Sensitivity and specificity of the Mini-Mental State Examination in a Spanish-speaking population

The Mini-Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1975) was given to a total of 430 normal participants divided into 3 age ranges (16-50, 51-65, and 66-89) and 4 educational ranges (0, 1-4, 5-9, and > or = 10 years). The educational level effect was notoriously stronger than the age effect. Normal illiterate participants obtained scores that would correspond to severe cognitive alterations (M = 17.67); low education participants (1-4 years) would be classified with moderate cognitive alterations (M = 20.61). Sensitivity and specificity of the MMSE were established. Low sensitivity and specificity were found for both the participants with 0 and 1 to 4 years of schooling, 50% and 72.73%, respectively. In participants with more than 5 years of schooling, the specificity (86.36%) and sensitivity (86.36%) indexes were higher. We concluded that the MMSE is an instrument with little diagnostic utility among participants with a low level of education.