title: Usefulness of repeated presentation of Mini-Mental State Examination as a diagnostic procedure--a population-based study.
abstract: METHODS
  The 280 subjects who achieved 24 points or less in the Mini-Mental State Examination (MMSE) in the first survey of 1449 subjects were invited for a comprehensive diagnostic examination for dementia including medical history, thorough neurological and cardiovascular examinations and detailed neuropsychological evaluation, magnetic resonance imaging (MRI)-study, cerebrospinal fluid (CSF)-analysis, electrocardiogram (ECG), chest radiograph and blood tests after the first assessment. The MMSE was presented again.
  
  
  RESULTS
  Out of 240 persons, 57 subjects were diagnosed as having dementia. When the cut-off point of 24 or less in the second MMSE was used, the sensitivity of the second MMSE was 82% and the specificity was 64%. The positive predictive value of the second MMSE was 42% and negative predictive value 92%. The non-demented subjects improved their MMSE score at the second examination. In contrast, the demented subjects maintained their low MMSE score at the second examination.
authors.affiliation: Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland. eeva-liisa.helkala@uku.fi
authors.forename: E-L
authors.initials: EL
authors.lastname: Helkala
authors.forename: M
authors.initials: M
authors.lastname: Kivipelto
authors.forename: M
authors.initials: M
authors.lastname: Hallikainen
authors.forename: K
authors.initials: K
authors.lastname: Alhainen
authors.forename: H
authors.initials: H
authors.lastname: Heinonen
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: H
authors.initials: H
authors.lastname: Soininen
authors.forename: A
authors.initials: A
authors.lastname: Nissinen
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011581:Psychological Tests; D011897:Random Allocation; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index