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Updated: Jun 14, 2026
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Mild cognitive impairment in medical inpatients: the Mini-Mental State Examination is a promising screening tool
G M De Marchis1, G Foderaro, J Jemora
1Department of Internal Medicine, Ospedale La Carità, Locarno, Switzerland. gian-marco.demarchis@insel.ch
Aim:
To assess the prevalence of mild cognitive impairment (MCI) in medical inpatients aged 55-85 years without known cognitive deficits, and how often ward physicians mentioned MCI in their discharge notes. Moreover, we aimed to identify variables associated with MCI and to assess the sensitivity and specificity of the Mini-Mental State Examination (MMSE) for MCI.
Methods:
Two neuropsychologists administered a 60-min battery of validated tests to evaluate different cognitive domains. The diagnosis of MCI was based on a prespecified algorithm. The sensitivity and specificity of the MMSE for MCI were calculated.
Results:
Fifteen patients showed a normal cognitive profile (21.4%), while 55 patients (78.6%) showed MCI. Ward physicians, blinded to the results of the neuropsychological evaluation, did not mention MCI in their discharge notes of any of the evaluated patients. The only variable independently associated with MCI was the MMSE. A MMSE score of < or =28 showed a sensitivity of 85.5% and a specificity of 66.7% for MCI.
Conclusion:
MCI is frequent albeit overlooked in elderly medical inpatients without previously known cognitive deficits. In view of therapies preventing the progression of MCI to dementia, MCI screening will be crucial. The MMSE represents a promising screening tool for MCI in medical inpatients.
Insights
Mild cognitive impairment (MCI) is common in elderly medical patients but often missed. The Mini-Mental State Examination (MMSE) shows promise as a screening tool for identifying MCI in this population.
Area of Science:
- Geriatric Medicine
- Neuropsychology
- Cognitive Science
Background:
- Mild cognitive impairment (MCI) affects a significant portion of elderly individuals.
- Early identification of MCI is crucial for interventions aimed at preventing dementia progression.
Purpose of the Study:
- To determine the prevalence of MCI in medical inpatients aged 55-85 without prior cognitive deficits.
- To evaluate the frequency of MCI documentation by ward physicians.
- To identify factors associated with MCI and assess the Mini-Mental State Examination (MMSE) as a screening tool.
Main Methods:
- A comprehensive 60-minute neuropsychological test battery was administered by two experts.
- MCI diagnosis was established using a predefined algorithm.
- Sensitivity and specificity of the MMSE for detecting MCI were calculated.
Main Results:
- A high prevalence of MCI (78.6%) was observed in the study population.
- MCI was not documented in any discharge notes by ward physicians.
- The MMSE score was the sole variable independently associated with MCI, with a score of ≤28 indicating 85.5% sensitivity and 66.7% specificity.
Conclusions:
- MCI is prevalent and frequently overlooked in elderly medical inpatients.
- Screening for MCI is essential for timely intervention and potential prevention of dementia.
- The MMSE is a valuable and promising tool for screening MCI in this demographic.
