title: Improving the diagnostic accuracy of the Mini-Mental State Examination.
abstract: BACKGROUND
  We determined the diagnostic accuracy of the Mini-Mental State Examination (MMSE) for dementia of the Alzheimer type (DAT) in an outpatient geriatric referral center in Switzerland.
  
  
  METHODS
  DAT patients and elderly controls were assigned to two groups: a validation sample (70 DAT patients; 50 controls) and a cross-validation sample (133 DAT patients; 43 controls). A Receiver Operating Characteristic curve was generated to derive the optimal MMSE cut-off score in the validation sample.
  
  
  RESULTS
  The optimal MMSE cut-off was < 26/30 (sensitivity of 74%, specificity of 100%). Adjustments for age and education were necessary. The cross-validation confirmed these findings.
  
  
  CONCLUSIONS
  iN A clinical setting the MMSE cut-off should be increased to < 26/30. A thorough neurobehavioral assessment is still necessary for a complete evaluation.
mesh_terms: D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015203:Reproducibility of Results