Validity of the Mini-Mental State examination as a screening instrument for cognitive impairment and dementia in French elderly community residents.
A survey was made of 2,792 subjects aged 65 and older living in the community of Gironde (South-Western France). The predictive value of the Mini-Mental state examination (MMS) as a screening instrument for the detection of cognitive impairment was tested against DSM-III criteria for dementing syndromes. Of the 2,792 subjects who consented to participate in the study, 101 met the DSM-III criteria for dementia, giving a 3.62% prevalence rate. With an MMS threshold of 24, the sensitivity was 100%, the specificity was 78%, and the positive predictive value was equal to 15%. Using the same MMS threshold, 572 subjects (85%) were false-positive for the diagnosis of dementia. A multiple logistic regression analysis revealed that age, sex, depressive symptomatology and educational level were independently correlated with false-positive cases of the MMS. Several issues are raised for using the MMS as the only screening instrument for cognitive impairment in elderly community residents.
Gagnon
M
M
Unité INSERM 330, Bordeaux, France.
Letenneur
L
L
Dartigues
J F
JF
Commenges
D
D
Orgogozo
J M
JM
Barberger-Gateau
P
P
Alpérovitch
A
A
Décamps
A
A
Salamon
R
R
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D003154:Community Medicine; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors