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

Anke Hensel1, Tobias Luck, Melanie Luppa

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

Dementia and Geriatric Cognitive Disorders
|January 9, 2009
PubMed
Abstract

Insights

Changes in Mini Mental State Examination (MMSE) scores can predict future dementia. While a decline of -1 point shows association, the diagnostic accuracy for dementia prediction remains low.

Area of Science:

  • Gerontology
  • Neurology
  • Cognitive Science

Background:

  • Established norms indicate a 2-4 point MMSE score decline signifies reliable change.
  • The predictive value of MMSE change norms for future dementia diagnosis is not well-understood.

Purpose of the Study:

  • To evaluate the suitability of MMSE change norms, specifically Reliable Change Indices (RCIs), for predicting dementia in elderly individuals.
  • To assess the diagnostic accuracy of MMSE score changes for future dementia prediction.

Main Methods:

  • Longitudinal study of 554 individuals aged 75+ without dementia at baseline.
  • MMSE administered up to 6 times over 1.5-year intervals.
  • Calculated two RCIs for MMSE score change (visit 1 to 2) and correlated with dementia diagnosis.

Main Results:

  • 88 participants developed dementia during the study.
  • RCIs demonstrated a significant association with subsequent dementia diagnosis.
  • A raw MMSE change cutoff of -1 point yielded moderate predictive accuracy (sensitivity 48%, specificity 67%).
  • RCI accounting for regression to the mean showed improved accuracy (sensitivity 61%, specificity 72%).

Conclusions:

  • Changes in MMSE total score are significantly linked to future dementia risk.
  • The diagnostic accuracy of MMSE score changes for predicting dementia is currently limited.

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