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

Douglas Galasko, MD; Melville R. Klauber, PhD; C. Richard Hofstetter, PhD; David P. Salmon, PhD; Bruce Lasker, MD; Leon J. Thal, MD
Arch Neurol. 1990;47(1):49-52. doi:10.1001/archneur.1990.00530010061020.
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• 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.

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