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Comparing the Mini-Mental State Examination and the modified Mini-Mental State Examination in the detection of mild cognitive impairment in older adults

Published online by Cambridge University Press:  19 July 2018

Ryan Van Patten Open the ORCID record for Ryan Van Patten [Opens in a new window] ,
Karysa Britton  and
Geoffrey Tremont
Ryan Van Patten*
Affiliation:
Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA Neuropsychology Program, Rhode Island Hospital, Providence, Rhode Island, USA
Karysa Britton
Affiliation:
Neuropsychology Program, Rhode Island Hospital, Providence, Rhode Island, USA
Geoffrey Tremont
Affiliation:
Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA Neuropsychology Program, Rhode Island Hospital, Providence, Rhode Island, USA
*
Correspondence should be addressed to: Ryan Van Patten, Neuropsychology Program, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903. Phone: +540-649-4702; Fax: +401-444-6643. Email: ryan_van_patten@brown.edu.
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Abstract

Objectives:

To show enhanced psychometric properties and clinical utility of the modified Mini-Mental State Examination (3MS) compared to the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI).

Design:

Psychometric and clinical comparison of the 3MS and MMSE.

Setting:

Neuropsychological clinic in the northeastern USA.

Participants:

Older adults referred for cognitive concerns, 87 of whom were cognitively intact (CI) and 206 of whom were diagnosed with MCI.

Measurements:

The MMSE, the 3MS, and comprehensive neuropsychological evaluations.

Results:

Both instruments were significant predictors of diagnostic outcome (CI or MCI), with comparable odds ratios, but the 3MS explained more variance and showed improved classification accuracies relative to the MMSE. The 3MS also demonstrated greater receiver operating characteristic area under the curve values (0.85, SE = 0.02) compared to the MMSE (0.74, SE = 0.03). Scoring lower than 95/100 on the 3MS suggested MCI, while scoring lower than 28/30 on the MMSE suggested MCI. Additionally, compared to the MMSE, the 3MS shared more variance with neuropsychological composite scores in Language and Memory domains but not in Attention, Visuospatial, and Executive domains. Finally, 65.5% MCI patients were classified as impaired (scoring ≤1 SD below the mean) using 3MS normative data, compared to only 11.7% of patients who were classified as impaired using MMSE normative data.

Conclusions:

Broadly speaking, our data strongly favor the widespread substitution of the MMSE with the 3MS in older adults with concerns for cognitive decline.

Keywords

mild cognitive impairmentagingneuropsychological testingcognitive assessment
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 5: Issue Theme: Well-Being in Dementia , May 2019 , pp. 693 - 701
Copyright
© International Psychogeriatric Association 2018 

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