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 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

UK Physical Activity Guidelines September 2017 A UK-wide CMOs report presents new physical activity guidelines for all four UK home countries, covering early years;...
Improved Online Resources For Patient And Drug Information September 2017 GPnotebook.co.uk (an online clinical medical encyclopaedia) has teamed up with medical search engine SearchMedica.co.uk to...
Online tool aids diagnosis September 2017 ISABEL, an on-line tool helping GPs and nurses to make fast and accurate diagnoses of children's illnesses.

Jason...
UK Physical Activity Guidelines September 2017 A UK-wide CMOs report presents new physical activity guidelines for all four UK home countries, covering early years;...
Comprehensive Antibiotic Resistance Website September 2017 The CAN-R website is aimed at supporting and educating Canadian healthcare providers and researchers on the escalating...
Elsevier Journals September 2017 Elsevier is a leading publisher of health science books and journals, helping to advance medicine by delivering superior...
Leadership guide September 2017 The NHS Leadership Framework is now available and is applicable to everyone in health and care, no matter what their...
Web Service Allows Patients To See How Drugs Work September 2017 iGuard.org, a free, patient-driven on-line health care community, has launched an innovative new patient empowerment tool....
Bone curriculum August 2017 The American Society for Bone and Mineral Research site provides information, resources and course material regarding bone...
Global Healthcare Resource August 2017 The US Institute for Healthcare Improvement free site enables healthcare professionals to tap the expertise of their...
Search by Keyword