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Dement Geriatr Cogn Disord. 2009;27(1):50-8. doi: 10.1159/000189267. Epub 2009 Jan 8.

Does a reliable decline in Mini Mental State Examination total score predict dementia? Diagnostic accuracy of two reliable change indices.

Author information

1
Department of Psychiatry, Public Health, University of Leipzig, Leipzig, Germany.

Abstract

BACKGROUND/AIM:

Norms for change in Mini Mental State Examination (MMSE) total score suggest that only a decline of at least 2-4 points indicates a reliable change. However, it is unknown whether change norms (Reliable Change Indices, RCIs) of the MMSE total score are suitable to predict future dementia.

METHODS:

554 elderly individuals aged 75 and over without dementia at the first 2 visits were tested with the MMSE at a maximum of 6 visits with 1.5-year intervals. Two different RCIs for change in MMSE score (first to second visit) were computed - one RCI which corrects for practice and one RCI which corrects for regression to the mean. The main outcome measure was the diagnosis of dementia.

RESULTS:

During the study, 88 persons developed dementia. RCIs were significantly associated with future dementia diagnosis. The best cutoff for raw change in MMSE total score to predict dementia was -1 point (sensitivity = 48%, specificity = 67%, relative risk = 1.6). With the RCI + regression to the mean, the diagnostic accuracy was moderate (sensitivity = 61%, specificity = 72%, relative risk = 3.2).

CONCLUSION:

A change in MMSE total score is significantly associated with future dementia, but the diagnostic accuracy for dementia prediction is rather low.

PMID:
19129701
DOI:
10.1159/000189267
[Indexed for MEDLINE]

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