Sensitivity and specificity of the mmse and moca in screening for mild and severe cognitive impairment related to dementia katie mcculloch, m. While the structure and scoring of the original 30point mmse remain, problematic items were replaced and several tasks were modified to adjust difficulty level. The rudas has been directly compared with the mmse, with no relevant differences in their accuracy. In fact, the results of another study 12 show only fair overall agreement between mmse scores and cdr stages. The mmse was significantly positively correlated with both the moca r. The generalizability coefficient n 411 between the mmse and the mmse2. Kalman filter difference between minimizing the mean. New orleans the montreal cognitive assessment moca was better than the minimental state examination mmse at teasing out subtle. The minicog versus the minimental state examination and. Pdf comparison between mini mental state examination mmse.
Among participants with a high education level, there was a marginal but significant difference in mean score between the mmse 29. Because the overall difficulty and raw score range remain the same as in the original, mmse2. Screening interviews were conducted with people aged 65 and over in noamdong, namwoncity, jeonbuk province. Comparison of montreal cognitive assessment and mini. Correlation between the montreal cognitive assessment. Compared to the mmse, the moca may be a more useful instrument to detect cognitive impairment in patients with schizophrenia. Standardised minimental state examination smmse tool.
We collected the different versions of mmse used in 11. Numbers in parentheses indicate subjects contributing data. Comparing the cognitive screening tools mmse and slums. Folstein minimental state exam 30 item screening tool useful for documenting serial cognitive changes an cognitive impairment document not only the total score but what items were missed on the mmse insightjudgment insight.
Minimental state examination mmse heart and stroke foundation. Score disparity between the mmse and the slums ann b. Mmse did not perform well as a screening instrument for mild cognitive impairment as there were 43 patients who scored 24 or more on mmse, and 25 patients 58% scored 25 or less on moca, indicating the presence of cognitive impairment. The mini mental state examination mmse is a tool that can be used to systematically. Functional assessment staging test the functional assessment staging test fast is the most well validated measure of the course of ad in the published, scientific literature. To compare the value of minicog and mmse in screening patients for mci in a neurological outpatient department, and determine differences in the value of minicog for different ages and educational levels. Differentiate aging and dementia exactly as it appears in the pdf available here. This article is a collaboration between medpage today and. The difference between mmse and moca scores ranged from 0 to 14, with a mean difference of 4.
Th e mmse usually can be administered in 510 min and has been employed extensively in clinical settings, community surveys, and epidemiological. A comparison between the minimental state examination and. Pdf comparison between mini mental state examination. The median difference was 0 iqr 1 to 1 for the van steenoven and colleagues article across all studies and the median difference was also 0 within each study, except for the modep cohort where the median. Stage stage name characteristic expected untreated ad duration months mental age years mmse score. Mmse and the dd sage channel estimators are presented for the 2. Assessment manual of intellectual function for the demented elderly. The pearsons correlation coefficient between mmse and moca score was poor at 0. Its also important to note that the mmse, and to a degree the moca, were not designed to be differential diagnostic tools for disambiguating between different types of cognitive conditions.
Comparison of the value of minicog and mmse screening in. Current versions of the mmse consist of a 30point test that assesses orientation, attention, working memory, word recall, language, and visuoconstruction. Therefore it is possible to switch from mmse to the mmse2. The mini mental state examination mmse cga toolkit. The minimental state examination mmse and the montreal cognitive assessment moca, often used in clinical practice as a quick screen for alzheimer disease ad or mild cognitive impairment mci, get high marks for diagnostic accuracy in a study of communitydwelling older adults, according to a study done by researchers from the university of pennsylvania in philadelphia. Interpreting mmse scores of bilingual speakers 4 interpreting mmse performance in highly proficient bilingual asian indianenglish and spanishenglish speakers. Characteristic differences in the minimental state examination used. The aim of this study was to compare the proportion of mci identified between the mmse and mocaina in stroke patients. The aim of this study was to compare the mmse and mocaina scores and to determine the correlation between the mmse and mocaina scores in elderly. The mmse is also one of the most frequently used screening and outcome measures in cognitionenhancing.
The short test of mental status stms 6,7 was developed and validated as a screening bedside mental status. The comparative diagnostic accuracy of the mini mental. We also aim to make clinical practice recommendations based upon the variations in diagnostic accuracy identified between the mmse and gpcog. Last minimental state examination mmse score compared with score at entry. Many practitioners have used mmse scores to recommend treatment options, but are unsure how slums scores compare to those wellknown cutoff scores. Comparison of approaches for equating different versions. The minimental state exam mmse is a widely used test of cognitive function among. The minimental state examination mmse is often used to screen for mci in outpatient departments in china. The mmse is a required part of this dementia assessment. Standardised minimental state examination smmse please see accompanying guidelines for administration and scoring instructions say. Variability in annual minimental state examination score.
