Reliability of a Standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination.
OBJECTIVE
The objective of this study was to compare the reliability of the Mini-Mental State Examination with that of a new Standardized Mini-Mental State Examination, which has expanded guidelines for administration and scoring.


METHODS
The subjects were 32 stable elderly residents of a nursing home and 16 elderly residents of a chronic care hospital unit. Six raters administered the Folstein Mini-Mental State to 22 of these stable elderly subjects, and five raters administered the standardized version to 26 of these subjects. Each subject was tested on three different occasions 1 week apart. Each rater tested 4-6 subjects at the first and third weeks and 4-6 different subjects at the second week. The analytic technique used was one-way analysis of variance to estimate the interrater variance and the intrarater variance.


RESULTS
The intrarater variance on all occasions was reduced by 86% and the interrater variance was reduced by 76% when the Standardized Mini-Mental State was used; the reductions in variance were significant (p less than 0.003). The intraclass correlation for the Mini-Mental State was 0.69; for the standardized version it was 0.90. It took less time to administer the Standardized Mini-Mental State than the Mini-Mental State.


CONCLUSIONS
The Standardized Mini-Mental State had better reliability than the Mini-Mental State in this study group. Although the improved reliability of the Standardized Mini-Mental State was achieved by reducing measurement noise, this advantage would likely occur in a broad spectrum of patients.
Molloy
D W
DW
Department of Medicine, McMaster University, Hamilton, Ont., Canada.
Alemayehu
E
E
Roberts
R
R
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics