Document Detail

Sensitivity and specificity of the mini-mental state examination for identifying dementia in the oldest-old: the 90+ study.
MedLine Citation:
PMID:  17302668     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate the sensitivity and specificity of the Mini-Mental State Examination (MMSE) in identifying dementia in the oldest-old when stratified by age and education.
DESIGN: Cross-sectional.
SETTING: Research clinic and in-home visits.
PARTICIPANTS: Population-based sample of adults aged 90 and older (n=435) who are enrolled in the 90+ Study, a longitudinal, population-based study.
MEASUREMENTS: Neurological examination to determine dementia diagnosis, MMSE, and demographic data.
RESULTS: Receiver operating characteristic (ROC) analyses indicated that the MMSE had high diagnostic accuracy for identifying dementia in subjects aged 90 and older across different age and education groups (area under the ROC curve values ranged from 0.82 to 0.98). A range of possible cutoff values and corresponding sensitivity and specificity are provided for the following age groups: 90-93, 94-96, and >or=97. Age groups were subdivided by educational attainment (<or=high school, vocational school or some college, college degree or higher). In subjects aged 90 to 93 with a college degree or higher, the suggested MMSE cutoff score is <or=25 (sensitivity=0.82, specificity=0.80). In those aged 94 to 96 with a college degree or higher, the suggested cutoff is <or=24 (sensitivity=0.85, specificity=0.80). Those aged 97 and older with an education of high school or less had the lowest suggested cutoff <or=22 (sensitivity=0.80, specificity=0.76).
CONCLUSION: Overall, the MMSE had good sensitivity and specificity across all age and educational groups. Optimal cutoff points were lower in the older age groups and those with less education, primarily to preserve specificity. This screening instrument is appropriate for use with the oldest-old.
Kristin Kahle-Wrobleski; Maria M Corrada; Bixia Li; Claudia H Kawas
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  55     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-16     Completed Date:  2007-03-30     Revised Date:  2013-03-27    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  284-9     Citation Subset:  IM    
Institute of Brain Aging and Dementia, University of California at Irvine, Irvine, California 92697, USA.
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MeSH Terms
Age Factors
Aged, 80 and over
Area Under Curve
Cross-Sectional Studies
Dementia / diagnosis*
Educational Status
Mental Status Schedule / standards*
ROC Curve
Sensitivity and Specificity
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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