The study included 83 subjects which were consisted of 46 55. Abppcn1, 3 introduction the minimental status examination mmse, developed by folstein, folstein and mchugh 1975, is a frequently utilized cognitive screening measure for detecting alzheimers. There was a statistically significant difference between participants performance on the mmse and moca tests p 0. We performed mmse and mocaina for assessment of cognitive function and the time between each test was at least 30 minutes. Minimental state examination mmse one of the most widely used neuropsychology tests and dementia screening tool.
Mild cognitive impairment mci has taken on increasing clinical importance because it is a precursor of dementia. Moreover, there are also strong links between mmse scores and education. A graph showing the comparison between the mmse and moca scores is shown in figure 1. Mmse 30 points possible developed by folstein and colleagues,8 and the telephone mmse bayer,personal communication,1999 26 points possible,an adaptation of the 22point alfimmse. Score one point for each correct response within each question or activity. The standardised minimental state examination provides clear, unequivocal guidelines for administration and scoring of the mini mental state examination mmse.
The intrarater variability is significantly lower with the smmse 86%, p mmse as a brief, objective assessment of cognitive functioning and as a measure of changes in cognitive status. I am going to ask you some questions and give yousome problems to solve. On home visits, the examiner can ask, what is the address of this place. The montreal cognitive assessment detects more visuoexecutive dysfunction than the minimental state examination but it is unclear which of the individual. The xaxis represents the last visit year for which data were obtained. For all age and educational groups the minicog outmatched the cdt and mmse, and was less affected by education than mmse and. Table 2 shows the difference both within and across cohorts between the true and equivalent mmse for the van steenoven and colleagues article conversion and our own conversion. Refer to waiver of informed consent section of manual for full protocol.
We assessed whether the korean version of modified minimental state examination kmmmse has improved performance as a screening test for cognitive impairment or dementia in a general population compared with the korean minimental state examination kmmse. Nevertheless when mmse is administered without spelling backward and with a score not adjusted for age and education, may detect mci. Comparison between mini mental state examination mmse and montreal cognitive assessment indonesian version moca ina as an early detection of cognitive impairments in poststroke patients. Implementation of ls, mmse and sage channel estimators.
The smmse takes less time to administer than the mmse and has significantly reduced the inter rater variability of the mmse. The results of this pilot study have important implications regarding how to choose an appropriate replacement for the mmse for practitioners who utilize cognitive screening instruments. The nurses assessment of an older adults cognitive status is instrumental in identifying. From decades, mmse is the basic crosscultural tool for assessing dementia 4. The stages of alzheimers disease as defined by fast are. Comparison of the folstein mini mental state examination. Conclusions moca and gpcog have similar performance in detecting mci and appear superior to mmse. The usefulness of the korean version of modified mini. A preliminary comparison of three cognitive screening. In this analysis the difference in longitudinal mmse trajectories split by education level was not statistically significant although those with less than statutory education did have lower mean mmse point estimates at.
Comparison of the short test of mental status and the mini. Implementation of ls, mmse and sage channel estimators for mobile mimoofdm. Cutoff scores for that study, however, were chosen to match other studies on clinical grounds without comparison to other scales. The minimental state examination mmse is a clinical diagnostic tool that is used both for research and in neurologic and psychiatric clinical practice.
More specifically, the agreement between mmse score ranges and cdr stages as such has not been examined. In a study comparing the mmse with the moca, the mmse had a sensitivity of only 18% to detect mci meaning it missed 82% of the people with mci. Comparative analysis between the mmse and the rudas for. In the years, the widespread and worldwide administration of mmse has pointed out some limitations 5 as a low sensitivity in mci especially in patients with high cognitive reserve 6 andor education 7. The minimental state examination mmse is one of the most widely used cognitive screening tests in the world. Ps0159 comparison of mmse, moca and gpccog in the early. The mini mental state examination mmse is a tool that can be used to systematically and thoroughly assess mental status. The examiner repeats them until patient learns all of them. Some additional points about the mini mental status examination in 34 dementia studies and 5 mci studies, it was determined that the best value of the mmse was for ruling out a diagnosis of dementia in community and primary care where negative predictive values were 98. In screening for cognitive impairment defined as two or more cognitive domain deficits, the optimal cutoffs for the moca and mmse were. Score disparity between the mmse and the slums article pdf available in american journal of alzheimer s disease and other dementias 321. Mmse as the blog post is all about bayesian estimators. Mmse ts, respectively, showed very slight differences.
The montreal cognitive assessmentindonesian version moca ina has been validated and recently been used as a cognitive screening tool. The ceiling for mmse is that a highly educated person may score well on the mmse but not be able to recognize their grandchildren, she says. Validation of a 26point telephone version of the mini. The yaxis indicates the annual change in score estimated as the difference between the last vs first mmse, divided by the last follow.
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