Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-25T01:06:06.188Z Has data issue: false hasContentIssue false

Chapter 11 - Mini-Mental State Examination for the Detection and Prediction of Dementia in People with and without Mild Cognitive Impairment

from Section 2 - Assessment and Investigations

Published online by Cambridge University Press:  12 September 2020

Julian C. Hughes
Affiliation:
University of Bristol
Philippa Lilford
Affiliation:
Severn Deanery, University of Bristol
Get access

Summary

Screening for dementia is usually considered important, but only if accuracy of detection is sufficient and treatments are available and effective. In the National Dementia Strategy for England, one of the three main areas promoted was early diagnosis with acknowledgement that much of this role falls to primary care. The majority of dementia and pre-dementia cases in the community and in primary care remain undetected. One in three of those diagnosed remains unaware of their diagnosis. GPs in the UK are encouraged actively to look for people with dementia through annual screening as well an opportunistic testing of older people attending primary care with any significant health concern. The UK government has also encouraged case finding for dementia on acute admission to secondary care services using a dementia CQUIN (Commissioning for Quality and Innovation) which meant that overall, between 80% and 90% of patients aged 75 years and over were screened and assessed.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Department of Health. Living Well with Dementia: A National Dementia Strategy. DoH, 2009.Google Scholar
Lang, L, Clifford, A, Wei, L, et al. Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis. BMJ Open 2017; 7: e011146.CrossRefGoogle ScholarPubMed
Amjad, H, Roth, DL, Sheehan, OC, et al. Underdiagnosis of dementia: an observational study of patterns in diagnosis and awareness in US older adults. J Gen Intern Med 2018; 33: 1131–8.CrossRefGoogle ScholarPubMed
Department of Health. General medical services – contractual changes 2013–2014 [Letter to chairman of BMA General Practitioners Committee]. DoH, 6th December 2012. www.wp.dh.gov.uk/publications/files/2012/12/GMS‐Contract‐letter.pdf (last accessed 30 November 2019).Google Scholar
Bayley, PJ, Kong, JY, Mendiondo, M, et al. Findings from the national memory screening day program. J Am Geriatr Soc 2015; 63: 309–14.CrossRefGoogle ScholarPubMed
Cordell, CB, Borson, S, Boustani, M, et al. Alzheimer’s Association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting. Alzheimer’s & Dementia 2013; 9: 141–50.Google Scholar
Mitchell, AJ, Meader, N, Pentzek . Clinical recognition of dementia and cognitive impairment in primary care: a meta-analysis of physician accuracy. Acta Psychiatr Scand 2011; 124: 165–83.Google Scholar
Iracleous, P, Nie, JX, Tracy, CS, et al. Primary care physicians’ attitudes towards cognitive screening: findings from a national postal survey. Int J Geriatr Psychiatry 2010; 25: 23–9.Google Scholar
Brodaty, H, Howarth, GC, Mant, A, Kurrle, SE. General practice and dementia. A national survey of Australian GPs. Med J Aust 1994; 160: 1014.Google Scholar
Tong, T, Thokala, P, McMillan, B, Ghosh, R, Brazier, J. Cost effectiveness of using cognitive screening tests for detecting dementia and mild cognitive impairment in primary care. Int J Geriatr Psychiatry 2017; 32: 13921400.CrossRefGoogle ScholarPubMed
Mitchell, AJ, Shiri-Feshki, M. Rate of progression of mild cognitive impairment to dementia–meta-analysis of 41 robust inception cohort studies. Acta Psychiatr Scand 2009; 119: 252–65.Google Scholar
Folstein, MF, Folstein, SE, McHugh, PR.Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.Google Scholar
Christa Maree Stephan, B, Minett, T, Pagett, E, et al. Diagnosing mild cognitive impairment (MCI) in clinical trials: a systematic review. BMJ Open 2013; 3(2). http://dx.doi.org/10.1136/bmjopen-2012-001909 (last Accessed 5 November 2019).Google Scholar
Toglia, J, Fitzgerald, KA, O’Dell, MW, Mastrogiovanni, AR, Lin, CD. The Mini-Mental State Examination and Montreal Cognitive Assessment in persons with mild subacute stroke: relationship to functional outcome. Arch Phys Med Rehabil 2011; 92: 792–8.CrossRefGoogle ScholarPubMed
Molloy, DW, Alemayehu, E, Roberts, R. Reliability of a standardized mini-mental-state-examination compared with the traditional mini-mental-state-examination. Am J Psychiatry 1991; 148: 102–5.Google ScholarPubMed
Crum, RM, Anthony, JC, Bassett, SS, Folstein, MF. Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA 1993; 269: 2386–91.CrossRefGoogle ScholarPubMed
O’Connor, DW, Pollitt, PA, Hyde, JB, et al. The reliability and validity of the Mini-Mental State in a British community survey. J Psychiatr Res 1989; 23: 8796.Google Scholar
Lin, JS. O’Connor, E. Rossom, RC, et al. Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventative Services Task Force. Evidence Synthesis Number 107. AHRQ Publication No. 14–05198-EF-1. Agency for Healthcare Research and Quality, 2013.Google Scholar
Mitchell, AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res 2009; 43: 411–31.Google Scholar
