Abstract
The Mini-Mental State Examination (MMSE) is the most commonly used brief cognitive tool in the assessment of a variety of cognitive disorders. The tool comprises a short battery of 20 individual tests covering 11 domains and totalling 30 points. Typical completion time is 8 min in cognitively unimpaired individuals, rising to 15 min in those with dementia. Internal consistency appears to be moderate and test-retest reliability good. However, the main psychometric issue concerns the MMSE’s diagnostic validity against dementia, mild cognitive impairment, and delirium. This chapter updates previous meta-analytic summary analyses for the performance of the MMSE in specialist and non-specialist settings. Summary sensitivity, specificity, positive and negative predictive values are presented. Results suggest that MMSE does not perform well as a confirmatory (case-finding) tool for dementia, mild cognitive impairment, and delirium but it does perform adequately in a rule-out (screening) capacity. For those scoring below threshold (positive) on MMSE, a more extensive neuropsychological and clinical evaluation should be pursued. The MMSE is neither the most accurate nor most efficient tool with which to evaluate cognitive disorders but it has provided a benchmark against which all newer tools can be measured.
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