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January 1990

The Mini-Mental State Examination in the Early Diagnosis of Alzheimer's Disease

Author Affiliations

From the Departments of Neurosciences (Drs Galasko, Lasker, and Thal), Family and Community Medicine (Dr Klauber), and Psychiatry, (Dr Salmon), University of California, San Diego, Veterans Administration Medical Center; and the Department of Political Science, San Diego State University (Dr Hofstetter).

Arch Neurol. 1990;47(1):49-52. doi:10.1001/archneur.1990.00530010061020

• The Mini-Mental State Examination (MMSE), a brief test of cognitive function, has been widely used to screen for dementia. We administered the MMSE to 74 community-dwelling patients meeting criteria for probable Alzheimer's disease (AD) and 74 age- and education-matched controls. Twenty-four patients with AD performed in the nondemented range by scoring above the recommended cutoff point of 23 of a possible 30 on the MMSE. We compared the scores for items of the MMSE in controls and subjects with AD and used logistic regression to model a shorter MMSE that retained the accuracy of the complete test. A score summing tests of recall and orientation for place had similar sensitivity to the full MMSE. Adding a verbal fluency test to the MMSE reduced the error rate by improving the accuracy of diagnosis of patients with AD scoring in the nondemented range.