression model was applied. To quantify the accuracy in discriminating no cognitive impairment from any cognitive impairment and from Alzheimer's disease (AD), the ROC curves (AUC) were calculated.

For the 317 patients, the mean score obtained by GPs was significantly lower. However, overall concordance was good (Kappa = 0.86). Only the diagnosis made by the UVA was associated with the difference between paired scores: the adjusted mean difference was 3.1 for no cognitive impairment and 3.8 for mild cognitive impairment. The AUC of the scores for GPs was 0.80 for discriminating between no impairment and any impairment and 0.89 for distinguishing patients with AD, though the UVA scores discriminated better.

The research concludes that in a public-health setting involving patients with symptoms of cognitive disturbances, the MMSE used by the GPs was sufficiently accurate to detect patients with cognitive impairment, particularly those with dementia.

'The accuracy of the MMSE in detecting cognitive impairment when administered by general practitioners: A prospective observational study' is available online.

Resources

The Linus Pauling Institute February 2018 The Linus Pauling Institute at Oregon State University has a website intended to provide ?scientific information on health...
Endocrinology Advisor January 2018 Endocrinology Advisor is a free, simple to use, medical app that offers endocrinologists, diabetes educators and other...
Breast Cancer Survivor January 2018 Survivorship encompasses a range of lifestyle approaches to improve wellbeing and survival after a diagnosis of cancer....
Cancer Emergency Response Tool January 2018 The Cancer Emergency Response Tool (CERT) allows cancer patients to rapidly and effectively manage chemotherapy toxicity...
Rheumatology Advisor January 2018 Rheumatology Advisor is a free, simple to use, medical app designed to be the essential resource for rheumatology...
Clinical Advisor January 2018 Clinical Advisor is the first app created specifically for nurse practitioners and physician assistants, from the...
The Drugs & Bugs app January 2018 The Drugs & Bugs app by Monthly Prescribing Reference (MPR) is an essential resource for allied healthcare professionals,...
Laceration repair and digital blocks January 2018 This website was created and is managed by Dr. Brian Lin, a board certified Emergency Medicine physician who practices at...
inPractice® Oncology January 2018 inPractice® Oncology is the only point-of-care clinical reference designed to meet the unique needs of specialists. Full...
Managing Head Injury January 2018 The National Institute for Health and Clinical Excellence (NICE) has issued an updated guideline on the early care of...
Search by Keyword