title: The reliability and validity of the Mini-Mental State in a British community survey.
abstract: The Mini-Mental State (MMSE) was administered to 2302 general practice patients aged 75 yr and over. Those scoring 23 or less and a sample of those scoring 24 or 25 were selected for further investigation using the Cambridge Mental Disorders of the Elderly Examination. Inter-observer reliability was high with a mean kappa value of 0.97. Eighty-six per cent of respondents judged to have organic mental disorders scored 23 or less on the MMSE and 92% of those judged to be cognitively intact scored 24 or more. However, only 55% of respondents who scored 23 or less were demented or delirious while a number of relatively well educated, mildly demented subjects scored 24 and 25. The customary cut-off point of 23/24 may need to be revised in future community studies. MMSE scores cannot be used to make even tentative psychiatric diagnoses; more detailed investigation of low scorers is essential.
authors.affiliation: Hughes Hall, Cambridge, U.K.
authors.forename: D W
authors.initials: DW
authors.lastname: O'Connor
authors.forename: P A
authors.initials: PA
authors.lastname: Pollitt
authors.forename: J B
authors.initials: JB
authors.lastname: Hyde
authors.forename: J L
authors.initials: JL
authors.lastname: Fellows
authors.forename: N D
authors.initials: ND
authors.lastname: Miller
authors.forename: C P
authors.initials: CP
authors.lastname: Brook
authors.forename: B B
authors.initials: BB
authors.lastname: Reiss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D003693:Delirium / Q000175:diagnosis / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012680:Sensitivity and Specificity; D013637:Tape Recording