Mitchell, AJ. The Mini-Mental State Examination (MMSE): an update on its diagnostic validity for cognitive disorders. In Cognitive Screening Instruments: A Practical Approach (ed. Larner, AJ): 1546. Springer, 2013.Google Scholar
Tsoi, KK, Chan, JY, Hirai, HW, Wong, SY, Kwok, TC. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med 2015; 175: 1450–8.Google Scholar
Creavin, ST, Wisniewski, S, Noel-Storr, AH, et al. Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations. Cochrane Database Syst Rev 2016; 1: CD011145.Google Scholar
Mitchell, AJ, Meader, N, Pentzek, M. Clinical recognition of dementia and cognitive impairment in primary care: a meta-analysis of physician accuracy. Acta Psychiatr Scand 2011; 124: 165–83.Google Scholar
Heinik, J, Solomesh, I, Bleich, A, et al. Are the clock-drawing test and the MMSE combined interchangeable with CAMCOG as a dementia evaluation instrument in a specialized outpatient setting? J Geriatr Psychiatry Neurol 2003; 16: 74–9.CrossRefGoogle Scholar
Meulen, EFJ, Schmand, B, van Campen, JP, et al. The seven minute screen: a neurocognitive screening test highly sensitive to various types of dementia. J Neurol Neurosurg Psychiatry 2004; 75: 700–5.Google Scholar
Yoshida, H, Terada, S, Honda, H, et al. Validation of Addenbrooke’s cognitive examination for detecting early dementia in a Japanese population. Psychiatry Res 2011; 185: 211–4.Google Scholar
Kalbe, E, Kessler, J, Calabrese, P, et al. DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 2004; 19: 136–43.Google Scholar
Grober, E, Hall, C, Lipton, RB, Teresi, JA. Primary care screen for early dementia. J Am Geriatr Soc 2008; 56: 206–13.Google Scholar
Mitchell, A.J. The Mini-Mental State Examination (MMSE): update on its diagnostic accuracy and clinical utility for cognitive disorders. In: Cognitive Screening Instruments (ed. Larner), AJ: 3748. Springer, 2017.Google Scholar
Breton, A, Casey, D, Arnaoutoglou, NA. Cognitive tests for the detection of mild cognitive impairment (MCI), the prodromal stage of dementia: meta-analysis of diagnostic accuracy studies. Int J Geriatr Psychiatry 2019; 34: 233–42.Google Scholar
Petersen, RC. Clinical practice. Mild cognitive impairment. N Engl J Med 2011; 364: 2227–34.Google Scholar
Arevalo-Rodriguez, I, Smailagic, N, Roqué, I. Mini-Mental State Examination (MMSE) for the detection of Alzheimer’s disease and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2015; 3: CD010783. DOI:10.1002/14651858.CD010783.pub2.Google Scholar
Whiting, PF, Rutjes, AW, Westwood, ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155: 529–36.Google Scholar
Mitchell, AJ. Can the MMSE help clinicians predict progression from mild cognitive impairment to dementia? Commentary On… Cochrane Corner. BJPsych Adv 2015; 21: 363–66.Google Scholar
Diniz, BS, Yassuda, MS, Nunes, PV, Radanovic, M, Forlenza, OV. Mini-mental State Examination performance in mild cognitive impairment subtypes. Int Psychogeriatr 2007; 19: 647–56.Google Scholar
Schultz-Larsen, K, Kreiner, S, Lomholt, RK. Mini-Mental Status Examination: mixed Rasch model item analysis derived two different cognitive dimensions of the MMSE. J Clin Epidemiol 2007; 60: 268–79.Google Scholar
Bravo, G, Hébert, R. Age- and education-specific reference values for the Mini-Mental and Modified Mini-Mental State Examinations derived from a non-demented elderly population. Int J Geriatr Psychiatry 1997; 12: 1008–18.Google Scholar
Kahle-Wrobleski, K, Corrada, MM, Li, B, Kawas, CH. Sensitivity and specificity of the Mini-Mental State Examination for identifying dementia in the oldest-old: the 90+ Study. J Am Geriatr Soc 2007; 55: 284–9.Google Scholar
Meulen, EFJ, Schmand, B, van Campen, JP, et al. The seven minute screen: a neurocognitive screening test highly sensitive to various types of dementia. J Neurol Neurosurg Psychiatry 2004; 75: 700–5.Google Scholar
Estrada-Orozco, K. Diagnostic performance of minimental against DSM-5 in cognitive disorder. Experience of a cohort in Colombia. Rev Ecuat Neurol 2018; 27 n.3. http://revecuatneurol.com/wp-content/uploads/2019/04/2631-2581-rneuro-27-03-00025.pdf (last accessed 6 November 2019).Google Scholar
Boustani, M1, Callahan, CM, Unverzagt, FW, et al. Implementing a screening and diagnosis program for dementia in primary care. J Gen Intern Med 2005; 20: 572–7.Google Scholar
Van Hout, H, Teunisse, S, Derix, M, et al. CAMDEX, can it be more efficient? Observational study on the contribution of four screening measures to the diagnosis of dementia by a memory clinic team. Int J Geriatr Psychiatry 2001; 16: 64–9.3.0.CO;2-4>CrossRefGoogle Scholar
Fowler, NR, Morrow, L, Chiappetta, L, et al. Cognitive testing in older primary care patients: a cluster-randomized trial. Alzheimers Dement 2015; 1: 349–57.Google ScholarPubMed
Pittam, G, Allaby, M. Screening for Dementia: Can Screening Bring Benefits to Those with Unrecognised Dementia, Their Carers and Society? An Appraisal against UKNSC Criteria. A Report for the UK National Screening Committee. Solutions for Public Health (SPH), 2015.Google Scholar
Wang, BR, Zheng, HF, Xu, C. Comparative diagnostic accuracy of ACE-III and MoCA for detecting mild cognitive impairment. Neuropsychiatr Dis Treat 2019; 15: 2647–53.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×