Folstein vs modified Mini-Mental State Examination in geriatric stroke. Stability, validity, and screening utility

Area of Science:

• Neurology
• Neuropsychology
• Rehabilitation Medicine

Background:

• Cognitive impairment is common in stroke survivors, necessitating effective screening tools.
• The Folstein Mini-Mental State Examination (MMS) is a widely used cognitive screening tool.
• The Modified Mini-Mental State Examination (3MS) is an expanded version designed to improve screening utility.

Purpose of the Study:

• To evaluate the clinical utility of the MMS and 3MS in screening for cognitive impairment in stroke populations.
• To compare the performance of the MMS and 3MS in relation to neuropsychological assessments and functional outcomes.
• To determine if the 3MS offers advantages over the MMS in stroke patients.

Main Methods:

• Two studies were conducted involving consecutive patient groups admitted to a university-affiliated hospital's medical rehabilitation unit.
• The Folstein Mini-Mental State Examination (MMS) and the Modified Mini-Mental State Examination (3MS) were administered.
• Neuropsychological performance and functional independence measure (FIM) were assessed to evaluate screening test utility.

Main Results:

• The 3MS demonstrated reliability, stability, and validity in the stroke population.
• Classification accuracy was similar between MMS and 3MS, but 3MS showed higher sensitivity.
• The 3MS provided additional cognitive information and was a better predictor of functional outcome compared to the MMS.

Conclusions:

• The 3MS is a reliable, valid, and stable cognitive screening instrument for stroke patients.
• Both MMS and 3MS have limitations in detecting cognitive impairment, particularly in right-sided cerebrovascular accidents.
• The 3MS offers advantages over the MMS by providing more cognitive data and improving functional outcome prediction.