Usefulness of repeated presentation of Mini-Mental State Examination as a diagnostic procedure - a population-based study

Helkala E‐L, Kivipelto M, Hallikainen M, Alhainen K, Heinonen H, Tuomilehto J, Soininen H, Nissinen A. Usefulness of repeated presentation of Mini‐Mental State Examination as a diagnostic procedure – a population‐based study. Acta Neurol Scand 2002: 106: 341–346. © Blackwell Munksgaard 2002. Material and methods– The 280 subjects who achieved 24 points or less in the Mini‐Mental State Examination (MMSE) in the first survey of 1449 subjects were invited for a comprehensive diagnostic examination for dementia including medical history, thorough neurological and cardiovascular examinations and detailed neuropsychological evaluation, magnetic resonance imaging (MRI)‐study, cerebrospinal fluid (CSF)‐analysis, electrocardiogram (ECG), chest radiograph and blood tests after the first assessment. The MMSE was presented again. Results– Out of 240 persons, 57 subjects were diagnosed as having dementia. When the cut‐off point of 24 or less in the second MMSE was used, the sensitivity of the second MMSE was 82% and the specificity was 64%. The positive predictive value of the second MMSE was 42% and negative predictive value 92%. The non‐demented subjects improved their MMSE score at the second examination. In contrast, the demented subjects maintained their low MMSE score at the second examination.